bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with disparities in out-of-pocket expenditure on dental care: results from two cross-sectional national surveys
Authors: Orenstein Liat , Chetrit Angela , Oberman Bernice , Benderly Michal , Kalter-Leibovici Ofra 
Published: June 2020

AbstractBackgroundSocioeconomic differences in oral health and dental care utilization are a persistent problem in many high-income countries. We evaluated demographic, geographic and socioeconomic factors associated with disparities in households’ out-of-pocket expenditure (OOPE) on dental care, and the effect of ongoing dental health reform on these disparities.MethodsThis cross-sectional analysis used data collected in two Israeli Household Expenditure Surveys conducted in 2014 and 2018. OOPE for dental care was estimated using a two-part multivariable model. A logistic regression was used to examine the likelihood of reporting any OOPE, and a log-transformed linear regression model examined the level of expenditure among those who reported any OOPE.ResultsIn 2018, OOPE on dental care accounted for 22% of total health expenditure for all households, whereas among those who reported dental OOPE it reached 43%. Households with children up to age 14 years reported lower OOPE, regardless of ownership of supplementary health insurance. Owning supplementary health insurance had a heterogeneous effect on the level of OOPE, with a significant increase among those with 0–8 years of education, compared to households without such insurance, but not among those of higher educational level. In 2014, Arab ethnic minority and residence in the country periphery were associated with a greater likelihood for any OOPE and higher amounts of OOPE on dental care. While the gaps between Jewish and Arab households persisted into 2018, those between peripheral and non-peripheral localities seem to have narrowed.ConclusionsThe burden of dental OOPE on Israeli households remains heavy and some disparities still exist, even after the implementation of the dental health reform. Expanding the dental health reform and addressing barriers to preventive dental care, especially among Arabs and those of lower educational level, may help in reducing households’ private expenses on dental care.
The r-central factorial numbers with even indices
Authors: Shiha F. A. 
Published: June 2020

AbstractIn this paper, we introduce the r-central factorial numbers with even indices of the first and second kind as extended versions of the central factorial numbers with even indices of both kinds. We obtain several fundamental properties and identities related to these numbers. The connections between the new numbers and the Stirling numbers are presented. In addition, we give the probability distribution of the unsigned r-central factorial numbers with even indices. Finally, we consider the r-central factorial matrices and study some of their properties.
Opioid-free anesthesia—caution for a one-size-fits-all approach
Authors: Gupta Sushan , Mohta Avani , Gottumukkala Vijaya 
Published: June 2020

AbstractPost-operative pain management should ideally be optimized to ensure patient’s mobilization and ability to partake in effective pulmonary exercises for patient’s early recovery. Opioids have traditionally been the main mode for analgesia strategy in the perioperative period. However, the recent focus on opioid crisis in the USA has generated a robust discussion on rational use of opioids in the perioperative period and also raised the concept of “opioid-free anesthesia” in certain circles. Opioid-related adverse drug events (ORADE) and questionable role of opioids in cancer progression have further deterred some anesthesiologists from the routine perioperative use of opioids including their use for breakthrough pain. However, judicious use of opioid in conjunction with the use of non-opioid analgesics and regional anesthetic techniques may allow for optimal analgesia while reducing the risks associated with the use of opioids. Importantly, the opioid epidemic and opioid-related deaths seem more related to the prescription practices of physicians and post-discharge misuse of opioids. Focus on patient and clinician education, identification of high-risk patients, and instituting effective drug disposal and take-back policies may prove useful in reducing opioid misuse.
Discursive conflicts in news media and the suspension of a government-led test of English in Korea
Authors: Shin Dongil , Cho Eunhae 
Published: June 2020

