bluuebunny/crossref_metadata_2025_split huggingface dataset:
Secular trend analysis of antibiotic utilisation in China's hospitals 2011-2018, a retrospective analysis of procurement data
Authors: Wushouer Haishaerjiang , Zhou Yue , Zhang Xi , Fu Mengyuan , Fan Daiming , Shi Luwen , Guan Xiaodong 
Published: March 2020

Abstract
Background: This study was aimed to explore the secular trends of antibiotic utilisation in China’s hospitals over an 8-year period.
Methods: We retrospectively analysed aggregated monthly antibiotic procurement data of 586 hospitals from 28 provinces in China from January 2011 to December 2018. Information including generic name, procurement amount, dosage form, strength, the route of administration, and geographical data were collected. Population weighted antibiotic utilisation were expressed in DDD per 1,000 inhabitants per day (DID). WHO’s ‘Access, Watch, Reserve’ categorization was also adopted to analyse antibiotic utilisation.
Results: Between 2011 and 2018, total antibiotic utlisation in China’s hospitals increased by 39.6% (from 4.8 DID in 2010 to 6.7 DID in 2018). Antibiotic utilisation was stable or had moderately decreased in 13 provinces, while in the other 15 provinces they had substantially increased. Cephalosporins were the most consumed antibiotics, accounting for 26.9% of the total antibiotic utilisation (1.8 DID/6.7 DID). In 2018, antibiotics in the Access category comprised 19.4% of the total utilisation (1.3 DID/6.7 DID), where antibiotics in the Watch category comprised the largest proportion of 71.6% (4.8 DID/6.7 DID). Population-weighted antibiotic utlisation was greater in secondary hospitals than in tertiary hospitals (7.3 DID vs 6.6 DID). The utilisation of oral forms was almost two times the amount of parenteral forms in secondary hospitals, whereas in tertiary hospitals the amounts were about the same.
Conclusions: Despite efforts have been made towards restricting antibiotic use by the Chinese government, antibiotic utilisation demonstrated an upward trend after the medical reform. The increase of last-resort antibiotics raises serious concern for public health. Current patterns of antibiotic utilisation demonstrated that gaps are existed towards the global target set up by the WHO. To better facilitate proper antibiotic use, more efforts are needed to explore the appropriateness of antibiotic use at the individual level.
A cross-sectional study of the relationships between different components of sarcopenia and brachial ankle pulse wave velocity in community-dwelling elderly
Authors: Rong Yu-Dong , Bian Ai-Lin , Hu Hui-Ying , Ma Yue , Zhou Xin-Zi 
Published: March 2020

Abstract
Background Declination of skeletal muscle mass or sarcopenia is associated with the arterial stiffness. However, but it is unclear whether muscle strength and physical performance; important contributors of sarcopenia are associated with the arterial stiffness. The aim of this study was to investigate the relationship between sarcopenia, the components of sarcopenia and arterial stiffness among elderly population. Methods Four hundred and fifty community dwelling elderly participants (266 male, and 184 female, >65 years) were enrolled in this study. Each participant received general medical examinations in Tianjin First Center Hospital. Based on the diagnostic criteria for sarcopenia in older people developed by the Asian Working Group for Sarcopenia (AWGS), 89 participants were separated into the sarcopenia group. The living habits, disease status, general status and laboratory examinations of all participants were collected. The body composition (including appendicular skeletal muscle mass , and visceral fat area (VFA) was measured by bioimpedance analysis. Handgrip strength (HS), usual gait speed (GS), and brachial ankle pulse wave velocity (baPWV) were measured. Results Sarcopenia participants had higher baPWV, nutrition risk and lower appendicular skeletal muscle index(ASMI), HS, GS, body mass index(BMI), triacylglycerol(TG), serum albumin(ALB) and creatinine(Cr) than the non-sarcopenia participants; Sarcopenia participants also had higher visceral fat area (VFA)compared to non-sarcopenia participants (p<0.05). ASMI and HS were negatively associated with baPWV (t=-5.807, p=0.000 and t=-3.085, p=0.002), but the relationship between baPWV, and GS was not statistically significant (t=-0.862, p=0.389) by multivariable linear regression. After adjusting for confounders, a multivariate logistic regression analysis revealed that sarcopenia was related to age, BMI, sports and baPWV in community dwelling elderly. Conclusions ASMI and HS were negatively associated with baPWV in community dwelling elderly in China; and baPWV was a risk factor of sarcopenia.
Parents' and healthcare professionals' perceptions of the use of live video recording in neonatal units: A focus group study
Authors: BRIS Aude LE , MAZILLE-ORFANOS Nadia , SIMONOT Pauline , LUHERNE Maude , FLAMANT Cyril , GASCOIN Geraldine , Laighin Gearóid Ó , HARTE Richard , PLADYS Patrick 
Published: March 2020

