bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preparedness of Health Care Systems for Ebola Outbreak Response in Kasese and Rubirizi districts, Western Uganda
Authors: Kibuule Michael , Sekimpi Deogratias , Agaba Aggrey , Halage Abdullah Ali , Jonga Michael , Manirakiza Leonard , Kansiime Catherine , Travis Dominic , Pelican Katharine , Rwego Innocent 
Published: June 2020

Abstract
Background
The level of preparedness of the health care workers, the health facility and the entire health system determines the magnitude of the impact of an Ebola Virus Disease (EVD) outbreak as demonstrated by the West African Ebola outbreak. The objective of the study was to assess preparedness of the health care facilities and identify appropriate preparedness measures for Ebola outbreak response in Kasese and Rubirizi districts in western Uganda.
Methods
A cross sectional descriptive study was conducted by interviewing 189 health care workers using a structured questionnaire and visits to 22 health facilities to determine the level of health care system preparedness to EVD outbreak. District level infrastructure capabilities, existence of health facility logistics and supplies, and health care workers’ knowledge of EVD was assessed. EVD Preparedness was assessed on infrastructure and logistical capabilities and the level of knowledge of an individual health work about the etiology, control and prevention of EVD.
Results
Twelve out of the 22 (55%) of the health facilities, especially health center III’s and IV’s, did not have a budget to respond to EVD. The majority (> 59%%) of the facilities did not have the following: case definition books, rapid response teams and/or committees, burial teams, simulation drills. Information on presence of personal protective equipment within 8 hours was lacking for 62% of the health facilities. All facilities (100%) did not have Viral Hemorrhagic Fever (VHF) incident management centers, isolation units, guidelines for burial, and one-meter distance between health care worker and patient during triage. Overall, 54% (n = 102) of health care workers (HCWs) did not know the incubation period of EVD. HCWs who had tertiary education (cOR = 6.36; CI = 2.05–19.66; p = 0.001), were Clinical Officers (cOR = 3.13; CI = 1.02–9.59; p = 0.046) and were Christian (cOR = 5.73; CI = 1.22–26.78; p = 0.027) were more likely to know about EVD.
Conclusions
Feedback on the level of preparedness for the rural districts helps inform strategies for building capacity of these health centers in terms of infrastructure, logistics and improving knowledge of health care workers.
The Influence of Cultural and Policy Intervention on Medical Values: Based on Chinese Theories and Empirical Research
Authors: He Wei , liu Huan , Hu Tian Tian 
Published: June 2020

Abstract
Background People's view of value medical care has taken on a great change, and then transferred to medical treatment behaviors and medical decision-making.Methods Based on the data of the Chinese Health Service Survey and the CLHLS survey database, this paper empirically tests the impact of traditional culture and policy protection on value medical care from the perspective of disease occurrence and the laws of life course.Results The results show that cultural traditions have a greater impact on the medical values of urban residents than that of rural residents, and the income level has significantly increased the level of medical expenditures one month before the end of life. Borne by the spouse or children living together or subsidized by the state or collective, the elderly who have no money to pay for the medical consumption will have a significantly lower medical expenses in the month before death. Conclusions Based on this, the article explores the importance of constructing effective health management policies and medical consumption guidance from two aspects of health value concept and value medical treatment, in order to promote people to form better medical consumption habits and health management concepts .Highlights1.In the course of illness, there are more patients who seek medical treatment in the early stages of the disease, but at the end of life there is excessive consumption of medical resources.2.The medical consumption habits in a country ’s traditional culture will affect the current decision-making for medical treatment. At the same time, medical insurance policies and public health policies will also have a greater impact on their behavior, but the formation of a valued medical concept may be more affected by traditional culture. .3.Through the research on the impact of disease occurrence law and life course law on the formation of value medical concept, it provides reliable support for promoting multi-level medical insurance system and improving the protection of basic public health policies. Policy intervention needs to combine the medical habits under the traditional culture and implement it to the supply of primary health services, guide medical consumption behavior through protection policies, control medical consumption, and enhance the value of medical consumption.
The relationship between key natural and social factors and the transmission of novel coronavirus disease 2019 in China
Authors: Lin Shengnan , Li Yaman , Rui Jia , Wang Yao , Wang Ruixin , Zhao Zeyu , Zhu Yuanzhao , Yang Meng , Xu Jingwen , Liu Xingchun , Luo Li , Chen Jingwei , Guo Dongbei , Zhao Benhua , Su Yanhua , Li Feng , Chiang Yi-Chen , Chen Tianmu 
Published: June 2020

