bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Different Health Literacy Dimensions Influences Health Status and Well-being among Men and Women: The Mediating Role of Health Behaviors
Authors: Zhang Fan , Or Peggy Pui-Lai , Chung Joanne Wai-Yee 
Published: May 2020

Abstract
Background. Health literacy, the ability to access, understand, evaluate, and apply health information, was found to contribute to positive health outcomes, possibly via promoting healthy behaviors. However, the specific pathways linking different health literacy skills to health and well-being has remained unclear.Methods. A cross-sectional survey with structural questionnaires was administered among 2236 community-based adults in Hong Kong (mean age = 46.10 ± 19.05). Health literacy was measured by HLS-Asian-47. Participants' health behavior, physical conditions, and well-being were reported.Results. With structural modeling path analysis, health literacy in finding and understanding information showed a direct effect on enhancing physical health. While applying information capacity had an indirect positive effect via promoting health behaviors, which was moderated by gender. Only among women this indirect effect in predicting fewer physical symptoms and greater well-being was significant.Conclusions. Although similar patterns were found in physical condition and well-being, distinct direct and indirect pathways were found of different health literacy dimensions for men and women. Based on the findings, by targeting specific health literacy skills, education programs should be developed to enhance women’s health knowledge, and men's application of the knowledge in healthy lifestyle.
The Relationship of Nursing Home Price and Quality of Life
Authors: Raes Sarah , Vandepitte Sophie , De Smedt Delphine , Wynendaele Herlinde , DeJonghe Yannai , Trybou Jeroen 
Published: May 2020

Abstract
Background Knowledge about the relationship between the residents’ Quality Of Life (QOL) and the nursing home price is currently lacking. Therefore, this study investigates the relationship between 11 dimensions of QOL and nursing homes price in Flemish nursing homes.Methods The data used in this cross-sectional study were collected by the Flemish government from years 2014 to 2017 and originates from 659 Flemish nursing homes. From 2014 to 2016, data on the QOL of 21,756 residents was assessed with the InterRAI instrument. This instrument contains 11 QOL dimensions. Multiple regression analyses were conducted to examine the research question.Results The multiple regressions indicated that a 10 euro increase in the daily nursing home price is associated with a significant decrease (P < 0.001) of 0.1 in 5 dimensions of QOL (access to services, comfort and environment, food and meals, respect, and safety and security). Hence, our results indicate that the association between price and QOL is very small. When conducting a subgroup analysis based on ownership type, the earlier found results remained only statistically significant for private nursing homes.Conclusion Our findings show that nursing home price is of limited importance with respect to resident QOL. Contrary to popular belief, our study demonstrates a limited negative effect of price on QOL. Further research that includes other indicators of QOL is needed to allow policymakers and nursing home managers to improve nursing home residents’ QOL.
Modeling Count Data for Healthcare Utilization: an Empirical Study of Outpatient Visits Among Vietnamese Older People
Authors: Le Dung Duc , Leon-Gonzalez Roberto , Matola Joseph Upile 
Published: May 2020

Abstract
Background Vietnam is undergoing an unprecedented pace of aging process and is expected to experience the fastest aging process in region. Association between increasing age and health deterioration has been well-documented across settings. Consequently, demand for healthcare utilization is rising among older people. However, healthcare utilization, here measured as count data, creates challenges for modeling because such data typically has distributions that are skewed with a large mass at zero. This study compares empirical econometric strategies for the modeling of healthcare utilization (measured as the number of outpatient visits in the last 12 months), and identifies the determinants of healthcare utilization among Vietnamese older people based on the best-fitting model identified. Methods Using the Vietnam Household Living Standard Survey in 2006 (N=2426), nine econometric regression models for count data were examined to identify the best-fitting one. We used model selection criteria; statistical tests; and goodness-of-fit for in-sample model selection. In addition, we conducted 10-fold cross-validation checks to examine reliability of in-sample model selection. Finally, we utilized marginal effects to identify the factors associated with number of outpatient visits among Vietnamese older people based on the best-fitting model identified. Results We found strong evidence in favor of hurdle negative binomial model 2 (HNB2) for both in-sample selection and 10-fold cross-validation checks. The marginal effect results of the HNB2 showed that predisposing, enabling, need, and lifestyle factors were significantly associated with number of outpatient visits. The predicted probabilities for each count event showed the distinct trends of healthcare utilization among specific groups: at low count events, women and people in younger age group used more healthcare utilization than did men and their counterparts in older age groups, but a reversed trend was found at higher count events. Conclusions The findings here suggest that the HNB2 model should be considered for use in modeling counts of healthcare use. This study’s findings lay the groundwork for future research on the modeling of healthcare utilization in developing countries and those findings could be used to forecast on healthcare demand and making provisions for healthcare costs.
Analysis of hospitalization expenditure and its influencing factors for lung cancer patients in China: a research based on the “System of Health Accounts 2011”
Authors: Pan Le , Meng Zhaolin , Cai Yuanyi , Wu Huazhang 
Published: May 2020

