bluuebunny/crossref_metadata_2025_split huggingface dataset:
Higher Treg FoxP3 and TGF-β mRNA Expression in Type 2 Reaction ENL (Erythema Nodosum Leprosum) Patients in Mycobacterium leprae Infection
Authors: Mas Rusyati Luh Made , Hatta Mochammad , Widiana I Gede Raka , Adiguna Made Swastika , Wardana Made , Dwiyanti Ressy , Noviyanti Rizki Amelia , Sabir Muhammad , Yasir Yadi , Paramita Swandari , Junita Ade Rifka , Primaguna Muhammad Reza 
Published: December 2020

Background and Aim:
The pathology of leprosy is determined by the host immune response to Mycobacterium leprae. Almost 40% of patients with leprosy undergo immune-mediated inflammatory episodes such as type 1 reactions and Erythema Nodosum Leprosum (ENL or type 2 reactions). Regulatory T (Treg) is a subset of T cells that are involved in the immune response. Treg cells express Forkhead Box P3 (FoxP3), which plays a role in suppressing the immune response. FoxP3 may work alongside Transforming Growth Factor Beta (TGF-β) to down-regulate T cells responses, leading to the antigen-specific anergy associated with leprosy, whereas ENL occurrs mostly in multibacillary leprosy patients. Based on that, the aim of our study was to analyze Treg FoxP3 and TGF-β mRNA expression in type 2 reactions ENL with Mycobacterium leprae infection.

Methods:
Forty-nine newly diagnosed multibacillary (MB) leprosy patients attending the Dermatovenereology Clinic of Leprosy Subdivision, Sanglah General Hospital, Denpasar, Indonesia, were included in the study. The study group consists of 25 leprosy patients with ENL and 24 non-ENL leprosy patients. Twenty-five patients were included in the study as healthy controls. In this study, Treg FoxP3 and TGF-β mRNA expressions were identified with the Real-time PCR method. Analysis of Variant (ANOVA), Chi-square test and odds ratio (OR) calculation were used; p<0.05 was considered statistically significant.

Results:
The result of this study showed that the mean of Treg FoxP3 mRNA expression was 13.3 ± 2.9 on ENL leprosy patients, 11.6 ± 4.1 on non-ENL, and 9.3 ± 1.2 on healthy controls. The mean of TGF-β mRNA expression was 11.7 ± 2.7 on ENL leprosy patients, 9.5 ± 3.6 on non-ENL, and 9.3 ± 1.2 in healthy patients. Statistical analysis for Treg FoxP3 and TGF-β mRNA level between ENL, non-ENL patients and healthy control group showed significance at p<0.05.

Conclusion:
From this study, it was concluded that higher Treg FoxP3 and TGF-β mRNA expressions were found in type 2 reaction ENL patients with Mycobacterium leprae infection. The role played by Treg FoxP3 and TGF-β in type 2 reaction episodes can possibly provide a new target for the treatment of this still-challenging complication of leprosy. Further studies are required to determine the involvement of other cytokines in type 2 reaction ENL patients.
Giving Your Electronic Health Record a Checkup After COVID-19: A Practical Framework for Reviewing Clinical Decision Support in Light of the Telemedicine Expansion
Authors: Feldman Jonah , Szerencsy Adam , Mann Devin , Austrian Jonathan , Kothari Ulka , Heo Hye , Barzideh Sam , Hickey Maureen , Snapp Catherine , Aminian Rod , Jones Lauren , Testa Paul 
Published: December 2020

Background
The transformation of health care during COVID-19, with the rapid expansion of telemedicine visits, presents new challenges to chronic care and preventive health providers. Clinical decision support (CDS) is critically important to chronic care providers, and CDS malfunction is common during times of change. It is essential to regularly reassess an organization's ambulatory CDS program to maintain care quality. This is especially true after an immense change, like the COVID-19 telemedicine expansion.

Objective
Our objective is to reassess the ambulatory CDS program at a large academic medical center in light of telemedicine's expansion in response to the COVID-19 pandemic.