Abstract
Background

Novel coronavirus disease 2019 (COVID-19) has become a global pandemic. This study aims to explore the relationship between key natural and social factors and the transmission of COVID-19 in China.
Methods

This study collected the number of confirmed cases of COVID-19 in 21 provinces and cities in China as of February 28, 2020. Three provinces were included in the sample: Hainan, Guizhou, and Qinghai. The 18 cities included Shanghai, Tianjin and so on. Key natural factors comprised monthly average temperatures in the January and February 2020 and spatial location as determined by longitude and latitude. Social factors were population density, Gross Domestic Product (GDP), number of medical institutions and health practitioners; as well as the per capita values for GDP, medical institutions, and health practitioners. Excel was used to collate the data and draw the temporal and spatial distribution map of the prevalence rate (PR) and the proportion of local infection (PLI). The influencing factors were analyzed by SPSS 21.0 statistical software, and the relationship between the dependent and independent variables was simulated by 11 models. Finally, we choose the exponential model according to the value of R2 and the applicability of the model.
Results

The temporal and spatial distribution of the PR varies across the 21 provinces and cities identified. The PR generally decreases with distance from Hubei, except in the case of Shenzhen City, where the converse is observed. The results of the exponential model simulation show that the monthly minimum, median, and maximum average temperatures in January and February, and the latitude and population density are significant and thus will affect the PLI. The corresponding values of R2 are 0.297, 0.322, 0.349, 0.290, 0.314, 0.339, 0.344, and 0.301. The effects of other factors were not statistically significant.
Conclusions

Among the selected key natural and social factors, higher temperatures may decrease the transmission of COVID-19. From this analysis, it is evident that if the temperature decreases by 1℃, the average PLI increases by 0.01. Further, it was established that locations at more northern latitudes had a higher PLI, and population density showed an inverse relationship with PLI.
Balloon tamponade sequentially combined with TIPS for refractory acute variceal bleeding: efficacy, safety and procedure techniques
Authors: Yang Chongtu , Liu Jiacheng , Zhou Chen , Ma Jingqiang , Song Songlin , Qian Kun , Xiong Bin 
Published: June 2020

Abstract
Background
This study aimed to evaluate the efficacy and safety of a therapeutic strategy, balloon tamponade (BT) sequentially combined with transjugular intrahepatic portosystemic shunt (TIPS), in cirrhotic patients with refractory acute variceal bleeding (AVB), and to introduce technique points of performing TIPS under BT.
Methods
Fifteen consecutive patients with refractory AVB who had been treated with balloon tamponade sequentially combined with TIPS between February 2017 and November 2019 were retrospectively analyzed. We evaluated the technical success rate, efficacy and procedure-related complications, and compared pre- and post-TIPS portal pressure gradient (PPG). Variceal rebleeding, overt hepatic encephalopathy (OHE), TIPS patency was assessed periodically and survival at 6 weeks and 1 year were recorded during follow-up.
Results
The procedure was successfully performed in all patients. Balloon was deflated during TIPS procedure in seven patients, after TIPS in three and before TIPS in five. Mean PPG decreased from 27.7 ± 4.3 mmHg to 10.7 ± 2.8 mmHg (P < 0.001). No TIPS- and balloon-related complications were observed. Two patients died during a median follow-up of 12 months (range 1–34 months). The 6-week and 1-year survival rate was 100% and 76% respectively. The incidence of OHE was 21% (3/14). The probability of remaining free of recurrent bleeding was 100%, and the probability of maintaining TIPS patency was 100%.
Conclusions
Balloon tamponade sequentially combined with TIPS should be considered an effective and safe strategy for patients with refractory AVB (especially bleeding from esophageal varices). This strategy could increase bleeding control rate and reduce the incidence of procedure-related complications and rebleeding.
Awareness about cancer in Baluchistan
Authors: Nasrullah  , Ullah Naimat , Qadir Muhammad Imran 
Published: June 2020