Abstract
Background At present, lung cancer is the common malignant tumor of respiratory system worldwide. The disease poses a serious health threat and a substantial economic burden to patients. The economic risks brought by lung cancer arouses widespread public concern. Therefore, the target of this research is to calculate lung cancer expenditure in China under the framework of the System of Health Account 2011 (SHA 2011). Intensive studies on working mechanism of influencing factors to lung cancer expenditure will be further explored, in order to achieve the goal of controlling lung cancer expenditure.Methods A multistage stratified sampling method was conducted in Liaoning province in China, and a total of 23559 patients were included into hospitalization expenditure analysis according to the framework of SHA 2011. The relation between the total hospitalization expenditure of lung cancer and its influencing factors including of demographic characteristics, diagnosis and treatment, and hospital condition was analyzed with the multiple stepwise regression analysis. The impact mechanism of these influencing factors was revealed through path analysis and survival analysis.Results The total hospitalization expenditure of lung cancer was $ 1581.8. Multiple stepwise regression analysis indicated that the total hospitalization expenditure was associated with length of stay, surgery, hospital level, insurance status, and hospital type, according to the sequence of standardized estimate (β). Length of stay contributed the most to the model R-square. Path analysis showed that surgery, hospital type, and insurance status not only made a direct impact on the hospitalization expenditure, but also made an indirect impact on it through the length of stay. Through survival analysis, we found self-funded patients of lung cancer were quicker to run out of the affordable money.Conclusions Lung cancer brought a heavy economic burden for patients. More efficient and stringent clinical control strategies should be conducted to limit the increase of the expenditure.
Not all dietary fibers alleviate type 2 diabetes
Authors: Nie Qixing , Gao He , Li Mingzhi , Sun Yonggan , Chen Haihong , Zuo Sheng , Fang Qingying , Huang Xiaojun , Yin Junyi , Hu Jielun , Nie Shaoping 
Published: May 2020

Abstract
Background High intake of dietary fiber was found to be inversely associated with type 2 diabetes (T2D), whereas the difference among different dietary fibers on T2D is still not clear.Results Here we investigated the effects of 9 types of dietary fiber on type 2 diabetic rats. we found supplementation with β-glucan, arabinogalactan, guar gum, apple pectin, glucomannan, arabinoxylan (especially β-glucan and arabinogalactan treatment) significantly reduced the fasting blood glucose, whereas carrageenan, xylan and xanthan gum had no effect on glycemic control in rats with T2D. Fibers with hypoglycemic effects associated with the increased butyric acid level and abundance of beneficial bacteria (Anaeroplasma, Parabacteroides and some butyric acid-producing bacteria), as well as improved host metabolism by decreasing 12α-hydroxylated bile acids, acylcarnitines and amino acids (leucine, phenylalanine, citrulline, and etc.). It was also found that only β-glucan can attenuate insulin resistance in T2D via down-regulation of Prevotella copri mediated branched chain amino acids biosynthesis.Conclusions not all dietary fibers were able to improve T2D, which mainly relied on the improvement of composition and functions of gut microbiota.
Intention to use long acting contraceptive methods and associated factors among women currently using short acting contraceptive methods in Gondar city, northwest Ethiopia: using the theory of planned behavior.
Authors: Berhe Resom , Nigusie Adane 
Published: May 2020

