bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inequity under Equality: Research on the Benefits Equity of Chinese Basic Medical Insurance
Authors: Diao Li , Liu Yiwei 
Published: June 2020

Abstract

Background: The pursuit of equity is one of the basic principles behind the strengthening of health care reform. China's new rural cooperative medical insurance (NRCMI) and urban residents' basic medical insurance (URBMI) are both “equalized” in terms of fundraising and reimbursement. This paper studies the benefits equity under this "equalized" system.Methods: The data analysed in this paper are from the China Family Panel Studies (CFPS) from 2014 to 2016, implemented by the Institute of Social Science Survey at Peking University. A two-part model and a binary choice model are used in the empirical test.Results: The empirical test revealed that high-income people benefit more from basic medical insurance than low-income people. Mechanism analysis demonstrated that high-income people have higher medical insurance applicability and can utilize better health care. Since low-income people are unhealthier, inequity in benefits exacerbates health inequity. We also found that the benefits equity of URBMI is better than that of NRCMI.Conclusions: The government needs to pay more attention to the issue of medical insurance inequity. We should consider allowing different income groups to pay different premiums according to their medical expenses or applying different reimbursement policies for different income groups.
The Kickstart Walk Assist system for improving balance and walking function in stroke survivors: a feasibility study
Authors: Yao Jiajia , Sado Takashi , Wang Wenli , Gao Jiawen , Zhao Yichao , Qi Qi , Mukherjee Mukul 
Published: June 2020

Abstract
Background: Compared with traditional physical therapy for stroke patients, lower extremity exoskeletons can provide patients with greater endurance and more repeatable and controllable training, which can reduce the therapeutic burden of the therapist. However, most exoskeletons are expensive, heavy or require active power to be operated. Therefore, a lighter, easy to wear, easy to operate, low-cost technology for gait rehabilitation in stroke survivors would be a welcome opportunity for stroke survivors, caregivers and clinicians. One such device is the Kickstart Walk Assist system and the purpose of this study was to determine feasibility of using this unpowered exoskeleton device in a sample of stroke survivors. Methods: Thirty stroke survivors were enrolled in the study and experienced walking with the Kickstart exoskeleton device that provided spring-loaded assistance during gait. After 5 days of wearing the exoskeleton, participants were evaluated in the two states of wearing and not wearing the exoskeleton. Outcome measures included: a) gait measures, b) balance measures and c) exoskeleton-use feedback questionnaire. Results: In comparison to not wearing the device, wearing the Kickstart Walk Assist system, weight bearing asymmetry was reduced. The time spent on the 10-meter walk test was reduced, but there was no difference in the timed-up-and-go test (TUGT). Gait analysis data showed reduction in step time and double support time. Stroke survivors were positive about the Kickstart Walk Assist system’s ability to improve their balance, speed and gait. In addition, their confidence level and willingness to use the device was also positive. Conclusions: These findings show the feasibility of using the Kickstart Walk Assist system for improving walking performance in stroke survivors. Our future goal is to perform a longer duration study with more comprehensive pre- and post-testing in a larger sample of stroke survivors.
Facility level factors that determine consistent delivery of essential newborn care at health centers in Ethiopia
Authors: Desta Binyam Fekadu , Beshir Ismael Ali , Tafesse Zergu , Segni Hailemariam 
Published: June 2020

Abstract
Background: Essential newborn care (ENC) is a package of interventions which should be provided for every newborn baby regardless of body size or place of delivery immediately after birth and should be continued for at least the seven days that follows. Although a minimum package of proven interventions to reduce newborn mortality have been adopted, countries are still challenged by multiple system related problems. Methods: This study employed a retrospective cross-sectional study design and used program monitoring data collected from 425 facilities between October and December 2019. Descriptive statistics were formulated and presented in tables. Binary logistic regression was employed to assess the statistical association between the outcome variable and the independent variables. All variables with p<0.2 in the bivariate analysis were identified as candidate variables. Then, multiple logistic regression analysis was performed using candidate variables to determine statistically significant predictors of the consistent delivery of ENC by adjusting for possible confounders. Results: A total of 273, (64.2%), of facilities demonstrated consistent delivery of ENC. Five factors - availability of essential obstetrics drugs in delivery rooms, high CSC performances, availability of maternity waiting homes, consistent partograph use, and availability of women-friendly delivery services were included in the model. The strongest predictor of CD-ENC was consistent partograph use, recording an odds ratio of 2.66. Similarly, providing women-friendly services was strongly associated with increased likelihood of exhibiting CD-ENC. Furthermore, facilities with essential obstetric drugs had 1.88 times higher odds of exhibiting consistent delivery of ENC. Conclusion: Health worker commitment to provide ENC is linked to the practices and platforms created by health facility management. Health facility managers should establish a platform or mechanism to enhance providers relationship with their clients as well as comprehensive tools to remind health workers’ responsibilities with regards to ENC. In addition, the health service managers should also consider availing the required supplies and drugs closer to the service delivery rooms and tables.
Dignity of informal caregivers of migrant patients in the last phase of life. A qualitative study.
Authors: de Voogd Xanthe , Willems Dick , Torensma Marieke , Onwuteaka-Philipsen Bregje , Suurmond Jeanine 
Published: June 2020