Abstract
Background;Propose of presence study was to evaluate the knowledge of Baluchistan’s people about cancer. Cancer is a disease which can occur at any time, any age and anywhere in the world. It is caused basically by certain types of disease, infection, mutation and due to genetic abnormalities. Method; For purpose to check the basic awareness of people of Baluchistan province (Pakistan) a randomized survey was design. Almost 1200 subjects from district Quetta, Killa Abdullah and Zhob were interviewed. Results; Results showed that people of living in urban areas had more basic awareness about cancer than other rural ones. Conclusion; It has been concluded that it is because of educational difference the awareness level is also different. As there is more educational development in urban areas as compare to rural areas so people living in rural lack basic awareness about cancer.
Bioinformatics Approach to Investigate the Genes Manifesting Alopecia Areata
Authors: Kaushal Shruti , Puri Veena 
Published: June 2020

Abstract
Background: Alopecia areata (AA) is a type of alopecia or hair loss, which is very common in human. It is classified as an autoimmune disorder, which has a variable course. It can be either relapsing or persistent type. The persistent type is seen in patients with extensive hair loss. AA affects young people most commonly with an age less than 20 years but can also concern adults. It makes up to 4% dermatology cases in China, around 2-3% in UK and USA and 0.7% in India. Patients with alopecia have social and economic suffering due to anxiety symptoms, avoidance behavior, and social anxiety disorder, making it a very important non lethal disease to study. Methods: In the present study, microarray datasets GDS5274 and GDS5272 of AA have been re-analyzed from mouse as well as human respectively. The simultaneous analysis of model organism and patient data has provided two pronged validation approach to delineate potential biomarkers of the disease. Out of 45101 genes of model organism (Mus musculus), and 54675 genes of patient (Homo sapiens), top 100 up regulated and down regulated genes were selected and further analyzed by DAVID and Enrichr tools for KEGG (Kyoto Encyclopedia of Genes and Genomes) pathways, GO (gene ontology) (cellular component, molecular function and biological process). Results: Four genes viz. CXCL9, CXCL10, STAT1 and CCL5 were differentially regulated in both organisms, hence can be considered as plausibly contributing in triggering the AA. The network and pathway analysis by PathwayLinker2.0 revealed the partners of these crucial genes i.e. CCR1, CCR5, IGFBP7, VCAN, DPP4, CCR3, CXCR3 through which these genes might coordinate to manifest hair fall.Conclusions: The dual analysis approach has helped to generate plausible novel biomarkers of the disease for diagnostic and therapeutic approach. Stimulation of any of these biomarkers by various triggers can damage hair follicle. These genes can be targeted therapeutically to halt the hair follicle damage by inhibiting their expression hence, providing novel future drug targets for AA.
Companion-Intensive Multi-aspect Weight Management in Chinese Adults with Obesity: A Six-Month Multicenter Randomized Clinical Trial
Authors: Jiang Wanzi , Ma Shuai , Huang Shushu , Gong Yingyun , Fu Zhenzhen , Zhou Li , Hu Wen , Mao Guofang , Ma Zhimin , Yang Ling , Tang Guangfeng , Sun Xiaofang , Zhang Ping , Chen Lei , Shi Bimin , Ye Xinhua , Zhou Hongwen 
Published: June 2020