Abstract
Background: The emerging use of video in neonatology units raises ethical and practical questions. This study aims to gain a better understanding of the suitability, limitations and constraints concerning the use of live video as a tool in neonatal clinical practice. The perceptions of parents and healthcare professionals in regard to live video were examined.
Methods : Nine focus groups were conducted in four neonatal units involving 20 healthcare professionals and 19 parents. Data were triangulated using transcripts and field notes and analyzed using inductive and semantic thematic analysis.
Results: The seven major themes that emerged from the healthcare professionals focus groups were (i) the impact of video recording on healthcare professionals’ behavior; (ii) the impact on parents; (iii) forensic issues ;(iv) guarantee of use; (v) benefits for the newborn; (vi) methodology of use; and (vii) technical considerations & feasibility. The five major themes that emerged from parents focus groups were (i) benefits for the newborn and care enhancement; (ii) impact on parents and potential benefits in case of newborn child/parent separation; (iii) informed consent and guarantee of use;(iv) concern about a possible disruptive impact on healthcare professionals; and (v) data protection.
Conclusion: Both parents and healthcare professionals found video recording useful and acceptable if measures were taken to protect the data and mitigate any negative impacts on healthcare professionals.
Changes in individual and contextual socio-economic level influence on reproductive behavior in Spanish women. The MCC-Spain study
Authors: Gómez-Acebo Ines , Dierssen-Sotos Trinidad , Palazuelos Camilo , Castaño-Vinyals Gemma , Pérez-Gómez Beatriz , Amiano Pilar , Fernández-Villa Tania , Ardanaz Eva , Suarez-Calleja Claudia , Alguacil Juan , Molina-Barceló Ana , Jiménez-Moleón José J. , Molero Jessica Alonso , Roca-Barceló Aina , Chirlaque María-Dolores , Vázquez José Pedro Fernández , Molinuevo Amaia , Aragonés Nuria , Serra Maria Sala , Binefa Gemma , Moreno Victor , Pollán Marina , Kogevinas Manolis , Llorca Javier 
Published: March 2020

Abstract
Background

The association between socioeconomic level and reproductive factors has been widely studied. For example, it is well known that women with lower socioeconomic status (SES) tend to have more children, the age at first-born being earlier. However, less is known about to what extent the great socioeconomic changes occurred in a country (Spain) could modify women reproductive factors. The main purpose of this article is to analyze the influence of individual and contextual socioeconomic levels on reproductive factors in Spanish women, and to explore whether this influence has changed over the last decades.

Methods

We performed a cross-sectional design using data from 2038 women recruited as population-based controls in an MCC-Spain case-control study.

Results

Higher parent’s economic level, education level, occupational level and lower urban vulnerability were associated with higher age at first delivery and lower number of pregnancies. These associations were stronger for women born after 1950: women with unfinished primary education had their first delivery six years before women with high education if they were born after 1950 (23.4 vs. 29.8 years) but only three years before if they were born before 1950 (25.7 vs. 28.0 years). For women born after 1950, the number of pregnancies dropped from 2.1 (unfinished primary school) to 1.7 (high education), whereas it remained almost unchanged in women born before 1950.

