bluuebunny/crossref_metadata_2025_split huggingface dataset:
Responsiveness of The Health Care System Towards The Elderly In Tanzania: Does Health Insurance Make a Difference? A cross Sectional Study
Authors: Amani Paul Joseph , Tungu Malale , Hurtig Anna-Karin , Kiwara Angwara Denis , Frumence Gasto , Sebastian Miguel San 
Published: March 2020

Abstract
Background

Responsiveness has become an important tool in evaluating the ability of the health care systems to meet the expectations of the patients. However, its measurement in sub-Saharan Africa remains scarce. This study aimed to assess the responsiveness of the health care services among the insured and non-insured elderly in Tanzania, in order to contribute with relevant knowledge to improve the performance of health insurance among the elderly in the country.

Methods

This is across sectional study. We used a pre-tested household survey administered to elderly (60 years +) living in Igunga and Nzega districts. Participants with and without health insurance attending outpatient and inpatient health care services in the past three and twelve months were selected. Responsiveness was based on the WHO-SAGE questionnaire that included the dimensions of quality of basic amenities, choice, confidentiality, autonomy, communication and prompt attention. Quantile regression was used to explore the specific association of the responsiveness index with health insurance and socio-demographic factors.

Results

A total of 1453 and 744 elderly, of whom 50.1% and 63% had health insurance, used the outpatient and inpatient health services respectively. All the different domains were rated relatively high but the uninsured elderly reported better responsiveness in all domains of outpatient and inpatient care. Waiting time was the dimension that performed worst. Possession of health insurance was negatively associated with responsiveness in outpatient (-1; 95% CI: -1.45, -0.45) and inpatient (-2; 95% CI: -2.69, -1.30) care.

Conclusion

The uninsured elderly reported better responsiveness than the insured elderly in both outpatient and inpatient care. Special attention should be paid to those dimensions, like waiting time, which ranked low. Further research is necessary to reveal the reasons for the lower responsiveness among insured elderly. A continuous monitoring of the health care system responsiveness is recommended.
Effects of HTR1B 3' region polymorphisms and functional regions on gene expression regulation
Authors: xia xi , Ding Mei , Xuan Jin-feng , Xing Jia-xin , Pang Hao , Yao Jun , Wu Xue , Wang Bao-jie 
Published: March 2020

Abstract
Background The HTR1B gene encodes the 5-hydroxytryptamine (5-HT1B) receptor, which is involved in a variety of brain activities and mental disorders. The regulatory effects of non-coding regions on genomic DNA are one of many reasons for the cause of genetic-related diseases. Post-transcriptional regulation that depends on the function of 3' regulatory regions plays a particularly important role. This study investigated the effects, on reporter gene expression, of several haplotypes of the HTR1B gene (rs6297, rs3827804, rs140792648, rs9361234, rs76194807, rs58138557, and rs13212041) and truncated fragments in order to analyze the function of the 3' region of HTR1B. Methods Seven haplotypes, consisting of rs6297, rs3827804, rs140792648, rs9361234, rs76194807, rs58138557, and rs13212041, and truncated fragments of the HTR1B gene 3' region were transfected into SK-N-SH, HEK-293, and U87 cell lines. The relative fluorescence intensities were detected by a dual luciferase reporter assay system.Results We found that the haplotype, AG_CT_A, enhanced the expression level compared to the main haplotype; AG_CG_A; GG_CG_G decreased the expression level. Two alleles, rs76194807T and rs6297G, exhibited different relative luciferase intensities compared to their counterparts at each locus. We also found that +2440 ~ +2769 bp and +1953 ~ +2311 bp regions both had negative effects on gene expression.ConclusionsThe 3' region of HTR1B has a regulatory effect on gene expression, which is likely closely associated with the interpretation of HTR1B-related disorders. In addition, the HTR1B 3' region includes several effector binding sites that induce an inhibitory effect on gene expression.
The Correlation Analysis of Baseline Serum CA199, CEA and CA125 in Patients with Advanced Pancreatic Cancer
Authors: Deng Guochao , Yan Huan , Guo Zhipeng , Dai Guanghai 
Published: March 2020