Methods
Our clinical informatics team devised a practical framework for an intrapandemic ambulatory CDS assessment focused on the impact of the telemedicine expansion. This assessment began with a quantitative analysis comparing CDS alert performance in the context of in-person and telemedicine visits. Board-certified physician informaticists then completed a formal workflow review of alerts with inferior performance in telemedicine visits. Informaticists then reported on themes and optimization opportunities through the existing CDS governance structure.

Results
Our assessment revealed that 10 of our top 40 alerts by volume were not firing as expected in telemedicine visits. In 3 of the top 5 alerts, providers were significantly less likely to take action in telemedicine when compared to office visits. Cumulatively, alerts in telemedicine encounters had an action taken rate of 5.3% (3257/64,938) compared to 8.3% (19,427/233,636) for office visits. Observations from a clinical informaticist workflow review included the following: (1) Telemedicine visits have different workflows than office visits. Some alerts developed for the office were not appearing at the optimal time in the telemedicine workflow. (2) Missing clinical data is a common reason for the decreased alert firing seen in telemedicine visits. (3) Remote patient monitoring and patient-reported clinical data entered through the portal could replace data collection usually completed in the office by a medical assistant or registered nurse.

Conclusions
In a large academic medical center at the pandemic epicenter, an intrapandemic ambulatory CDS assessment revealed clinically significant CDS malfunctions that highlight the importance of reassessing ambulatory CDS performance after the telemedicine expansion.
Disparities in Care Outcomes in Atlanta Between Black and White Men Who Have Sex With Men Living With HIV: Protocol for a Prospective Cohort Study (Engage[men]t)
Authors: Sullivan Patrick Sean , Taussig Jennifer , Valentine-Graves Mariah , Luisi Nicole , Del Rio Carlos , Guest Jodie L , Jones Jeb , Millett Greg , Rosenberg Eli S , Stephenson Rob , Kelley Colleen 
Published: December 2020

Background
The US HIV epidemic is driven by infections in men who have sex with men and characterized by profound disparities in HIV prevalence and outcomes for Black Americans. Black men who have sex with men living with HIV are reported to have worse care outcomes than other men who have sex with men, but the reasons for these health inequities are not clear. We planned a prospective observational cohort study to help understand the reasons for worse HIV care outcomes for Black versus White men who have sex with men in Atlanta.

Objective
The aim of this study is to identify individual, dyadic, network, neighborhood, and structural factors that explain disparities in HIV viral suppression between Black and White men who have sex with men living with HIV in Atlanta.

Methods
Black and White men who have sex with men living with HIV were enrolled in a prospective cohort study with in-person visits and viral suppression assessments at baseline, 12 months, and 24 months; additional surveys of care and risk behaviors at 3, 6, and 18 months; analysis of care received outside the study through public health reporting; and qualitative interviews for participants who experienced sentinel health events (eg, loss of viral suppression) during the study. The study is based on the Bronfenbrenner socioecological theoretical model.

Results
Men who have sex with men (n=400) were enrolled between June 2016 and June 2017 in Atlanta. Follow-up was completed in June 2019; final study retention was 80% at 24 months.

Conclusions
Health disparities for Black men who have sex with men are hypothesized to be driven by structural racism and barriers to care. Observational studies are important to document and quantify the specific factors within the socioecological framework that account for disparities in viral suppression. In the meantime, it is also critical to push for steps to improve access to care, including Medicaid expansion in Southern states, such as Georgia, which have not yet moved to expand Medicaid.

International Registered Report Identifier (IRRID)
DERR1-10.2196/21985
Social Capital–Accrual, Escape-From-Self, and Time-Displacement Effects of Internet Use During the COVID-19 Stay-at-Home Period: Prospective, Quantitative Survey Study
Authors: Cheng Cecilia , Lau Yan-Ching , Luk Jeremy W 
Published: December 2020

Background
COVID-19 has spread like wildfire across the globe, prompting many governments to impose unprecedented stay-at-home orders to limit its transmission. During an extended stay-at-home period, individuals may engage in more online leisure activities. Internet use is a double-edged sword that may have both desirable and undesirable effects on psychological well-being, and this study sought to disentangle adaptive from maladaptive internet use amidst this unusual health crisis.