Conclusions

Reproductive behavior was associated with both individual and area-level socio-economic indicators. Such association was stronger for women born after 1950 regarding age at first delivery and number of pregnancies and for women born before 1950 regarding consumption of hormonal contraceptives or postmenopausal therapy.
Clinical Implications of Pachyvessels in Polypoidal Choroidal Vasculopathy
Authors: Ijuin Nobuo , Tsujinaka Hiroki , Hirai Hiromasa , Jimura Hironobu , Nakao Shigeya , Yamashita Mariko , Nishi Tomo , Ueda Tetsuo , Ogata Nahoko 
Published: March 2020

Abstract
Purpose: Polypoidal choroidal vasculopathy (PCV) is one of the disorders within the pachychoroid spectrum diseases. The presence of pachyvessels is one of the characteristics of pachychoroid disorders. However, the relationship between the presence of pachyvessels and the clinical characteristics of PCV eyes has not been determined. The purpose of this study was to determine the relationship between the presence of choroidal pachyvessels and the clinical characteristics of eyes with PCV. Methods: The medical records of patients who were diagnosed with PCV and were treatment-naïve were reviewed. Fluorescein and indocyanine green angiography, fundus photography, spectral domain optical coherence tomography (SD-OCT), and enhanced depth imaging OCT (EDI-OCT) were used to obtain images of the choroid. The presence of pathologically dilated outer choroidal vessels, pachyvessels, was determined by ICGA images. These pachyvessels were confirmed to correspond with the large choroidal vessels in the EDI OCT images. The PCV eyes were divided into two groups based on the presence or absence of pachyvessels and clinical features and subfoveal choroidal thickness (SFCT) were evaluated between the two groups. Results: Eighty-six eyes of 84 patients with PCV were evaluated. Pachyvessels were detected in 48 eyes (55.8％). The mean SFCT was 203.9 ± 83.9 μm in all 86 eyes, and it was significantly thinner in eyes with pachyvessels (+) than without pachyvessels (-) (183.2 ± 58.4 μm vs 230.2 ± 103.1 μm; P =0.01). The differences in the incidence of subretinal fluid, pigment epithelial detachments, and hemorrhages between the two groups were not significant. However, the PCV eyes in pachyvessels (+) group with hemorrhage had the thinnest choroid ( P =0.047). The choroidal features of the fellow eyes were similar to those of the PCV affected eyes, that is, the fellow eyes in pachyvessels (+) group had pachyvessels and the fellow eyes in pachyvessels (-) group did not have pachyvessels. Conclusions: Pachyvessels were presented 55.8% in eyes with PCV, and these eyes had the thin SFCT. The presence of pachyvessels and attenuation of the inner choroid were probably due to the pathological changes in the eyes with PCV.
Burden of Fatigue among Adults Living with HIV/AIDS Attending Antiretroviral Therapy in Ethiopia
Authors: Gebreyesus Tsiwaye , Belay Addisalem , Berhe Gebretsadik , Haile Gebremedhin 
Published: March 2020

Abstract
Background: Fatigue is one of the most common and devastating HIV-related symptoms, with a varying prevalence in different study areas. In Ethiopia, there is a paucity of information on the magnitude and factors associated with fatigue among HIV/AIDS patients. This may lead to under-diagnosis and eventually under-management of the symptom. Objectives: This study assessed the prevalence and factors associated with fatigue among adults living with HIV/AIDS attending antiretroviral therapy at health facilities of Mekelle city, Tigray, North Ethiopia, 2019. Methods: Institution based cross-sectional study design was conducted among 609 HIV/AIDS patients who were selected by using a systematic random sampling method. Data were collected by using interviewer administered structured questionnaire. Level of fatigue was measured by Fatigue Severity Scale. Results: The prevalence of fatigue was found to be 51.7%. The factors associated with fatigue were: Parity [AOR= 2.01; 95% CI: 1.09-3.71], CD4 count 200-499 cells/mm3 [AOR= 2.81; 95% CI: 1.58-4.99], anemia [AOR= 4.90 95% CI: 2.40-9.97], co-morbidities [AOR= 3.65; 95% CI: 1.71-7.78], depression [AOR= 3.68 95% CI: 1.99-6.79], not being physically active [AOR= 3.20 95% CI: 1.50-6.81], clinical stage II or IV HIV [AOR= 3.11; 95% CI: 1.51-6.40] and [AOR= 4.08; 95% CI: 1.37-12.14], respectively. Conclusion: The finding of this study revealed that fatigue is a common health problem among adult PLHIV. Factors associated with fatigue included: Parity, CD4 count 200-499 cells/mm3, Clinical Stage II or IV HIV, anemia, co-morbidities, depression, and not being physically active. The health care service needs to address the predisposing factors by provision optimum care so that PLHIV can be encouraged in physical activity in order to relieve the impact of fatigue. Keywords: Fatigue, HIV/AIDS, Associated factors, Prevalence, Ethiopia
Identifying predictive biomarkers of CIMAvaxEGF success in Non–Small Cell Lung Cancer Patients
Authors: Lorenzo-Luaces Patricia , Sanchez Lizet , Saavedra Danay , Crombet Tania , Elst Wim Van der , Alonso Ariel , Molenberghs Geert , Lage Agustin 
Published: March 2020

