bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Involvement of Male Partners in Care: Socio Determinants of Health Among Women in Prevention of Mother to Child Transmission Program in Malawi
Authors: Triulzi Isotta , Keiser Olivia , Somerville Claire , Salimu Sangwani , Ciccacci Fausto , Palla Ilaria , Sagno Jean Baptiste , Gondwe Jane , Marazzi Cristina , Orlando Stefano , Palombi Leonardo , Turchetti Giuseppe 
Published: June 2020

Abstract
Background
Male partners are rarely present during PMTCT (Prevention-Mother-To-Child-Transmission) services in Sub-Saharan Africa (SSA). The involvement of men is increasingly recognised as an important element of women’s access to care. The study aims to identify the socio-demographic characteristics, HIV-Knowledge, Attitude and Practice (KAP) among women accompanied and not accompanied by the male partners to the facilities.
Methods
We included pregnant women enrolled in PMTCT programme between August 2018 and November 2019 in the Southern Region of Malawi. Eligible women were aged 18 years or older, lived with a male partner, enrolled for the first time in four DREAM facilities. We provided a KAP survey to women and their partners attending the facilities. Our primary outcome was to assess and analyse the proportion of women who were accompanied by their partner at least once. We applied descriptive statistics, and logistic regressions to study the association between being accompanied and explanatory variables.
Results
We enrolled 128 HIV-positive women: 82 (64.1%) were accompanied by their male partners and 46 (35.9%) were alone. Women with high level of knowledge on HIV/AIDS are more likely to be accompanied by the male partners (53.7% vs 34.8%, p = 0.040). Level of attitude and practice were not different between women accompanied or not. Patients owning a mean of transport were more likely to go alone to facility (OR 4.16, 95% CI 1.02–16.94). Women who travelled more than 90 minutes to get to the facilities (OR 0.10, 95% CI 0.02–0.49) with high HIV-knowledge (OR 0.38, 95% CI 0.16–0.91) are more likely to be accompanied.
Conclusions
Our study showed a good male partner involvement compared to other studies performed in SSA. To our knowledge this is the first study showing that women’s knowledge on HIV and healthcare system inequality as geographical accessibility, social class, gender norms and masculinity play a key role on male partner involvement. Therefore, considering the socio determinant of health is crucial to improve the health of all the family.
A Comparison of Diagnostic Algorithms and Clinical Parameters to Diagnose Ventilator-Associated Pneumonia: A Prospective Observational Study
Authors: Rahimibashar Farshid , Miller Andrew Carl , Yaghoobi Mojtaba H. , Vahedian-Azimi Amir 
Published: June 2020

Abstract
BACKGROUND: Suspicion and clinical criteria continue to serve as the foundation for ventilator-associated pneumonia (VAP) diagnosis, however the criteria used to diagnose VAP vary widely. Data from head-to-head comparisons of clinical diagnostic algorithms is lacking, thus a prospective observational study was performed to determine the performance characteristics of the Johanson criteria, Clinical Pulmonary Infection Score (CPIS), and Centers for Disease Control and Prevention’s National Healthcare Safety Network (CDC/NHSN) criteria as compared to Hospital in Europe Link for Infection Control through Surveillance (HELICS) reference standard. METHODS: A prospective observational cohort study was performed in three mixed medical-surgical ICUs from one academic medical center from 1 October 2016 to 30 April 2018. VAP diagnostic criteria were applied to each patient including CDC/NHSN, CPIS, HELICS and Johanson criteria. Tracheal cultures and serum procalcitonin values were obtained for each patient. RESULTS: Eighty-five patients were enrolled (VAP 45, controls 41), mean age 46.94±18.9 years with a male predominance (72.94%). Using HELICS as the reference standard, the true positive (TP; sensitivity) and false negative (FN; miss rate) rates were CDC/NHSN (TP 44%; FN 0%), CPIS (TP 43%; FN 1%), Johnson (TP 43%; FN 1%). The highest true negative rate was seen with CPIS. CPIS had the highest Youden index; CDC/NHSN had the lowest. The positive tracheal culture rate was 81.2%. The sensitivity for positive tracheal culture with the serum procalcitonin level >0.5 ng/ml was 51.8%. CDC/NHSN had the highest false positive correlation with tracheal aspirate cultures. CONCLUSION: VAP remains a considerable source of morbidity and mortality in modern ICUs. The optimal diagnostic method remains unclear. Using HELICS criteria as the reference standard, CPIS displayed greater diagnostic accuracy compared to CDC/NHSN and Johanson criteria. Accuracy was improved with the addition of serum procalcitonin >0.5 ng/ml, but not positive quantitative endotracheal aspirate culture.TRIAL REGISTRATION: Not indicated for this study type.
Residents Working With Médecins Sans Frontières: Training and Pilot Evaluation
Authors: Ripoll-Gallardo Alba , Ragazzoni Luca , Mazzanti Ettore , Meneghetti Grazia , Franc Jeffrey Michael , Costa Alessandro , Corte Francesco Della 
Published: June 2020