Abstract
Background
An important aim of palliative care is to improve the family’s and patient’s quality of life. To ensure quality of life for migrant patients’ families, the objective of this study was to get insight into the dignity of informal caregivers. This could provide insight on family-centered care for migrant patients.
Methods
20 semi-structured interviews with informal caregivers with a Turkish, Moroccan or Surinamese migration background living in the Netherlands were analyzed thematically.
Results
We found the dignity of the patient and the dignity of the informal caregiver were strongly related. Most important for the dignity of the informal caregiver was to ensure good care for and preserve the dignity of the patient. Ensuring good care encompassed advocating for good and dignified care and wishes of the patient. For many caregivers, it also included delivering care to the patient themselves or with other family members, despite having to give up a part of their own lives. Giving care themselves was part of maintaining a good relationship, it could cater to the patient’s preferences or preserve the patient’s dignity, and it could come with valuable aspects such as times for good conversations. The informal caregiver’s dignity and the patient’s dignity were often compromised simultaneously. When informal caregivers felt healthcare professionals were impairing the dignity of the patient, their own dignity suffered. Also, dignified behavior by the patient such as thankfulness influenced the informal caregiver’s dignity positively, undignified behavior of the informal caregiver themselves, such as showing their emotions to significant others could influence it negatively. According to informal caregivers, healthcare professionals can help them preserve their dignity by taking their advice about the patient seriously, informing them about the disease and the patient’s prognosis, and dealing respectfully with value differences at the end of life.
Conclusion
The dignity of migrant patients’ informal caregivers in the last phase of the patient’s life is entwined with ensuring good care for and dignity of the patient. Healthcare professionals could strengthen the informal caregiver’s dignity by supporting their role.
An easy and effective test to evaluate tear film stability as a self diagnosis of dry eye syndrome: Blinking tolerance time (BTT)
Authors: Hwang Hyung Bin , Ku Yong Ho , Kim Eun Chul , Kim Hyun Seung , Kim Man Soo , Hwang Ho Sik 
Published: June 2020

Abstract
Background: To introduce a new diagnostic test, blinking tolerance time (BTT) to evaluate tear film stability. We will compare it with tear break-up time (tBUT) and validate the value of the BTT as a new self-diagnostic tool for assessing tear film instability.Methods: This was a prospective controlled study involving 212 eyes of 106 participants aged 20–79 years. One hundred fourteen eyes of 57 dry eye patients and 98 eyes of 49 healthy subjects were included in the study. All patients and subjects were administered the following diagnostic tests of dry eye disease: Ocular Surface Disease Index, BTT, tBUT, slit lamp examination, corneal stain score, and Schirmer I test (without anesthesia). Patients and subjects were instructed to not to blinking as possible as he or she can after reset blinking. Examiner measure the time interval between reset blinking and next blinking. tBUTou was defined as the mean of the average of three tBUT values in the right and left eyes. Correlations between BTT and tBUTou were also evaluated. To evaluate the diagnostic efficacy of the BTT and tBUT, ROC curves were generated to obtain a cutoff score, and the sensitivities of the tests against the specificity at all possible thresholds were plotted.Results: Spearman’s correlation analysis showed a statistically significant, weakly positive correlation between BTT and tBUTOU (r = 0.447; p=0.000). The intraclass correlation coefficient (ICC) of the tBUT was 0.679 (95% confidence interval [CI]: 0.575–0.765) and the ICC of the BTT was 0.904 (95% CI: 0.867–0.932). The AUC of the tBUTOU was 0.678 and that of the BTT was 0.628. There was no statistically significant difference between these two AUC values (p=0.641). When the cutoff value of BTT was set to 8.1 sec, the sensitivity of the BTT was 63.3% and the specificity was 56.1%.Conclusion: As a simple and new self-diagnostic diagnosis of dry eye, BTT has diagnostic value in clinical practice. The BTT test has a unique advantage in that it can be used for self-diagnostic diagnosis of dry eye. The BTT test can also be widely used in the clinical setting because it is an inexpensive and simple procedure.
Safety and tolerability of oral lisdexamfetamine in adults with methamphetamine dependence: a phase-2 dose-escalation study
Authors: Ezard Nadine , Clifford Brendan , Dunlop Adrian , Bruno Raimondo , Carr Andrew , Liu Zhixin , Siefried Krista , Lintzeris Nicholas 
Published: June 2020