Abstract
Background: Immunosenescence biomarkers and peripheral blood parameters are evaluated separately as possible predictive markers of immunotherapy. Here, we illustrate the use of a causal inference model to identify predictive biomarkers of CIMAvaxEGF success in the treatment of Non–Small Cell Lung Cancer Patients. Methods: Data from a clinical trial evaluating the effect on survival time of CIMAvax-EGF versus best supportive care were analyzed retrospectively, following a causal inference approach. Pre-treatment potential predictive biomarkers included basal serum EGF concentration, peripheral blood parameters and immunosenescence biomarkers. The proportion of CD8 + CD28- T cells, CD4+ and CD8+ T cells, CD4/CD8 ratio and CD19+ B cells. The 33 patients with complete information were included. The predictive causal information (PCI) was calculated for all possible models. The model with a minimum number of predictors, but with high prediction accuracy (PCI>0.7) was selected. Good, rare and poor responder patients were identified using the predictive probability of treatment success. Results: The mean of PCI increased from 0.486, when only one predictor is considered, to 0.98 using the multivariate approach with all predictors. The model considering the proportion of CD4+ T cell, basal Epidermal Growth Factor (EGF) concentration, neutrophil to lymphocyte ratio, Monocytes, and Neutrophils as predictors were selected (PCI>0.74). Patients predicted as good responders according to the pre-treatment biomarkers values treated with CIMAvax-EGF had a significant higher observed survival compared with the control group (p=0.03). No difference was observed for bad responders. Conclusions: Peripheral blood parameters and immunosenescence biomarkers together with basal EGF concentration in serum resulted in good predictors of the CIMAvax-EGF success in advanced NSCLC. Future research should explore molecular and genetic profile as biomarkers for CIMAvax-EGF and it combination with immune-checkpoint inhibitors. The study illustrates the application of a new methodology, based on causal inference, to evaluate multivariate pre-treatment predictors. The multivariate approach allows realistic predictions of the clinical benefit of patients and should be introduced in daily clinical practice.
Patient outcomes in Anteromedial Osteoarthritis Patients over 80 Years Old Undergoing Oxford Unicompartmental Knee Arthroplasty in China
Authors: Cheng Jingbo , Feng Mingli , Cao Guanglei , Li Zheng , An Shuai , Lu Shibao 
Published: March 2020

Abstract
Background: The use of Oxford Unicompartmental Knee Arthroplasty (UKA) has increased rapidly both Western and Asian populations. And Oxford UKA also has excellent functional outcomes with high patient satisfaction. While previous evidence regarding clinical outcomes and survival rate after Oxford UKA based on studies in western populations, results may be different in Asian patients. Thus, the relevance of age for postoperative function after Oxford UKA is therefore still unclear. Hence, the aim of our study was to clarify the effectiveness and safety of Oxford UKA in Asian patients aged over 80 years.
Methods: A retrospective review was performed of 195 patients (209 knees)who underwent OxfordUKA between June 2015 and January 2018. We divided all patients into threegroups (ages 60–69; ages 70-79; age over 80). We used the HSS score and WOMAC score to evaluate the general condition of the patients’ knees before surgery and at last follow-up.We also recorded perioperative complications and short-termcomplications.
Result: 60 patients (60 knees) between the ages of 60 and 69 (Group 1), 70 patients (79 knees) between the ages of 70-79 (Group 2) and 65 patients (70 knees) over 80 years old (Group 3) were included in the study. The mean follow-up was 21.34±12.04, 22.08±11.38 and 21.76 ± 10.20 months in Group 1, 2 and 3, respectively.At last follow-up, the patients in Group 3 showed lower function scores as compared to group 1 and 2 ( P <0.05), butthe HSS score and the WOMAC score were significantly improved in three groups after surgery. In terms of perioperative and other complications, the three age groups did not differ significantly.
Conclusion: Oxford UKA is an effective and safe treatment for osteoarthritis, even in old adult patients in China.Elderly patients have lower knee function scores than younger patients. But the knee joint pain symptoms of the elderly patients are relieved and the function is also improved compare to preoperative condition.
Association of acute kidney injury with readmissions after hospitalization for acute exacerbation of chronic obstructive pulmonary disease: A population-based study
Authors: Hirayama Atsushi , Goto Tadahiro , Hasegawa Kohei 
Published: March 2020