Abstract
BackgroundWell-prepared humanitarian workers are now more necessary than ever. Essential to the preparation process are:clearly defined learning objectives, curricula tailored to the nuances of humanitarian settings, simulation-based training, and evaluation.This paper describes a training program designed to prepare medical residents for their first field deployment with Médecins Sans Frontières and presents the results of a pilot assessment of its effectiveness.MethodsThe training was jointly developed by the Research Center in Emergency and Disaster Medicine-CRIMEDIM of the Università del Piemonte Orientale, Novara, Italy, and the humanitarian aid organization Médecins Sans Frontières- Italy (MSF-Italy); the following topics were covered: disaster medicine, public health, safety and security, infectious diseases, psychological support, communication, humanitarian law, leadership, and job-specific skills. It used a blended-learning approach consisting of a 3-month distance learning module; 1-week instructor-led coaching; and a field placement with MSF. We assessed its effectiveness using the first three levels of Kirkpatrick’s training evaluation model.ResultsEight residents took part in the evaluation. Four were residents in emergency medicine, 3 in anesthesia, and 1 in pediatrics; 3 of them were female and the median age was 31 years. Two residents were deployed in Pakistan, 1 in Afghanistan, 1 in the Democratic Republic of Congo, 1 in Iraq, 2 in Haiti and 1 on board of the MSF Mediterranean search & rescue ship. Mean deployment time was 3 months. The average median score for the overall course was 5 (excellent). There was a significant improvement in post-test multiple choice scores (p = 0.001) and in residents’ overall performance scores (P = 0.000001). ConclusionResidents were highly satisfied with the training program and their knowledge and skills improved as a result of participation. Trial registration: This study was approved by the Institutional Ethics Committee (date 24-02-2016, study code UPO.2015.4.10)
Development of a repertoire and a food frequency questionnaire for estimating dietary fiber intake considering prebiotics: input from the FiberTAG project
Authors: Neyrinck Audrey M , Nazare Julie-Anne , Rodriguez Julie , Jottard Romain , Dib Sarah , Sothier Monique , Berghe Laurie Van Den , Alligier Maud , Alexiou Hélène , Maquet Véronique , Vinoy Sophie , Bischoff Stephan C , Walter Jens , Laville Martine , Delzenne Nathalie 
Published: June 2020

Abstract

BackgroundTo develop a dedicated database and food frequency questionnaire (FFQ) allowing detailed dietary fiber (DF) intake estimation including prebiotic (oligo)saccharides.MethodsA repertoire of DF detailing total, soluble DF, insoluble DF and prebiotic (oligo)saccharides (inulin-type fructans, fructo-oligosaccharides and galacto-oligosaccharides) in food products consumed in Europe has been established on basis of the German and Canadian databases and published data. A 12-month FFQ was developed and submitted to 15 healthy volunteers (mean age: 21 yrs; mean BMI: 22 kg/m2) from the FiberTAG study (https://www.fibertag.eu/).ResultsThe FiberTAG repertoire details DF and prebiotic (oligo)saccharides in 283 food items allocated into 4 categories and 15 subcategories. The FiberTAG FFQ consists in 302 items regrouped in 4 high DF-containing food groups (vegetables including legumes, fruits including nuts and seed, cereal products and others), proposes intake frequency scales, photographs for portion size evaluation and considers the seasonal occurrence for vegetables or fruits. Our data in the tested population report a total DF intake of 38 g/d (1/3 of soluble and 2/3 of insoluble DF). Fructan and fructo-oligosaccharides intake, linked notably to condiments (garlic and onions) ingestion, reached 5 and 2 g/d, respectively, galacto-oligosaccharides intake level being lower (1 g/d).ConclusionsThe FiberTAG repertoire and FFQ are major tools for the evaluation of the total amount of DF including prebiotics. Their use can be helpful in intervention or observational studies devoted to analyze microbiota-nutrient interactions in different pathological contexts, as well as to revisit DF intake recommendations as part of healthy lifestyles considering specific DF.Trial registrationNCT03494491(clinicaltrials.gov)
Deep Sedation using Propofol Target-Controlled Infusion for Gastrointestinal Endoscopic Procedures: A Retrospective Cohort Study*
Authors: GUZZO MARIA EUGENIA GARCIA , Fernandez María Sol , Novas Delfina Sánchez , Salgado Sandra S. , Terrasa Sergio A. , Domenech Gonzalo , Teijido Carlos Alberto 
Published: June 2020