Objective
The objectives of this study were to assess the prevalence of probable depression during the COVID-19 stay-at-home period and to test three hypothesized risk reduction or risk elevation mechanisms, namely social capital–accrual, escape-from-self, and time-displacement effects.

Methods
This study took place from March to May 2020 at the early stage of the pandemic. The study adopted a prospective design, with an online survey administered to 573 UK and 474 US adult residents at two assessment points 2 months apart.

Results
The prevalence of moderate to severe depression was 36% (bootstrap bias-corrected and accelerated [BCa] 95% CI 33%-39%) at Time 1 (ie, initial time point) and 27% (bootstrap BCa 95% CI 25%-30%) at Time 2 (ie, follow-up time point). The results supported the social capital–accrual hypothesis by showing that the approach coping style was inversely associated with Time 2 depression through its positive associations with both social networking and perceived family support. The results also supported the escape-from-self hypothesis by revealing that the avoidant coping style was positively associated with Time 2 depression through its positive associations with both gaming and cyberbullying victimization, but the serial mediation model was no longer significant after Time 1 depression and some demographic risk factors had been controlled for. Finally, the results supported the time-displacement hypothesis by showing that gaming was positively associated with Time 2 depression through its inverse associations with social networking and perceived family support.

Conclusions
During the extended stay-at-home period in the early stages of the COVID-19 pandemic, the prevalence of probable depression during the 2-month study period was high among the UK and US residents. Individuals with distinct coping styles may engage in different types of online leisure activities and perceive varying levels of social support, which are associated with risks of probable depression.
ALBERT-Based Self-Ensemble Model With Semisupervised Learning and Data Augmentation for Clinical Semantic Textual Similarity Calculation: Algorithm Validation Study
Authors: Li Junyi , Zhang Xuejie , Zhou Xiaobing 
Published: December 2020

BackgroundIn recent years, with increases in the amount of information available and the importance of information screening, increased attention has been paid to the calculation of textual semantic similarity. In the field of medicine, electronic medical records and medical research documents have become important data resources for clinical research. Medical textual semantic similarity calculation has become an urgent problem to be solved.ObjectiveThis research aims to solve 2 problems—(1) when the size of medical data sets is small, leading to insufficient learning with understanding of the models and (2) when information is lost in the process of long-distance propagation, causing the models to be unable to grasp key information.MethodsThis paper combines a text data augmentation method and a self-ensemble ALBERT model under semisupervised learning to perform clinical textual semantic similarity calculations.ResultsCompared with the methods in the 2019 National Natural Language Processing Clinical Challenges Open Health Natural Language Processing shared task Track on Clinical Semantic Textual Similarity, our method surpasses the best result by 2 percentage points and achieves a Pearson correlation coefficient of 0.92.ConclusionsWhen the size of medical data set is small, data augmentation can increase the size of the data set and improved semisupervised learning can boost the learning efficiency of the model. Additionally, self-ensemble methods improve the model performance. Our method had excellent performance and has great potential to improve related medical problems.
Improving Detection of Disease Re-emergence Using a Web-Based Tool (RED Alert): Design and Case Analysis Study
Authors: Parikh Nidhi , Daughton Ashlynn R , Rosenberger William Earl , Aberle Derek Jacob , Chitanvis Maneesha Elizabeth , Altherr Forest Michael , Velappan Nileena , Fairchild Geoffrey , Deshpande Alina 
Published: December 2020

Background
Currently, the identification of infectious disease re-emergence is performed without describing specific quantitative criteria that can be used to identify re-emergence events consistently. This practice may lead to ineffective mitigation. In addition, identification of factors contributing to local disease re-emergence and assessment of global disease re-emergence require access to data about disease incidence and a large number of factors at the local level for the entire world. This paper presents Re-emerging Disease Alert (RED Alert), a web-based tool designed to help public health officials detect and understand infectious disease re-emergence.

Objective
Our objective is to bring together a variety of disease-related data and analytics needed to help public health analysts answer the following 3 primary questions for detecting and understanding disease re-emergence: Is there a potential disease re-emergence at the local (country) level? What are the potential contributing factors for this re-emergence? Is there a potential for global re-emergence?