AbstractDrawing on critical discourse analysis methodologies, this study examines the discursive conflicts and strategies employed by newspaper media surrounding the National English Ability Test (NEAT) in Korea. NEAT was reported to cause severe competition among young learners of English and lacked public support. Discursive conflicts over whether NEAT would be legitimized flourished in the media. In this study, the discursive practices adopted by both proponents and opponents of NEAT in two leading Korean newspapers of different political orientations—Chosun Ilbo and Hankyoreh—were analyzed from 2006 to 2016. Over this decade, there were three periods of transformation: creation, expansion, and extinction. During the creation period, the discursive conflict focused on the TOEFL crisis in Korea, expansion on the implementation of NEAT, and extinction on its abolition. From creation to abolition, there were competing rationales for developing, suspending, or abolishing NEAT. This study investigated the underlying orientations (neoliberal and evaluative state) of the two newspapers and found that they examined the pros and cons of using the test. Moreover, the government’s implementation of high-stakes testing and its attempt to reward those who complied and to curb the private education sector stresses market-friendly state interaction, which accordingly perpetuates neoliberal conditions.
Utilization of isoniazid prophylaxis therapy and its associated factors among HIV positive clients taking antiretroviral therapy at Fre Semaetat primary hospital, Hawzien districts, Tigrai, Northern Ethiopia
Authors: Legese Haftom , Degefa Hagos , Gebrewahd Aderajew , Gebremedhin Haftay 
Published: June 2020

Abstract
Background
Isoniazid prophylaxis therapy is a significant public health intervention to prevent the progression of latent tuberculosis to active tuberculosis disease among people living with HIV. Those with HIV are at high risk to develop active Tuberculosis from latent Tuberculosis than those without HIV. Even though there is strong evidence supporting Isoniazid Prophylaxis therapy for Tuberculosis prevention, there is limited information about the implementation of isoniazid prophylaxis therapy in Ethiopia as well as in the study area.

Objective
To determine the effects of Isoniazid Prophylaxis therapy and its associated factors among HIV positive clients taking antiretroviral therapy at Fre Semaetat primary Hospital, Hawzien districts, Tigray, northern Ethiopia.

Method
Institutional based cross-sectional study design was conducted from April to August 2019 among HIV positive clients who came to Fre Semaetat primary Hospital. Data related to socio-demographic characteristics and associated risk factors were taken from 372 HIV positive clients who were selected by a simple random sampling method. Data was coded and cleaned by using SPSS version 23.0 for the final analysis.

Results
A total of 372 HIV positive clients taking antiretroviral therapy were included in the study. Of those, the overall prevalence that took and completed their Isoniazid Prophylaxis therapy for 6 months was found to be 231(62.1%). From those who completed Isoniazid Prophylaxis therapy (IPT), 13(3.5%) was developed active Tuberculosis (TB) incidence. Gender, co-trimexazol Prophylaxis therapy users, HIV positive clients who took Anti-pain and married clients were the predictor among statistically significant variables of Isoniazid Prophylaxis therapy.

Conclusions
Isoniazid Prophylaxis therapy utilization found to below. Therefore, health education and counseling of patients who are in their first 2 months of therapy should be strengthened further. Prophylaxis should be given by service providers, medication side effects should be addressed rapidly.
Conceptualisation of Cyberattack prediction with deep learning
Authors: Ibor Ayei E. , Oladeji Florence A. , Okunoye Olusoji B. , Ekabua Obeten O. 
Published: June 2020

AbstractThe state of the cyberspace portends uncertainty for the future Internet and its accelerated number of users. New paradigms add more concerns with big data collected through device sensors divulging large amounts of information, which can be used for targeted attacks. Though a plethora of extant approaches, models and algorithms have provided the basis for cyberattack predictions, there is the need to consider new models and algorithms, which are based on data representations other than task-specific techniques. Deep learning, which is underpinned by representation learning, has found widespread relevance in computer vision, speech recognition, natural language processing, audio recognition, and drug design. However, its non-linear information processing architecture can be adapted towards learning the different data representations of network traffic to classify benign and malicious network packets. In this paper, we model cyberattack prediction as a classification problem. Furthermore, the deep learning architecture was co-opted into a new model using rectified linear units (ReLU) as the activation function in the hidden layers of a deep feed forward neural network. Our approach achieves a greedy layer-by-layer learning process that best represents the features useful for predicting cyberattacks in a dataset of benign and malign traffic. The underlying algorithm of the model also performs feature selection, dimensionality reduction, and clustering at the initial stage, to generate a set of input vectors called hyper-features. The model is evaluated using CICIDS2017 and UNSW_NB15 datasets on a Python environment test bed. Results obtained from experimentation show that our model demonstrates superior performance over similar models.
Chemoradiotherapy With or Without Surgery for Esophageal Squamous Cancer According to Hospital Volume
Authors: Duarte Mateus Bringel Oliveira , Pereira Eduardo Baldon , Lopes Luiz Roberto , Andreollo Nelson Adami , Carvalheira José Barreto Campello 
Published: June 2020