Abstract
Background: Propofol sedation is effective for gastrointestinal endoscopic procedures, but its narrow therapeutic window highlights the importance of identifying an optimal administration technique regarding effectiveness and safety. This study aimed to determine the incidence of significant adverse events in adult patients scheduled for gastrointestinal endoscopy under anaesthetist-performed sedation using propofol target-controlled infusion and determine its potentially improved safety over other anaesthetic strategies. Methods: This single-centre, retrospective cohort study took place in a tertiary referral university hospital. Medical records of 823 patients (age >18 years, American Society of Anesthesiologists physical status classification scores I–III) who had undergone elective gastrointestinal endoscopy under propofol target-controlled infusion sedation during September 2018 were reviewed. Outcomes included hypoxia, hypotension, and bradycardia events, requirement of vasoactive drugs, unplanned tracheal intubation or supraglottic device insertion, and need for advanced cardiac life support. Results: The most frequently encountered adverse event was oxygen desaturation <95% with an incidence of 22.35%. Vasoactive drug administration, hypotension, and oxygen desaturation <90% followed, with incidences of 19.2%, 12.64%, and 9.92%, respectively. Only 0.5% of patients required advanced airway management. Multivariate analysis revealed an association between hypotension events, colonoscopic procedures, and propofol doses (odds ratio: 3.08, 95% confidence interval: 1.43 to 6.61; P=0.004 and odds ratio: 1.14, 95% confidence interval: 1.00 to 1.29; P=0.046). A strong dose-effect relationship was found between hypoxia and obesity; patients with body mass index ≥40 were nine times (odds ratio: 10.22, confidence interval: 95% 2.83 to 36.99) more likely to experience oxygen desaturation <90% events. Conclusions: Propofol sedation using target-controlled infusion appears to be a safe and effective anaesthetic technique for gastrointestinal endoscopic procedures with low rates of adverse events and could be more widely adopted in clinical practice.
Early fibroproliferative changes on high-resolution CT predict mortality in COVID-19 pneumonia patients with ARDS
Authors: Zeng Zhilin , Xiang Min , Guan Hanxiong , liu Yiwen , Zhang huilan , Xia Liming , Juan Zhan , Hu Qiongjie 
Published: June 2020

Abstract
Objectives: To investigate the chest high-resolution CT (HRCT) findings in coronavirus disease 2019 (COVID-19) pneumonia patients with acute respiratory distress syndrome (ARDS) and to evaluate its relationship with clinical outcome.Materials and Methods In this retrospective study, seventy-nine COVID-19 patients with ARDS were recruited. Clinical data were extracted from electronic medical records and analyzed. HRCT scans, obtained within 3 days before clinical ARDS onset, were evaluated by three independent observers and graded into six ﬁndings according to the extent of ﬁbroproliferation. Multivariable Cox proportional hazard regression analysis was used to assess the independent predictive value of the CT score and radiologically ﬁbroproliferation. Patient survival was determined by Kaplan-Meier analysis.Results: Compared with survivors, non-survivors showed higher of lung ﬁbroproliferation, whereas there no signiﬁcant differences in the area of increased attenuation without traction bronchiolectasis or bronchiectasis. A HRCT score <230 enabled prediction of survival with 73.5% sensitivity and 93.3% speciﬁcity (AUC= 0.9; 95% CI 0.831 to 0.968). Multivariate Cox proportional hazards model showed that the HRCT score is a significant independent risk factor for mortality (HR 13.007; 95% CI 3.935 to 43.001). Kaplan-Meier analysis revealed HRCT score≥230 was associated with higher fatality rate. Organ injury occurred less frequently in patients with HRCT score<230 compared to those with HRCT score≥230.Conclusion: Early pulmonary ﬁbroproliferative changes in HRCT predicts increased mortality and susceptibility to organ injury in COVID-19 pneumonia patients with early ARDS.
High Smad7 in the early post-operative recurrence of Crohn’s disease
Authors: Zorzi Francesca , Calabrese Emma , Fusco Davide Di , De Cristofaro Elena , Biancone Livia , Casella Sara , Palmieri Giampiero , Monteleone Giovanni 
Published: June 2020