Abstract
Background:CA199, CEA and CA125 were the most widely used tumor markers in pancreatic cancer. However, the studies associated with the relationship between the three markers and pancreatic cancer were limited. This study aimed to explore the correlation between baseline serum CA199, CEA, CA125 levels and clinical characteristics in pancreatic cancer. Methods:278 patients with advanced pancreatic cancer received first-line chemotherapy treatments enrolled in this research. Correlated analysis between tumor markers and disease characteristics was performed by Pearson’s Chi-squared test or Fisher exact test. We used Pearson’s correlation test to investigate the relationship between tumor markers and peripheral blood parameters. Univariate analysis was estimated by Kaplan-Meier method and compared using the log-rank test. Multivariate analysis and HR calculation was determined by the Cox regression model. Results: Baseline CA199, CEA, and CA125 both positively associated with the primary tumor site (p=0.007; p=0.012; p=0.003, respectively);liver metastasis (p=0.001; p=0.001; p=0.028, respectively); number of organ metastasis (p=0.001; p=0.008;p=0.042, respectively); baseline WBC levels (p<0.001; p<0.001; p<0.001, respectively), LDH levels (p<0.001; p=0.004; p<0.001, respectively). And CA199 also correlated with years of smoking(p=0.024); diabetes and year of diabetes (p=0.012; p=0.012); baseline glycemic levels (p=0.004). CA199 and CA125 levels had the relationship with baseline neutrophil counts (p<0.001; p<0.001, respectively). Years of smoking, baseline neutrophil counts, LDH levels, CA199 levels and CA125 levels were independent prognostic factors. Conclusion: Combinations of the four factors were also correlated with survival. It’s concluded that CA199, CEA, CA125 correlated with multi-factors of clinical factors. And combinations of baseline neutrophil counts, LDH levels, CA199 levels and CA125 levels were also prognostic factor.
Impact of an educational intervention on knowledge and attitude regarding pharmacovigilance among health professionals working on cancer hospital attached to a regional pharmacovigilance center
Authors: Shrestha Sunil , Sharma Sabina , Bhasima Ramesh , Kunwor Puskar , Adhikari Baburam , Sapkota Binaya 
Published: March 2020

Abstract
Aims: The main aim of the study was to assess the impact of a pharmacovigilance education intervention on the knowledge and attitude of healthcare professionals (HCPs) attached to a regional pharmacovigilance center in an oncology based hospital of Nepal. Methods: Knowledge and attitude were studied before and immediately after the educational intervention among 89 HCPs working in a different department at an oncology based hospital of Nepal. A pretested questionnaire having twelve and nine statements for assessing knowledge and attitude were used. Responses were analyzed using descriptive and inferential statistics. The knowledge and attitude scores before and after educational intervention were analyzed with Wilcoxon rank-sum test, using SPSS version 21.0.Results: The knowledge score was significantly increased from [mean ± S.D (Ranges)] [6.90 ± 2.527 (1-12)] to [11.36±1.189 (6-12)] after an intervention. The attitude score was also significantly increased from [5.56±1.616 (4-10)] to a [6.97±1.793 (4-12)] after an intervention. Twenty-one (23.6%) of participants responded that they lacked the time to report adverse drug reactions (ADR), while 12 (13.5 %) of the participants replied that there was no remuneration for reporting ADR. Around 24 % of them suggested for frequent pharmacovigilance awareness programs via Continuing Medical Education or workshop for improvement of pharmacovigilance.Conclusion: The preliminary finds of this study showed that knowledge and attitude scores were increased following an educational intervention. It also suggests that training on pharmacovigilance and ADR tends to have a positive impact on knowledge and attitude among nurses and pharmacists working at an oncology based hospital of Nepal.
Visual assessment of 18F-FDG metabolic spatial distribution improves the differential diagnosis of indeterminate pulmonary nodules and masses with high FDG uptake
Authors: Lin Jie , Wang Ling , Ji Xiaowei , Zheng Xiangwu , Tang Kun 
Published: March 2020