Methods
We collected and cleaned disease-related data (eg, case counts, vaccination rates, and indicators related to disease transmission) from several data sources including the World Health Organization (WHO), Pan American Health Organization (PAHO), World Bank, and Gideon. We combined these data with machine learning and visual analytics into a tool called RED Alert to detect re-emergence for the following 4 diseases: measles, cholera, dengue, and yellow fever. We evaluated the performance of the machine learning models for re-emergence detection and reviewed the output of the tool through a number of case studies.

Results
Our supervised learning models were able to identify 82%-90% of the local re-emergence events, although with 18%-31% (except 46% for dengue) false positives. This is consistent with our goal of identifying all possible re-emergences while allowing some false positives. The review of the web-based tool through case studies showed that local re-emergence detection was possible and that the tool provided actionable information about potential factors contributing to the local disease re-emergence and trends in global disease re-emergence.

Conclusions
To the best of our knowledge, this is the first tool that focuses specifically on disease re-emergence and addresses the important challenges mentioned above.
Telehealth Demand Trends During the COVID-19 Pandemic in the Top 50 Most Affected Countries: Infodemiological Evaluation
Authors: Wong Mark Yu Zheng , Gunasekeran Dinesh Visva , Nusinovici Simon , Sabanayagam Charumathi , Yeo Khung Keong , Cheng Ching-Yu , Tham Yih-Chung 
Published: December 2020

Background
The COVID-19 pandemic has led to urgent calls for the adoption of telehealth solutions. However, public interest and demand for telehealth during the pandemic remain unknown.

Objective
We used an infodemiological approach to estimate the worldwide demand for telehealth services during COVID-19, focusing on the 50 most affected countries and comparing the demand for such services with the level of information and communications technology (ICT) infrastructure available.

Methods
We used Google Trends, the Baidu Index (China), and Yandex Keyword Statistics (Russia) to extract data on worldwide and individual countries’ telehealth-related internet searches from January 1 to July 7, 2020, presented as relative search volumes (RSV; range 0-100). Daily COVID-19 cases and deaths were retrieved from the World Health Organization. Individual countries’ ICT infrastructure profiles were retrieved from the World Economic Forum Report.

Results
Across the 50 countries, the mean RSV was 18.5 (SD 23.2), and the mean ICT index was 62.1 (SD 15.0). An overall spike in worldwide telehealth-related RSVs was observed from March 11, 2020 (RSV peaked to 76.0), which then tailed off in June-July 2020 (mean RSV for the period was 25.8), but remained higher than pre-March RSVs (mean 7.29). By country, 42 (84%) manifested increased RSVs over the evaluation period, with the highest observed in Canada (RSV=100) and the United States (RSV=96). When evaluating associations between RSV and the ICT index, both the United States and Canada demonstrated high RSVs and ICT scores (≥70.3). In contrast, European countries had relatively lower RSVs (range 3.4-19.5) despite high ICT index scores (mean 70.3). Several Latin American (Brazil, Chile, Colombia) and South Asian (India, Bangladesh, Pakistan) countries demonstrated relatively higher RSVs (range 13.8-73.3) but low ICT index scores (mean 44.6), indicating that the telehealth demand outstrips the current ICT infrastructure.

Conclusions
There is generally increased interest and demand for telehealth services across the 50 countries most affected by COVID-19, highlighting the need to scale up telehealth capabilities, during and beyond the pandemic.
Edukasi Menjadi Remaja Sehat dan Berkualitas Melalui Program SMART Remaja
Authors: Mediastuti Fitriani 
Published: December 2020