Abstract
Objective Despite its effectiveness, the intention and utilization of long acting contraceptive methods is very low in many developing countries and the use of long acting contraceptive methods has not kept in pace with that of short-acting methods such as, oral contraceptives and injectables.Result The magnitude of intention to use long acting contraceptive methods was 39.8%. Intention to use long acting contraceptive methods was higher for women whose husbands were farmers when compared to women whose husbands were government employees (β = 0.49, 95% CI: 0.41, 0.72). Number of children wanted (β = − 0.19, 95%CI: -0.28, -0.1), attitude (β = 0.34, CI: 0.23, 0.46), subjective norm (β = 19, 95%CI: 0.12, 0.27) and perceived behavioral control (β = 0.18, 95%CI: 0.06, 0.3) were factors significantly associated with intention to use long acting contraceptive methods. Intention to use long acting contraceptive methods was low. Interventions that focus on women’s attitude towards long acting contraceptive methods and support group, peer education, social mobilization and persuasive communication could promote intention to use long acting contraceptive methods.
Microbiome meets classical microbiology: quantifying sample CFU using 16S rRNA gene sequencing data
Authors: Cruz Giuliano Netto Flores , Christoff Ana Paula , Oliveira Luiz Felipe Valter de 
Published: May 2020

Abstract
Background Next-generation sequencing (NGS) has been extensively employed to perform microbiome characterization worldwide. As a culture-independent methodology, it has allowed high-level profiling of sample microbial composition. However, most studies are limited to sample information regarding relative bacterial abundances (sample proportions), ignoring scenarios in which sample microbe biomass can vary widely. Here, we develop an equivolumetric protocol for amplicon library preparation capable of generating NGS data responsive to input DNA, recovering proportionality between observed read counts and absolute bacterial abundances within each sample. Within a determined range, we show that the estimation of sample colony-forming units (CFU), the most common unit of bacterial abundance in classical microbiology, is challenged mostly by resolution and taxon-to-taxon variation. We propose Bayesian cumulative probability models to address such issues.Results Observed read counts were consistently proportional to input DNA, total microbial load, and bacterium-specific sample abundances, although a saturation tendency was observed as abundances increased. Using Bayesian cumulative probability models, predictive errors in sample CFU estimation varied constantly below one order of magnitude - as measured by the mean absolute log10-ratio (MALR). For total microbial load, observed MALR was no greater than 0.2 during both cross-validation and validation on a test dataset. For observed bacteria, estimation of taxon-specific CFU showed MALR values of at most 0.5. We also performed leave-one-group-out cross-validation to assess predictive performance for previously unseen bacteria. While most bacteria showed MALR no greater than 1, such a threshold was exceeded only by Bacillus cereus.Conclusions Being able to estimate sample CFU in a high-throughput fashion has a wide range of applications, from the study of built environments to public health surveillance. This study shows that equivolumetric protocols along with cumulative probability models allow sample CFU estimation from microbiome datasets. Further, our approach has the potential to generalize to previously unmodeled bacteria, an important feature in high-throughput settings. Lastly, it remains clear that NGS data are not inherently restricted to sample proportions only, and microbiome science can finally meet the working scales of classical microbiology.
Association between neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and diabetic retinopathy among diabetic patients without a related family history
Authors: Wang Jinrui , Chen Zhongli , Yang Ying , Yang Ke , Yang Huijun , Tao Wenyu , Li Yiping , Jiang Zejia , Bai Chaofang , Yin Yuechuan , Duan Jianmei , Zhou Yuanyuan , Geng Xinqian 
Published: May 2020