Abstract
Purpose The aim of this study was to evaluate the value of visual analysis of 18 F-fluorodeoxyglucose ( 18 F-FDG) metabolic spatial distribution (V-FMSD) in diagnosis of indeterminate pulmonary nodules and masses with high 18 F-FDG uptake. Methods A total of 301 patients with indeterminate pulmonary nodules or masses who undergone 18 F-FDG positron emission tomography/computed tomography (PET/ CT) imaging were studied retrospectively. The characteristics of 18 F-FDG metabolic spatial distribution (FMSD) of proximal and distal regions of the lesion were visually analyzed using a 5-point scoring system. The sensitivity, specificity, accuracy and area under receiver operating characteristic curve (AUC) were compared between V-FMSD and conventional PET/CT methods for diagnosis of hypermetabolic indeterminate pulmonary nodules and masses. Results The V-FMSD results showed that 180 (92.8%) malignant lesions’ scores were ≥ 3 and 78 (72.9%) benign lesions’ scores were ≤ 2. It indicated that the FMSD in the proximal region of malignant lesions was significantly higher than that of the distal region, and the FMSD in the proximal region of benign lesions was significantly lower than that of the distal region. The specificity of V-FMSD was 72.9%, which was obviously higher than the maximum standard uptake value (SUVmax) (0%, P < 0.001) and retention index (RI) (26.2%, P < 0.001). The AUC of V-FMSD was 0.886, which was significantly larger than SUVmax (0.626, P < 0.001), RI (0.670, P < 0.001) and PET/CT (0.788, P < 0.05). Conclusions The characteristics of FMSD between pulmonary benign and malignant lesions are different. V-FMSD can be taken as a novel auxiliary marker to improve the diagnostic performance for hypermetabolic indeterminate pulmonary nodules and masses.
Characterization of neuraminidase inhibitor-resistant influenza virus isolates from immunocompromised patients in the Republic of Korea
Authors: Kim Heui Man , Lee Namjoo , Kim Mi-Seon , Kang Chun , Chung Yoon-Seok 
Published: March 2020

Abstract
Background: The emergence of influenza viruses resistant to anti-influenza drugs is a threat to public health. The Korea Centers for Disease Control and Prevention operates the Korea Influenza and Respiratory Viruses Surveillance System (KINRESS) to monitor epidemic of influenza and Severe Acute Respiratory Infection (SARI) to identify mutated influenza viruses affecting drug resistance, pathogenesis, and transmission. Methods: Oropharyngeal swab samples were collected from KINRESS and SARI during the 2018-2019 season. The specimens confirmed influenza virus using real-time RT-PCR on inoculated MDCK cells. HA and NA sequences of the influenza viruses were analyzed for phylogeny and mutations. Neuraminidase inhibition and hemagglutination inhibition assays were utilized to characterize the isolates. Results: Two A(H1N1)pdm09 isolates harboring an H275Y substitution in the neuraminidase sequence were detected in patients with acute hematologic cancer. They had prolonged respiratory symptoms, with the virus present in the respiratory tract despite oseltamivir and peramivir treatment. Through the neuraminidase inhibition assay, both the viruses were found to be resistant to oseltamivir and peramivir, but not to zanamivir. Although hemagglutinin and neuraminidase phylogenetic analyses suggested that the two A(H1N1)pdm09 isolates were not identical, their antigenicity was similar to that of the 2018-19 influenza vaccine virus. Conclusions: Our data indicate the utility of monitoring influenza-infected immunocompromised patients in general hospitals for the early detection of emerging neuraminidase inhibitor-resistant viruses and maintaining continuous laboratory surveillance of patients with influenza-like illness in sentinel clinics to monitor the spread of such new variants. Finally, characterization of the virus can inform the assessment of risk for future epidemics and pandemics caused by drug-resistant influenza viruses.
Differences between native and prosthetic knees in trochlear groove tracking based on a morphometric measurement of three-dimensional reconstruction models in Chinese people
Authors: Chen Shi Chang , Xu Hua , Gong Shaohua 
Published: March 2020