PURPOSE Esophageal squamous cell cancer (ESCC) is still associated with a dismal prognosis. However, surgical series have shown that high-volume hospitals have better outcomes and that the impact of center volume on definitive chemoradiotherapy (dCRT) or CRT plus surgery (CRT + S) remains unknown. METHODS We performed a retrospective analysis of patients with locally advanced stage II-III (non-T4) ESCC treated with dCRT or CRT + S in São Paulo state, Brazil. Descriptive variables were assessed with the χ2 test after categorization of hospital volume (high-volume [HV] center, top 5 higher volume, or low-volume [LV] center). Overall survival (OS) was assessed with Kaplan-Meier curves, log-rank tests, and Cox proportional hazards. Finally, an interaction test between each facility’s treatments was performed. RESULTS Between 2000 and 2013, 1,347 patients were analyzed (77% treated with dCRT and 65.7% in HV centers) with a median follow-up of 23.7 months. The median OS for dCRT was 14.1 months (95% CI, 13.3 to 15.3 months) and for CRT + S, 20.6 months (95% CI, 16.1 to 24.9 months). In the multivariable analysis, dCRT was associated with worse OS (hazard ratio [HR], 1.38; 95% CI, 1.19 to 1.61; P < .001) compared with CRT + S. HV hospitals were associated with better OS (HR, 0.82; 95% CI, 0.71 to 0.94; P = .004) compared with LV hospitals. Importantly, CRT + S superiority was restricted to HV hospitals (dCRT v CRT + S: HR, 1.56; 95% CI, 1.29 to 1.89; P < .001), while in LV hospitals, there was no statistically significant difference (HR, 1.23; 95% CI, 0.88 to 1.43; P = .350), with a significant interaction test ( P interaction = .035). CONCLUSION Our data show that CRT + S is superior to dCRT in the treatment of ESCC exclusively in HV hospitals, which favors the literature trend to centralize the treatment of ESCC in HV centers.
Effect of Ramadan fasting on disease activity in patients with rheumatoid arthritis presenting in tertiary care hospital
Authors: Siddique Samara , Imran M. Yaser , Afzal Muhammad Naeem , Malik Uzma 
Published: June 2020

Background and objective: Rheumatoid Arthritis (RA) is a common inflammatory disorder affected by various factors, including fasting. The objective of the study was to establish the effect of Ramadan fasting on DAS 28 in Rheumatoid Arthritis patients.
Methods: In this observational cohort study done in department of rheumatology, Mayo hospital, Lahore, between May 2019 to July 2019, 240 patients were divided in fasting (n=120) and non-fasting cohort (n=120) based on their own choice. Mean DAS-28 scores before and after Ramadan was compared in both cohorts with appropriate statistical analyses.
Results: Two hundred forty participants, (74 males, 166 females), were recruited. Baseline DAS of fasting group was significantly low (4.35±0.9) as compared to non-fasting group (5.07±0.91). Paired t-test showed statistically significant improvement in fasting and non-fasting groups in total and in both genders (p=0.000). Mean improvement in DAS was numerically greater and statistically significant (p=0.000) in non-fasting group (1.08±0.62) as compared to fasting ones (0.86±0.61). Post-Ramadan DAS was, however, significantly low in fasting group (3.49±0.9) versus non-fasting group (3.98±1.0) (p=0.000).
Conclusion: DAS 28 score decreased in both non-fasting as well as fasting patients of RA during the month of Ramadan. RA patients with moderate disease activity, who want to keep fast, can be allowed to do so without any fear of disease worsening.
doi: https://doi.org/10.12669/pjms.36.5.2099
How to cite this:Siddique S, Imran Y, Afzal MN, Malik U. Effect of Ramadan fasting on disease activity in patients with rheumatoid arthritis presenting in tertiary care hospital. Pak J Med Sci. 2020;36(5):1032-1035. doi: https://doi.org/10.12669/pjms.36.5.2099
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Sigmoid volvulus: An update for Atamanalp classification
Authors: Atamanalp Sabri Selcuk 
Published: June 2020