Abstract
Background: Diabetic retinopathy (DR) is a specific neurovascular complication of diabetes mellitus (DM). Clinically, family history is a widely recognized risk factor for DR,assisting diagnosis and risk strata. However, among a great amount of DR patients without hereditary history like hypertension and diabetes, direct and simple risk factors to assist clinical decisions are still required. Herein, we intend to investigate the associated risk factors for these DR patients based on systemic inflammatory response indexes, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Methods: We consecutively enrolled 1030 patients with a definite diagnosis of type 2 diabetes mellitus(T2DM) from the endocrinology department of the Second hospital of People in Yun Nan. Based on funduscopy and family history checking, we excluded patients with a family history of hypertension and diabetes and finally enrolled 264 patients with DR and 206 patients with non diabetic retinopathy(NDR).Through correlation analysis, univariate and multivariate regression, we further explore the association between NLR, PLR, and DR. On top of that we investigate the effect of NLR and PLR on risk reclassification of DR. Results: Compared with NDR patients, NLR and PLR levels are significantly higher among DR patients (NLR:2.36±1.16 in DR group versus 1.97±1.06 in NDR group, p<0.001; PLR: 11.62±4.55 in DR group versus10.56±4.45 in NDR group, p=0.012). According to univariate analysis, NLR and PLR add risks to DR. After fully adjusting co-founders, NLR, as both continuous and categorical variate, remains an independent risk factor for DR(OR(95%CI):1.37 (1.06,1.78) P= 0.018). And though PLR not independently associated with DR as a continuous variable (OR (95%CI)1.05 (0.99, 1.11) p=0.135 ), the highest quantile of PLR add two-fold increased risk (OR(95％CI) 2.20 (1.05, 4.59) p=0.037) in the fully adjusted model for DR. In addition, addition of PLR and NLR to the established factor hemoglobin (Hb) improved the discriminability of the model and assisted the reclassification of DR. After combining PLR and NLR the Area under curve (AUC) of Hb based model raised from 0.76 to 0.78, with a category-free net reclassiﬁcation improvement (NRI) of 0.532 (p < 0.001) and Integrated discrimination improvement (IDI) of 0.029(p < 0.001). Conclusions: Systemic inflammatory response indexes NLR and PLR were associated with the presence of DR among patients without associated family history and contributed to improvements in re-classification in addition to Hb.
Energy cost of selected training and non-training activities of 10-17-year-old Indian athletes: a cross-sectional study
Authors: Cherian Keren Susan , Sainoji Ashok , Nagalla Balakrishna , Yagnambhatt Venkata Ramana 
Published: May 2020

Abstract
Background Factorial approach using activity recording and metabolic equivalents (METs) is most often used to compute 24-hr energy expenditure pattern among athletes. However, the existing compendiums for energy cost of physical activities were developed on non-athlete adults or children. Therefore, the present study aimed to determine the energy cost of selected physical activities of junior athletes. Further, the suitability of existing compendiums among Indian junior athletes were assessed.Methods In this cross-sectional study, 91 Indian junior athletes (Boys: 45 and Girls: 46) from athletics, soccer and weightlifting events, were monitored for their activity pattern (Rest, Training and non-training activities) and volume of oxygen consumed (ml/kg/min) using portable metabolic analyser. Sex and/or age-specific differences were determined using ANOVA and measured METs were compared with Compendium of Physical Activity (CPA) and Compendium of Energy Expenditure for Youth (CEEY) using single-sample t-test.Results The energy cost and METs showed sex-specific differences with a strong association between measured Heart rate and METs. The measured METs covered a range of physical activities from 0.7 (Resting Metabolic Rate; RMR) to 10.8 (shuttle run). On comparison with compendium, measured METs for RMR was significantly higher in junior athletes, except in soccer players (junior boys and girls) having lower METs. For majority of the activities, measured METs were comparable with adult compendium (CPA), than children’s (CEEY).Conclusions Thus, the METs determined on Indian junior athletes adds to the existing database and is useful to evaluate energy expenditure. Further, in the absence of athlete-specific compendium, CPA seems prudent for determining energy needs.
Features and prognosis of cytomegalovirus-associated biliary atresia: a retrospective study
Authors: Wang Zhe , Guan Xi-Si , Wu Yue , He Qiu-Ming , Li Le , Yu Jia-Kang , Zhong Wei 
Published: May 2020

Abstract
Purpose

To investigate the relationship between cytomegalovirus (CMV) infection and biliary atresia (BA) onset, development and short-term prognosis after Kasai operation.
Methods