Abstract
Background
In Crohn’s disease (CD), one of the major inflammatory bowel disease (IBD) in human beings, there is over-expression of Smad7, an intracellular inhibitor of the suppressive cytokine TGF-β1. The aim of this study was to assess whether Smad7 over-expression occurs in the early and/or late phases of CD.
Methods
Mucosal samples were taken from the neo-terminal ileum of CD patients undergoing ileocolonic resection, with or without (early CD) post-operative endoscopic recurrence, and terminal ileum of CD patients with long-standing disease undergoing intestinal resection (late CD). Smad7 was examined by immunohistochemistry and cytokine expression was analysed by flow-cytometry.
Results
Before the appearance of endoscopic lesions, the mucosa of the neo-terminal ileum contained high number of Smad7-expressing cells in both the epithelial and lamina propria compartments. Transition from this stage to endoscopic recurrence was marked by persistence of high number of Smad7-positive cells, which reduced significantly in the late stages of the disease, where Smad7 expression remained, however, greater than that seen in normal controls. In samples with early lesions, Smad7 expression positively correlated with the number of interferon-γ-secreting cells.
Conclusions
Smad7 induction is an early event in the inflammatory sequence occurring in CD, thus suggesting that knockdown of Smad7 can help prevent post-operative recurrence.
Predictive Accuracy of Biomarkers for Survival Among Cardiac Arrest Patients With Hypothermia: A Prospective Observational Cohort Study in Japan
Authors: Okada Yohei , Kiguchi Takeyuki , Irisawa Taro , Yoshiya Kazuhisa , Yamada Tomoki , Hayakawa Koichi , Noguchi Kazuo , Nishimura Tetsuro , Ishibe Takuya , Yagi Yoshiki , Kishimoto Masafumi , Shintani Hiroshi , Hayashi Yasuyuki , Sogabe Taku , Morooka Takaya , Sakamoto Haruko , Suzuki Keitaro , Nakamura Fumiko , Nishioka Norihiro , Matsuyama Tasuku , Matsui Satoshi , Shimazu Takeshi , Koike Kaoru , Kawamura Takashi , Kitamura Tetsuhisa , Iwami Taku 
Published: June 2020

Abstract
Background:There is little information onthe predictive accuracy of commonly used predictors, such as lactate,pH or serum potassium for the survival among out-of-hospital cardiac arrest (OHCA) patients with hypothermia. This studyaimed to identify the predictive accuracy of these biomarkers forsurvival among OHCA patients with hypothermia.Methods: In this retrospective study, we analyzed the data from a multicenter, prospective nationwide registry among OHCA patients transported to emergency departments in Japan (the JAAM-OHCA Registry). We included all adult (≥18 years) OHCA patients with hypothermia (≤32.0°C)who were registeredfrom June 2014 to December 2017and whose blood test results on hospital arrival were recorded. We calculated the predictive accuracy of pH and lactate for 1-month survival.Results: Of the 34,754 patients in the JAAM-OHCA database, we included 754 patients from 66 hospitals. The 1-monthsurvival was 5.8% (44/754). The areas under the curve of the predictors were as follows: pH 0.829[0.767–0.877] and lactate 0.843[0.793–0.882]. On setting the cutoff points of 6.9 in pH, and 120 mg/dL (13.3 mmol/L) in lactate, the predictors had a high sensitivity (lactate: 0.91, and pH 0.91) and a low LR- (lactate: 0.14 and pH 0.13), which are suitable to rule-out 1-month survival.Conclusion: Among adult OHCA patients with hypothermia, pH 6.9 and lactate 120 mg/dLcan predictivelyrule out 1-month survival.
Relationships of Family Food Environment with Food and Nutrition Literacy in Chinese School-Age Children
Authors: Li Niuniu , Su Xiao , Liu Tan , Sun Jing , Zhu Wenli 
Published: June 2020