Sigmoid volvulus (SV), the wrapping of the sigmoid colon around itself, is a rare colonic obstruction form. SV requires emergency endoscopic or surgical treatment following an urgent resuscitation and the prognosis is relatively poor. Although many different classifications have been made for SV in the past, the unique classification system, which assists the decision making in the management in addition to the estimation of the prognosis, was described in 2017. Thereafter, a great number of relevant subjects were discussed in the literature. The aim of this study is to update the present classification system in light of above-mentioned discussions and our experience with 1,028 SV patients, which is the largest single-centre SV series over the world.
doi: https://doi.org/10.12669/pjms.36.5.2320
How to cite this:Atamanalp SS. Sigmoid volvulus: An update for Atamanalp classification. Pak J Med Sci. 2020;36(5):1137-1139. doi: https://doi.org/10.12669/pjms.36.5.2320
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Convergent validity and reliability of a novel repeated agility protocol in junior rugby league players
Authors: Nicholls Anthony , Leicht Anthony , Connor Jonathan , Halliday Aaron , Doma Kenji 
Published: June 2020

Background: Rugby league involves repeated, complex, change-of-direction movements, although there are no test protocols that specifically assesses these physical fitness profiles. Thus, the current study examined the convergent validity and reliability of a repeated Illinois Agility (RIA) protocol in adolescent Rugby League players. Methods: Twenty-two junior Rugby League players completed 4 sessions with each separated by 7 days. Initially, physical fitness characteristics at baseline (i.e., multi-stage fitness, countermovement jump, 30-m sprint, single-effort agility and repeated sprint ability [RSA]) were assessed. The second session involved a familiarisation of RIA and repeated T-agility test (RTT) protocols. During the third and fourth sessions, participants completed the RIA and RTT protocols in a randomised, counterbalanced design to examine the validity and test-retest reliability of these protocols. Results: For convergent validity, significant correlations were identified between RIA and RTT performances (r= >0.80; p<0.05). For contributors to RIA performance, significant correlations were identified between all baseline fitness characteristics and RIA (r = >0.71; p < 0.05). Reliability of the RIA protocol was near perfect with excellent intra-class correlation coefficient (0.87-0.97), good ratio limits of agreement (×/÷ 1.05-1.06) and low coefficient of variations (1.77-1.97%). Conclusions: The current study has demonstrated the RIA to be a simple, valid and reliable field test that can provide coaches with information about their athlete’s ability to sustain high intensity, multi-directional running efforts.
Development and feasibility testing of an interactive avatar education application for education of patients with heart failure
Authors: Du Huiyun , Wonggom Parichat , Burdeniuk Christine , Wight Justin , Nolan Paul , Barry Tracey , Nesbitt Katie , Clark Robyn A 
Published: June 2020

Background/aims Heart failure self-care is important for achieving optimal patient outcomes. Interactive information technology has been shown to enhance self-care knowledge and behaviours. This study aimed to codevelop and evaluate with consumers an avatar app for teaching heart failure self-care. Methods Consumer participation and pre-post test methods. Findings A total of six heart failure patients, two patients' family members and 15 heart failure clinicians and app developers participated in the development of the app. Overall, 13 people completed the app's feasibility testing and demonstrated a significant improvement in heart failure knowledge (P=0.020), self-care maintenance (P=0.027) and self-care confidence (P=0.002). Self-care management did not improve significantly (P=0.113) and satisfaction with learning using the app was very high (90%). Conclusions The codevelopment approach used in this project resulted in a high level of user satisfaction. Consumers felt the app was a very feasible mechanism of heart failure education delivery.
The Cambridge Companion to Operetta, Anastasia Belina and Derek B. Scott (eds) (2020)
Authors: Woller Megan 
Published: June 2020