A retrospective study was conducted. BA Patients with obstructive jaundice and tested for CMV infection were included and grouped by CMV-IgM and CMV-DNA test results, between-group differences of preoperative blood tests and short-term prognosis indicators were investigated for the statistical significance.
Results

the CMV infection rate was higher in BA patients compared with non-BA jaundiced patients. Higher preoperative gamma-glutamyl transferase (GGT) level and lymphocyte percentage (Lym%) were significantly corelated with the CMV infection in BA patients. CMV(+) BA Patients had similar short-term outcome comparing with CMV(-) patients. IgM(+)DNA(+) group had highest GGT, total bilirubin (TBiL) and direct bilirubin (DBiL) level. IgM(-)DNA(+) group had the lowest GGT and the highest alkaline phosphatase (ALP) level. IgM(+)DNA(-) group had the highest bodyweight and lymphocyte percentage. The IgM (+)DNA (-) group had more patient achieved complete jaundice clearance than other groups.
Conclusion

CMV infection may associate to BA development and progression. Perioperative antivirus treatments may be necessary for improving outcome. Better elucidation of the underlying mechanism will require further investigation.
Combination of convolutional networks with a learning based ensemble strategy for hippocampus subfield segmentation
Authors: He Guanghua , Lu Tianzhe , Zhu Hancan 
Published: May 2020

Abstract
Background Accurate segmentation of hippocampal subfields from magnetic resonance (MR) brain images is an important step for studying brain disorders, including epilepsy, Alzheimer’s Disease (AD) and Parkinson’s disease. However, it is a difficult task because of the low signal contrast and small structural size.Methods Many advanced convolutional networks have been proposed and have achieved state-of-the-art performances in various applications. To take advantage of these advanced convolutional networks, in this paper, we propose a learning based ensemble strategy to integrate the results of different convolutional networks for hippocampus subfield segmentation. Our ensemble strategy is implemented by using a convolutional network. We have validated the proposed method based on a publicly available dataset.Results The experiment results have showed that the proposed ensemble strategy can significantly improve the performance of each single convolutional network, and outperform the state-of-the-art hippocampus subfield segmentation method.ConclusionThe proposed ensemble strategy is effective for combining multiple different convolutional networks in hippocampus subfield segmentation.Background Hippocampus is a bilateral brain structure, involved in many brain disorders, such as epilepsy, Alzheimer’s disease (AD), and Parkinson's disease 1. It consists of several histologically and functionally specialized subfields: the subiculum (SUB), the cornu ammonis sectors (CA) 1–3, and the dentate gyrus (DG) 2. The studies have shown that different diseases affect different subfields, which suggest that hippocampal subfields may provide more precise information for earlier disease diagnosis than using the whole hippocampus 3.
Introduction of the Aspergillus fumigatus α-1,2-mannosidase MsdS into Trichoderma reesei improves the ligno-cellulose degradation
Authors: Ghimire Prakriti Sharma , Ouyang Haomiao , Zhao Guangya , Xie Mingming , Zhou Hui , Yang Jinghua , Jin Cheng 
Published: May 2020

Abstract
Background: a-1,2-Mannosidase is an important enzyme essential for N-glycan processing and plays a significant role in the biosynthesis and organization of fungal cell wall. Lacking of α-1,2-mannosidase leads to cell wall defect in yeast and filamentous fungi. In Trichoderma reesei, a fungus known to be non-toxic to human, its N-glycan on secreted glycoprotein is Man8GlcNAc2, which is different from that in Aspergillus fumigatus. To evaluate the significance of the N-glycan processing in T. reesei, in this study A. fumigatus α-1, 2-mannosidase MsdS, an enzyme that cleaves N-linked Man8GlcNAc2 in Golgi to produce Man6GlcNAc2 on secreted glycoprotein, was introduced into T. reesei.Results: The msdS-expressing strain Tr-MsdS produced a major glycoform of Man6GlcNAc2 on its secreted glycoproteins, instead of Man8GlcNAc2 in the parent strain. Although the cell wall content of msdS-expressing strain Tr-MsdS was changed, it appeared that the cell wall integrity was not affected. However, phenotypes such as increased conidiation, multiple budding and random branching were observed in strain Tr-MsdS. In addition, expression of MsdS into T. ressei also affected protein secretion and improved the ligno-cellulose degradation of T. reesei.Conclusions: Our results indicate that processing of the N-glycan is species-specific and plays an important role in protein secretion in T. reesei, specially cellulases. Also, our results provide a new strategy to improve cellulases production by interfering the N-glycan processing in T. reesei.