Abstract
Background Prosthetic trochlear design is important to ideal postoperative patellofemoral kinematics and knee function. But there has been little research on the differences of trochlear groove trackings between the native and prosthetic knees. We aimed to investigate the differences between native and prosthetic knees through the entire trochlear length by three-dimensional computerized quantification.Methods Virtual total knee arthroplasty was performed, using three-dimensional models of 42 healthy knees that were matched to the femoral components of five different prosthesis systems. Coaxial planes were created along the trochlear groove in 3° increments, and the deepest points of the trochlear groove were marked in each plane. Taking the lower extremity mechanical axis as reference line, the differences in the mediolateral location of the groove tracking were analyzed between the native and prosthetic knees.Results From the proximal to the distal end, the native tracking started from 0° cross section and extended laterally and then medially with its turning point located in 69° cross section, while the prosthetic knees showed medial orientation throughout the trochlear length. Compared with the proximal portion of the native tracking, the prosthetic trackings extended along a paradoxical orientation and started from a more proximal and lateral position, with maximal discrepancy to, 3.2 mm in the 0° cross section. Distally, the prosthetic trackings were located significantly medial, with maximal discrepancy, to 2.4 mm in the 69° cross section.Conclusion The prosthetic trochlear design varies among different types, and does not conform to that of the native knee in terms of shape, orientation, and location, which may cause soft tissue tension imbalance and abnormal patellofemoral biomechanics during knee flexion. This study may be helpful for prosthetic trochlear design that accords with native anatomy so as to optimize patellofemoral biomechanics and decrease the risk of patellofemoral complications.
Cardiorenal Syndrome in Thalassemia Patients
Authors: Makmettakul Sorasak , Tantiworawit Adisak , Phrommintikul Arintaya , Rattanathammethee Thanawat , Chai-Adisaksopha Chatree , Rattarittamrong Ekarat , Norasetthada Lalita , Fanhchaksai Kanda , Charoenkwan Pimlak , Lekawanvijit Suree 
Published: March 2020

Abstract
Background Cardiorenal syndrome (CRS) is a serious condition with high morbidity and mortality. Secondary CRS (type 5 CRS) is characterized by the coexistence of cardiac abnormality and renal dysfunction occurring secondarily to a systemic condition. There is limited information about CRS in thalassemia. This study aimed to investigate the prevalence of secondary CRS in thalassemia patients and also associated risk factors.Methods In this cross-sectional cohort study, thalassemia patients who attended the out-patient clinic of University hospital from October 2016 to September 2017 were enrolled onto the study. A criterion for diagnosis of secondary CRS is based on a system proposed by Ronco and McCullough. Cardiac abnormalities are assessed by clinical presentation, establishment of acute or chronic heart failure using definitions from 2016 ESC guidelines or from structural abnormalities shown in an echocardiogram. Renal dysfunction is defined by acute kidney injury or chronic kidney disease according to 2012 KDIGO guidelines. Clinical and laboratory findings from 2 consecutive visits, three months apart, were assessed.Results Out of 90 thalassemia patients, 25 (27.8%) had secondary CRS. The multivariable analysis showed a significant correlation between CRS and extramedullary hematopoiesis (EMH) (odds ratio (OR) 20.55, p=0.016); thalassemia type [β 0 /β E vs β 0 /β 0 thalassemia (OR = 0.005, p=0.002)]; pulmonary hypertension (OR 178.1, p=0.001); elevated serum NT-proBNP (OR 1.028, p=0.022), and elevated 24-hour urine magnesium (OR 1.913, p=0.016). There was no correlation between CRS and frequency of blood transfusion, serum ferritin, liver iron concentration, cardiac T2*, type of iron chelating agents, and urine neutrophil gelatinase-associated lipocalin level.Conclusions Secondary CRS is not rare in thalassemia patients. We also identified useful condition and markers for the detection of CRS in thalassemia cases.
Genetic diversity analysis of a Flax (Linum usitatissimum L.) global collection
Authors: Hoque Ahasanul , Fiedler Jason D. , Rahman Mukhlesur 
Published: March 2020

Abstract
Background A sustainable breeding program requires a minimum level of germplasm diversity to provide varied options for the selection of new breeding lines. To maximize genetic gain of the North Dakota State University (NDSU) flax breeding program, we aimed to increase the genetic diversity of its parental stocks by incorporating diverse genotypes. For this purpose, we analyzed the genetic diversity, linkage disequilibrium, and population sub-structure of 350 globally-distributed flax genotypes with 6,200 SNP markersResults All the genotypes tested clustered into seven sub-populations (P1 to P7) based on the admixture model and the output of neighbor-joining (NJ) tree analysis and principal coordinate analysis were in line with that of structure analysis. The largest sub-population separation arose from a cluster of NDSU/American genotypes with Turkish and Asian genotypes. All sub-populations showed moderate genetic diversity (average H = 0.22 and I = 0.34). The pairwise F st comparison revealed a great degree of divergence ( F st > 0.25) between most of the combinations. A whole collection mantel test showed significant positive correlation (r = 0.30 and p < 0.01) between genetic and geographic distances, whereas it was non-significant for all sub-populations except P4 and P5 (r= 0.251, 0.349 respectively and p < 0.05). In the entire collection, the mean linkage disequilibrium was 0.03 and it decayed to its half maximum within < 21 kb distance.Conclusions To maximize genetic gain, hybridization between NDSU stock (P5) and Asian individuals (P6) are potentially the best option as genetic differentiation between them is highest ( F st > 0.50). In contrast, low genetic differentiation between P5 and P2 may enhance the accumulation of favorable alleles for oil and fiber upon crossing to develop dual purpose varieties. As each sub-population consists of many genotypes, a Neighbor-Joining tree assists to identify distantly related genotypes. These results also inform genotyping decisions for future association mapping studies to ensure the identification of a sufficient number of molecular markers to tag all linkage blocks.
Masculinity and Mental Health Treatment Initiation for Former Political Prisoners in Yangon, Myanmar – A Qualitative Investigation
Authors: Lakin Daniel Paul , Win Kyaw Soe , Aung Htin , Soe Khin Nyein Chan , Kyi Bo , Marcell Arik V. , Tol Wietse A , Bass Judith K 
Published: March 2020