Review of: The Cambridge Companion to Operetta, Anastasia Belina and Derek B. Scott (eds) (2020)
Cambridge and New York: Cambridge University Press, 319 pp.,
ISBN 978-1-31663-334-2, p/bk, £22.99
Boho Days: The Wider Works of Jonathan Larson, J. Collis (2018)
Authors: Robbins Hannah 
Published: June 2020

Review of: Boho Days: The Wider Works of Jonathan Larson, J. Collis (2018)
Sheffield: Jonathon Collis, 404 pp.,
ISBN 978-3-00059-113-6, h/bk, $46.00
Does Genetics Play a Role in Acute Liver Injury After Amoxicillin Exposure?
Authors: Schosheim Alexander , Mockler Daniel , Chawla Anupama 
Published: June 2020

ABSTRACT
Amoxicillin-clavulanate has long been associated with drug-induced liver injury (DILI) and although approximately 4 times less common, amoxicillin has also been implicated. Many studies have associated possible genetic factors with susceptibility to DILI, but there is currently no literature with evidence of instances of DILI within the same family. Two sisters presented with similar symptoms and signs of liver injury including jaundice, scleral icterus, abdominal pain, and anorexia with transaminitis and abnormal coagulation studies. Both sisters were started on amoxicillin approximately 2–3 weeks before presentation. They both had progression of the liver injury, and on biopsies, they had similar findings indicative of DILI as well.
OPTIMIZING EXPERIMENTAL SIMULATION DESIGN FOR THE EMERGENCY DEPARTMENTS
Authors: Atalan Abdulkadir , Dönmez Cem Cagri 
Published: June 2020

Goal: this study aimed to use the experimental simulation method to obtain the optimum results by using the simulation technique of the models, which are modeled mathematically but not solved.
Design/Methodology/Approach: a case study was conducted to apply the discrete-event simulation (DES) approach based on the design of experiment (DOE) technique to derive strategies and analyze situations in an emergency department (ED).
Results: by integrating the DOE approach with the DES technique for the ED, the average waiting time for a patient in a small ED was reduced from 40.09 minutes to 9.83 minutes (75.48%), which is a significant result. Increasing the capacity of the resources without increasing the number of daily resources for the ED resulted in an increase from 133 to 147 (10.53%) in the number of patients treated. Additionally, the optimum number of healthcare resources to employ in EDs was calculated.
Limitations: there is no shift system for healthcare resources in the DES model. Since the ED was considered in this study, the same number of resources was run during the working hours of the DES model.
Practical implications: for researchers and healthcare professionals, the developed method is used to obtain results that cannot be obtained through the mathematical modeling of healthcare problems. The results of the changes in health resources on the outputs are obtained by this method as the shortest time frame and lowest cost.
Originality/Value: there is almost no detailed study of DES with the DOE technique. Providing high reliability has resulted in obtaining optimum values through the integration of the DOE approach with the DES technique in the healthcare area. It is very difficult to get accurate results anywhere where the human factor is present.
The Waste-Free Production Development for the Energy Autonomy Formation of Ukrainian Agricultural Enterprises
Authors: KALETNIK Grygorii , HONCHARUK Inna , OKHOTA Yuliia 
Published: June 2020

Agriculture has been considered as one of the priority countries sectors in our research; the share of agriculture in the gross domestic product of the world leading countries was investigated. The theoretical and practical aspects of non-waste agricultural production development using animal waste and crop residues fermented in biogas plants are revealed. The authors substantiate the relevance and potential of the introduction of waste-free technology which has considerable advantages of energy autonomy both for the enterprise and the country. The state of humus content in soils of Ukraine is also considered. International experience has been evaluated, which consists in the ability of agricultural waste both to produce alternative sources of energy and to use the products of their processing as organic fertilizers that significantly increase crop yields.
The first steps of the Ukrainian agricultural enterprises to introduction of non-waste production on the example of the company LLC Organic-D have been presented; it heats and electrifies the complex, dries crops, and also uses organic fertilizer (digestate) due to waste processing in the biogas station. As a result of the research, it was found that the application of organic fertilizer can have a positive effect on soil recovery, because the soil acidity has changed from a level of weak acid (5.4 pH) to a level close to neutral (6 pH) for one year of its application. To conclude, the obtained results prove the relevance of the research problem.