Abstract
Background: Methamphetamine (MA) dependence is a growing global health issue with no effective pharmacotherapy. Lisdexamfetamine (LDX) is approved for use in the treatment of attention-deficit/hyperactivity disorder (ADHD) and binge eating disorder (BED) in doses ranging from 30 to 70mg/day. LDX has a longer duration of action and lower abuse potential than other amphetamines, and presents a promising candidate for agonist-type treatment of MA dependence. People seeking treatment for MA dependence may require doses of LDX higher than used in ADHD and BED. We examined the safety of LDX at 250mg/day among adults with MA dependence, approximately equivalent to previously trialled doses of dexamphetamine. Methods: We conducted a dose-escalating, phase-2, open label, single-group study of oral LDX at two Australian drug treatment services. Eligible participants were MA dependent adults who reported use of MA on at least 14 of the preceding 28 days. Once daily, supervised LDX doses of 100 to 250mg/day were provided as a single-blinded, ascending-descending dose regimen over 8 weeks. The primary outcomes were safety, drug tolerability, and regimen completion at the end of Week 4 (maximum dose). Participants were followed through to Week 12. Secondary outcomes included: change in MA use; craving; withdrawal; severity of dependence; risk behaviour; change in other substance use; medication acceptability; potential for non-prescription use; adherence; and neurocognitive functioning. Results: Fourteen of 16 participants (87.5%) successfully completed the four week escalation regimen to 250mg/day. Two participants withdrew from the trial in the first week. No participant was withdrawn due to adverse events. MA use decreased significantly (p=0.013) from a median of 21 days (IQR: 16-23) to 13 days (IQR: 11-17) over the four week escalation period.Conclusions: LDX at a dose of up to 250 mg/day was safe and well tolerated in this population, with high retention. Larger trials of LDX as a pharmacotherapy for MA dependence are warranted. Trial Registration : Australian and New Zealand Clinical Trials Registry ACTRN12615000391572.
A Novel Method of Constrained Feature Selection by the Measurement of Pairwise Constraints Uncertainty
Authors: Berahmand Kamal , Rostami Mehrdad , Forouzandeh Saman 
Published: June 2020

Abstract
In recent years, with the development of science and technology, there were considerable advances in datasets in various sciences, and many features are also shown for these datasets nowadays. With a high-dimensional dataset, many features are generally redundant and/or irrelevant for a provided learning task, which has adverse effects with regard to computational cost and/or performance. The goal of feature selection over partially labeled data (semi-supervised feature selection) is to choose a subset of available features with the lowest redundancy with each other and the highest relevancy to the target class, which is the same objective as the feature selection over entirely labeled data. By appropriate reduction of the dimensions, in addition to time-cost savings, performance increases as well. In this paper, side information such as pairwise constraint is used to rank and reduce the dimensions. In the proposed method, the authors deal with checking the quality (strength or uncertainty) of the pairwise constraint. Usually, the quality of the pair of constraints on the dimension reduction is not calculated. In the first step, the strength matrix is created through a similarity matrix and uncertainty region. And then, by using the strength and similarity matrices, a new constraint feature selection ranking is proposed. The performance of the presented method was compared to the performance of the state-of-the-art, and well-known semi-supervised feature selection approaches on eight datasets. The findings indicate that the proposed approach improves previous related approaches with respect to the accuracy of constrained clustering. In particular, the numerical results showed that the presented approach improved the classification accuracy by about 3% and reduced the number of selected features by 1%. Consequently, it can be said that the proposed method has reduced the computational complexity of the machine learning algorithm despite increasing the classification accuracy.
Detection of Escherichia albertii in urinary and gastrointestinal infections in Kermanshah, Iran
Authors: Namdari Afshin , Rahimian-zarif Bahareh , Foroughi Azadeh 
Published: June 2020

Abstract
Background

Escherichia albertii (E. albertii) is a Gram-negative and facultative anaerobe bacterium. In recent years, the bacterium has been isolated from the feces of people with gastroenteritis as a pathogen that causes diarrhea. Due to insufficient information on the phenotypic and biochemical characteristics of E. albertii, it is difficult to distinguish it from other species of the Enterobacteriaceae family. This is especially prevalent in the pathotypes of Escherichia coli (E. coli). Moreover, in clinical laboratories, it is mistakenly identified as E. coli or even Hafnia alvei (H. alvei). This study was performed for the first time in Iran to identify E. albertii by PCR method from a sample of urinary and gastrointestinal infections obtained from clinical laboratories in Kermanshah, which were distinguished as E. coli.
Methods