Abstract
Background Eating behavior is influenced by multiple factors and understanding the interplay of these factors is necessary to promote children’s healthy food choices. This study investigated the relations of family food environment (FFE) factors with food and nutrition literacy (FNL) in Chinese school-age children.Methods A total of 605 children aged 7 ~ 13 years from grade 1 to 5, and their caregivers participated in the cross-sectional study in Beijing of China during April 2019. The FFE was assessed by the validated Family Food Environment Questionnaire for Chinese School-age Children (FFEQ-SC). For the children of grade 3 to 5 (n = 260), the FNL, including cognitive and skill domains, was assessed by Food and Nutrition Literacy Questionnaire for Chinese School-age Children (FNLQ-SC). Both FFEQ-SC and FNLQ-SC were developed firstly for Chinese school-age children and had good reliability. The anthropometric data (height and weight) was derived from local health information management system for primary schools.Results Overall, 68.9% of the children’s families had higher level of FFE. The total FNL score of 260 children from grade 3–5 was 63.23 ± 10.32. Comparison of children’s FNL score among different levels of FFE showed the children with higher level of FFE, especially higher level of caregiver’s educational degree and FNL, were more likely to have significant higher FNL scores (P < 0.05). The multivariate analysis showed the children’s total FNL score was significantly related with family caregiver (β= -0.123, P = 0.04) and caregiver’s nutritional literacy (β = 0.210, P = 0.002). Furthermore, the children with higher level of caregiver’s nutritional knowledge were less likely to be overweight or obesity (OR = 0.043, P = 0.04).Conclusions and Implications: Family food environment, especially caregivers’ FNL, were significantly related with children’s FNL, even the risk of overweight. These findings highlight the importance of targeting nutritional knowledge of family caregivers to facilitate the children’s FNL to maintain good health.
Sheltered homeless adults use more shelter services, have fewer health risk factors, and report lower stress than unsheltered adults
Authors: Ra Chaelin Karen , Hebert Emily , Alexander Adam , Kendzor Darla , Suchting Robert , Businelle Michael 
Published: June 2020

Abstract
Background: In the United States, approximately 568,000 individuals are homeless on a single night. Homelessness can be categorized into three subgroups: sheltered homeless, unsheltered homeless, and unstably housed. Few studies have examined the relations between homelessness subtypes, shelter service utilization, levels of stress experienced, and health risk factors. Methods: Data were collected at multiple homeless shelters in 2016 in the Oklahoma City area (N=575). Multiple linear and logistic regression analyses were conducted to examine relations between homelessness subgroups and outcomes.Results: Results indicated that the sheltered group was younger and more likely to be White than the unsheltered group, and had higher levels of education than the unstably housed group. In addition, unsheltered homeless and unstably housed adults used fewer shelter-based health services, exhibited more health risk factors, experienced greater levels of stress, and had higher levels of food insecurity than sheltered homeless adults.Conclusions: Homeless adults who reside at shelters benefit most from available shelter services. The development of policies and programs targeted toward increasing sheltering options for unsheltered and unstably housed adults is needed.
Transfer learning based ensemble support vector machine model for automated COVID-19 detection using lung computerized tomography scan data
Authors: Singh Mukul , Bansal Shrey , Ahuja Sakshi , Dubey Rahul Kumar , Panigrahi Bijaya Ketan , Dey Nilanjan 
Published: June 2020

Abstract
The novel discovered disease coronavirus popularly known as COVID19 is a lung infection disease that causes adverse effects on the human respiratory system. It is caused due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and declared a pandemic by the World Health Organization (WHO). For COVID-19 detection, chest radiography, i.e., computerized tomography(CT) scan, X-rays, etc. are widely investigated. In the proposed work, a deep learning model, i.e., truncated VGG16(Visual Geometry Group from Oxford) is implemented to screen COVID-19 CT scans. The VGG16 architecture is fine-tuned and used to extract features from CT Scan images. Further Principal Component Analysis (PCA) is used for feature selection. The final classification is performed using four different classifiers, namely deep convolutional neural network(CNN) , Extreme Learning Machine (ELM), Online sequential ELM, and Bagging Ensemble with support vector machine (SVM) . The best performing classifier Bagging Ensemble with SVM within 385 ms achieved an accuracy of 95.7%, precision of 95.8%, Area Under Curve (AUC) of 0.958, and an F1 score of 95.3% on 208 test images. The results obtained on diverse datasets prove the superiority and robustness of the proposed work in comparison to the techniques available in the literature.