Abstract
Background Men are less likely to seek care for mental health problems globally. This finding is more pronounced in low- and middle-income countries, where poor healthcare infrastructure, differences in illness conceptualization, and stigma impact treatment seeking. To improve the likelihood of successful engagement of men in psychotherapy, it is necessary to identify factors that influence treatment adherence, and to better understand men’s attitudes surrounding decisions to seek and initiate care. The purpose of this investigation was to explore themes of masculinity, treatment seeking, and differences between men who accepted and declined therapy in an urban low-income context. Methods We conducted a qualitative, interview-based investigation with 30 former political prisoners in Yangon, Myanmar who were eligible to receive mental health counseling provided by the Assistance Association for Political Prisoners. Men were initially screened using a composite questionnaire with items related to depression, anxiety, and posttraumatic stress symptom severity. After screening, if potential clients were identified as having probable mental health problems, they were asked if they would like to participate in a multi-session cognitive behavioral therapy program. Semi-structured, open-ended interviews were conducted with 15 participants who accepted and 15 participants who declined therapy. Interviews were transcribed and translated by local partners and thematically coded by the authors. We used thematic analysis to identify and explore differences in treatment-seeking attitudes between men who accepted and men who declined the intervention. Results Men described that being a community leader, self-reliance, morality, and honesty were defining characteristics of masculinity. A focus on self-correction often led to men declining psychotherapy. A general lack of familiarity with psychological therapy, and how it differed from locally available treatments (e.g. astrologists) was connected to stigma regarding mental health treatment. Conclusions Masculinity was described in similar terms by both groups of participants. The interpretation of masculine qualities within the context of help-seeking (e.g. self-reliance as refusing help from others versus listening to others and applying that guidance) were driving factors behind men’s decision to enter psychotherapy.
Mental health consequences of long-term stays in refugee camps: Preliminary evidence from Moria
Authors: Wiel willemine van de , Castillo-Laborde Carla , I. Francisco Urzúa , Fish Michelle , Scholte Willem F. 
Published: March 2020

Abstract
Background Over the last decade, millions of refugees have arrived in Europe. Upon arrival refugees reside in designated refugee camps which, even though originally designed to home refugees on a short stay basis only, developed into long-stay facilities. Some of these camps have detention-like characteristics and dire living conditions. One such example is Moria camp on the island of Lesvos, Greece, which has been repeatedly reported for being overcrowded, unhygienic, and unsafe. This study explores the incidence of acute mental health crises and their relationship with the length of stay in the camp. Methods A cross-sectional study was conducted using routinely collected data on 857 consultations during 90 nights at an emergency night clinic in Moria camp. Logistic regression analysis was used to explore whether the length of stay in the camp was predictive of the occurrence of acute mental health crises. Results Of all consultations (n=857), 25⋅5% (n=219) were related to mental health problems; 17⋅4% (n=38) of these met the study’s case definition of acute mental health crisis. Such crises were positively associated with the length of stay in the camp (p=0⋅044); the odds ratio increases with 1·03 for every 10% increase in days of residence. This is notable when considering the average length of stay in the camp (71 days). Conclusion Acknowledging that this study does not provide causal effects on the relation between length of stay and mental health crises, the established link can hardly be related to anything else but the inhumane living conditions in the camp, its inhabitants’ lack of future expectations, and the scarce provision of mental health services. This form of neglect urgently calls for attention of the medical world and Europe’s policy makers.