Remaja memiliki risiko tinggi terkait dengan aktivitas seksual dini dan tidak aman yang akan berdampak terjadinya infeksi menular seksual, HIV/AIDS dan kehamilan berisiko. Adanya informasi yang akurat sangat dibutuhkan oleh remaja dalam membentuk pribadi yang sehat dan berkualitas. Kegiatan pengabdian kepada masyarakat ini dilakukan dengan metode ceramah, pemutaran film edukasi dan diskusi. Kegiatan pengabdian dilaksanakan di SMP PGRI Kasihan Bantul, pada hari Rabu, 23 Januari 2019. Sasaran pengabdian ini adalah siswa SMP dengan jumlah 79 siswa. Materi tersebut diambil dari buku SMART Remaja untuk menggapai remaja yang SMART (Sehat secara Mandiri dan Bertanggungjawab). Mayoritas siswa berusia rata-rata 13 tahun dan tinggal bersama orangtua kandung sebesar 93,67%. Pendidikan ayah mayoritas SMA yaitu sebesar 55, 70 % dan ibu mayoritas juga SMA yaitu sebesar 59, 49%. Pekerjaan ayah mayoritas petani/ buruh yaitu sebesar 39.24% dan ibu mayoritas sebagai ibu rumah tangga sebesar 62.03 %. Masih ada siswa yang belum pernah mendapatkan materi kesehatan reproduksi remaja sebesar 27.85 %. Secara kuantitatif ada kenaikan skor pengetahuan sebelum dan sesudah penyuluhan, yaitu sebesar 10,45%. Hal tersebut dapat disimpulkan bahwa edukasi menjadi remaja sehat dan berkualitas melalui program SMART Remaja, efektif. Semakin tinggi pengetahuan yang dimiliki seseorang tentang kesehatan reproduksi remaja, misal dampak dari perilaku berisiko maka akan meningkatkan perilaku positif pada seseorang.
Processing plants for food: Experimental grinding within the ERC-project PLANTCULT
Authors: Bofill Maria , Chondrou Danai , Palomo Antoni , Procopiou Hara , Valamotti Soultana Maria 
Published: December 2020

PlantCult Project aims to explore the role of culinary traditions and innovations through their impact on shaping the social landscape in ancient Europe over long time periods (from the Neolithic period to the Iron Age) and large territories. The experimental program is part of an integrated study of food products and associated equipment focusing on whether the introduction of new species or changes in social and economic organisation brought about changes in the food grinding technologies of the area.
The experiments include tools operated by back and forth reciprocal motion and circular motion, and manufactured from different raw materials, with different morphologies and sizes. The tools design and the list of plant ingredients (cereals, legumes, acorns and oil-seeds) ground in the experiments are all based on the archaeological record of the studied area. In this paper we present the experimental protocol, the multi-scale methodology applied to the use-wear analysis of grinding stone tools, and the results of the experimental processing of the main plant ingredients detected in prehistoric European cuisine.
La arquitectura de los Tukano
Authors: Rodríguez Lamus Luis Raúl 
Published: December 2020

Las notas siguientes son el producto de la observación de algunos establecimientos de vivienda Tukana, durante una permanencia en los meses de junio y julio de 1955 en la región del Vaupés.
Se agradece al doctor Antonio Andrade Crispino la ayuda prestada como Director del Instituto Colombiano de Antropología en ese tiempo, en el desarrollo de la investigación.
Asímismo al profesor Marcos Fulop B., quien participó directamente en la selección y crítica del material de estudio.
VOCÊ TREINA OU ENSAIA? DICOTOMIAS NO CAMPO CIRCENSE E PROPOSTAS PARA APRENDIZAGEM/CRIAÇÃO/PERFORMANCE A PARTIR DE ELEMENTOS DO SISTEMA LABAN/BARTENIEFF
Authors: Machado Alex Rodrigues , Keiserman Nara Waldemar 
Published: December 2020

O artigo apresenta uma indicação artístico-pedagógica para o artista circense, que se dá com base nos princípios, conceitos e práticas do Sistema Laban/Bartenieff. A observação de alunos e alunas da Escola Nacional de Circo Luiz Olimecha, no Rio de Janeiro, um microcosmo significativo do circo no Brasil, fez ver a dicotomia, comum no campo circense - e não apenas na Escola, mas também em outros espaços de ensino assim como entre artistas profissionais - que distingue procedimentos técnicos de artísticos. Elementos do Sistema Laban/Bartenieff mostram-se eficientes na solução de tal dicotomia, por oferecerem referenciais que sustentam as duas instâncias, permitindo que se elabore uma metodologia em que são superadas as lacunas entre técnica e arte, treinamento e criação. Palavras-chavesPedagogia circense. Treinamento e Criação. Sistema Laban/Bartenieff.