Abstract
Background and Aim : Little is known about the relationship between acute kidney injury (AKI) and outcomes after acute exacerbation of chronic obstructive pulmonary disease (AECOPD). We aimed to investigate associations between AKI and readmission risks after hospitalization for AECOPD. Methods : A retrospective, population-based cohort study using State Inpatient Databases from seven U.S. states (Arkansas, California, Florida, Iowa, Nebraska, New York, and Utah) from 2010 through 2013. We identified all adults (aged ≥40 years) hospitalized for AECOPD during the study period. Among them, we further identified patients with a concurrent diagnosis of new AKI. The outcome measures were any-cause readmissions within 30 days and 90 days after hospitalization for AECOPD. To determine associations between AKI and readmission risk, we constructed Cox proportional hazards models examining the time-to-readmission. We also identified the primary reason of readmission. Results: We identified 356,990 patients hospitalized for AECOPD. The median age was 71 years and 41.9% were male. Of these, 24,833 (7.0%) had a concurrent diagnosis of AKI. Overall, patients with AKI had significantly higher risk of 30-day all-cause readmission compared to those without AKI (hazard ratio 1.47; 95% CI 1.43-1.51; P<0.001). Likewise, patients with AKI had significantly higher risk of 90-day all-cause readmission (hazard ratio 1.35; 95% CI 1.32-1.38; P<0.001). These associations remained significant after adjustment for confounders (both P<0.05). Additionally, patients with AKI were likely to be readmitted for non-respiratory reasons including sepsis, acute renal failure, and congestive heart failure. Conclusions : Among patients hospitalized for AECOPD, patients with AKI were at higher risk of 30-day and 90-day readmission, particularly with non-respiratory reasons.
Microscopic and submicroscopic Plasmodium infections in indigenous and non-indigenous communities in Colombia.
Authors: Montiel Jehidys , Zuluaga Lina M. , Aguirre Daniel C. , Segura Cesar , Tobon-Castaño Alberto , Vasquez Ana M 
Published: March 2020

Abstract
Background: The indigenous population is considered a highly susceptible group to malaria because they usually live in areas with high exposure to Anopheles and poverty, and have limited access to health services. There is a great diversity of indigenous communities in Colombia living in malaria-endemic areas; however, the burden of infection in these populations has not been studied extensively. This study aimed to determine the prevalence of Plasmodium infections in indigenous and non-indigenous communities in two malaria-endemic areas in Colombia.
Methods: A Community-based cross-sectional survey was conducted in seven villages of Turbo and El Bagre municipalities; three of these villages were indigenous communities. Inhabitants of all ages willing to participate were included. Sociodemographic and clinical data were recorded as well as household information. The parasitological diagnosis was performed by microscopy and nested PCR. The prevalence of microscopy and submicroscopic infection was estimated. An adjusted GEE model was used to explore risk factors associated with the infection. Results: Among 713 participants, 60.7% were from indigenous communities. Plasmodium spp. was detected in 30 subjects (4.2%, CI 95% 2.9-5.9); from those, 29 were in the indigenous population, 47% of infections were afebrile, and most of them submicroscopic (10/14). Microscopic and submicroscopic prevalence was 2.5% (CI 95% 1.6-3.9) and 1.7% (CI 95% 0.9-2.9) respectively. In El Bagre, all infections occurred in indigenous participants (3.9%, CI 95% 2.2-7.1), and 81% were submicroscopic. By contrast, in Turbo, the highest prevalence occurred in indigenous people (11.5%; CI 95%: 7.3-17.5), but 88.8% were microscopic. Living in an indigenous population increased the prevalence of infection compared with a non-indigenous population (PR 19.4; CI 95% 2.3-166.7). Conclusion: There is a high proportion of Plasmodium infection in indigenous communities. A substantial proportion of asymptomatic and submicroscopic carriers were detected. The identification of these infections, not only in indigenous but also in the non-indigenous population, as well as their associated factors, could help to implement specific malaria strategies for each context.