In this study, 60 urinary samples and 40 fecal samples that were identified as E. coli by phenotypic and biochemical methods in clinical laboratories. The samples were re-evaluated in the first step in terms of specific phenotypic and biochemical characteristics of E. coli. Subsequently, DNA was extracted from the isolates by the phenol method. Then, two lysP and mdh genes were detected for E. albertii and the uidA gene for E. coli by PCR using specific primers pairs.
Results

The results obtained from phenotypic and biochemical tests indicated that all samples were consistent with E. coli characteristics. However, findings from PCR showed that out of a total of 100 samples, specific genes of E. coli were identified in 6 samples (6%) and uidA gene in 94 remaining samples (94%). Of these 6 samples, 5 samples were urinary tract infections, and only one was a gastrointestinal infection.
Conclusion

The findings of this study show that E. albertii can be considered as one of the causes of urinary and gastrointestinal infections that are mistakenly identified in clinical laboratories as E. coli.Therefore, the use of molecular methods for accurate and definitive diagnosis of bacteria can be useful.
Long-Term Effectiveness and Safety of Infliximab and Golimumab in Ankylosing Spondylitis Patients from a Canadian Prospective Observational Registry
Authors: Rahman Proton , Starr Michael , Haaland Derek , Bessette Louis , Teo Michelle , Rampakakis Emmanouil , Lehman Allen J , Nantel Francois 
Published: June 2020

Abstract
Background: The objectives of this study were to describe the profile of ankylosing spondylitis (AS) patients treated with either infliximab (IFX) or subcutaneous golimumab (GLM) treatment in Canadian routine care setting along with assessing long-term effectiveness and safety. Methods: AS patients who were eligible for treatment with IFX or subcutaneous GLM as per their respective Canadian product monographs were enrolled into the BioTRAC registry from 2005-2017. The study visits occurred at baseline and every 6 months thereafter. Effectiveness was assessed by changes in clinical outcomes and acute phase reactants. Safety was evaluated by assessing the incidence of adverse events (AEs) and drug survival rates. Results: A total of 389 IFX- and 421 GLM-treated patients were enrolled. A significant decrease in disease duration at baseline was observed in the IFX cohort, from a median of 8.0 in 2005-2008 to 1.0 years in 2009-2015 (p<0.001). A reduction in baseline BASFI score (p=0.011) and proportion of patients in ASDAS very high disease activity (p=0.004) was also observed over time. Meanwhile, in the GLM cohort, most disease parameters remained similar from 2010-2017.Treatment with both agents significantly improved all disease parameters over time with similar efficacy between the two agents. The incidence of AEs and SAEs were 136 and 131 events/100 PYs and 10.5 and 8.45 events/100 PYs for IFX- and GLM-treated patients, respectively. Conclusion: Both IFX and GLM treatment in AS significantly reduced disease activity in most outcome measures in a similar fashion and were well tolerated in Canadian routine care. Trial Registration: NCT00741793
Barriers and facilitators for transitioning of young people from adolescent clinics to adult ART clinics in Uganda: Unintended consequences of successful adolescent ART clinics
Authors: Mbalinda Scovia Nalugo , Bakeera-Kitaka Sabrina , Amooti Derrick Lusota , Magongo Eleanor Namusoke , Musoke Philippa , Dan Kaye K 
Published: June 2020

Abstract
BackgroundThere is a growing number of adolescents and young adults with HIV who require transfer of care from pediatric/ adolescent clinics to adult ART clinic. Currently, adolescents are largely in the care of pediatricians; but as they grow, they transition to adult HIV clinics. The purpose of this study was to explore the facilitators and barriers of transitioning among adolescents from adolescent clinics to adult ART clinics.MethodAn explorative qualitative approach was utilised for this study. Eighteen focus group discussions were held in nine health facility with (191) adolescents and young people in order to capture their experiences, barriers and facilitators regarding transitioning to adult clinics. The focus group discussions were audio recorded and transcribed. The Silences Framework using thematic approach guided the analysis.Results The key emerging issues were: Care provided in the adolescent clinics, Unfriendly adults, stigma and discrimination, Congestion and long waiting time, health providers in adult clinics were barriers to transitioning. Moving as a cohort, Transition preparation, care in clinics, positive living, support from the guardian and Young adolescent program Support (YAPS) could facilitate readiness and transitioning.ConclusionAdolescents and young people expressed fear to transition to adult clinics mainly because of the perceived better care provided in adolescent clinic, thus constituting a barrier to smooth transition A range of individual, social and health system and services-related factors hindered transitioning. Expectation of transitioning as a group, assurance of similar care as in the adolescent clinic, and guarantees of confidentiality, privacy and autonomy in decision-making for care were perceived as facilitators. There is need to strengthen implementation of age-appropriate care and individualized case management during care transition at all health facilities. Furthermore, the findings suggest the need to create supportive family, peer, and healthcare environments for adolescent transition.