Abstract
Background
Obesity is a globally increasing health epidemic requiring early lifestyle intervention. Our main objective was to examine the effectiveness of companion-intensive multi-aspect weight management (CIMWM) for Chinese adults with obesity.
Methods
In this 6-month, prospective, open-label, multicenter, randomized controlled clinical trial, we included 272 obese adults aged 18–50 years with a body mass index (BMI) ≥ 28.0 kg/m2 and capable of using smartphones. CIMWM (n = 136) offered both daily online instructions and monthly face-to-face guidance by physicians, dietitians, and health managers along with the provision of meal replacements in the first 3 months. Traditional multi-aspect weight management (TMWM, n = 136) provided monthly face-to-face guidance by the above-mentioned professionals and required daily self-monitoring. Measurements of body composition and metabolic parameters were assessed face-to-face at baseline, 1, 2, 3, and 6 months by physicians. Primary outcomes were the changes in BMI and body composition.
Results
All participants showed significantly reduced BMI, body fat mass (BFM), visceral fat area (VFA), and HOMA-IR (P < 0.05). CIMWM was shown to be superior to TMWM in the improvement of BMI, alanine aminotransferase (ALT), and the body composition parameters BFM and VFA (P < 0.05). The relationship of baseline non-alcoholic fatty liver disease score (NFS) was positively related to the skeletal muscle mass-to-visceral fat area ratio (S/V). Additionally, the weight management program was beneficial in lowering the NFS among subjects with levels in the highest tertile (P < 0.05). Metabolic memory in terms of the continuous reduction of BMI, VFA, and ALT was retained up to 6 months in spite of participants transferring to self-monitored assessment in the final 3 months.
Conclusions
The CIMWM strategy in obese Chinese adults proved to be more effective than TMWM, and motivates greater adherence to intervention and lifestyle reprogramming.
Trial registration:
ChiCTR1800017463, Registered 31 July 2018, retrospectively registry. http://www.chictr.org.cn/showproj.aspx?proj=29649
Factors Associated with Burnout among Chinese Nurses during COVID-19 Epidemic: a cross-sectional study
Authors: Wan Zhiying , Lian Mengfei , Ma Hui , Cai Zhongxiang , Xianyu Yunyan 
Published: June 2020

Abstract
Background: The COVID-19 epidemic has been outbreak and even spread to the global. The whole medical system in the world is facing great challenges. As one of the main forces, nursing staff are at the highest risk. Their negative emotions and job burnout are worthy of attention. This study aims to investigate the status of burnout and anxiety among nurses during COVID-19 epidemic and analyze the influencing factors of burnout.Methods: A cross-sectional survey was conducted from February 19 to February 25, 2020. A total of 1011 nurses from Wuhan tertiary hospitals were distributed with the basic information questionnaire, Maslach Burnout Inventory - General Survey (MBI-GS) and State-Trait anxiety inventory (STAI). The number of final valid questionnaire was 885. The effective recovery rate was 87.5%. Linear regression analysis was performed to explore the influencing factors.Results: The mean score of three dimensions of MBI-GS was 11.50, 6.02, 24.47, respectively. The mean score of state anxiety was 45.52 and trait anxiety, 43.78. Anxiety was positively related to emotional exhaustion and cynicism, and negatively to personal accomplishment. The positive factors of burnout were personnel agency, 5 years or less work experience, living in hospital dormitory, Wuhan medical team, working more than 9 hours, and the best level of knowledge of COVID-19. And having no siblings, intermediate title, working in isolation wards, 3 and more night shifts per week, living in hotels, and having confirmed or suspected medical staff around were negative factors. Conclusions: From this study, the anxiety level among nurses during the COVID-19 is serious, however, the level of burnout is mild to medium. Managers should continue to pay attention to the negative emotions of nurses and related factors, and take interventions timely to stabilize the nursing team.
More Than Smart Pavements: Connected Infrastructure for Enhanced Winter Safety and Resilience on Highways
Authors: Shi Xianming 
Published: June 2020

Abstract
Currently, there is an urgent demand for more cost-effective, resource-efficient and reliable solutions to address safety, mobility, and resilience challenges on highways enduring snowy winter weather. To address this pressing issue, this commentary proposes that the physical and digital infrastructures should be upgraded to take advantage of emerging technologies and facilitate the vehicle-infrastructure integration (VII), to better inform decision-makers at various levels. Driven by the paradigm shift towards more automation and more intelligent transportation, it is time to reimagine the vehicle-infrastructure ecosystem with the cold-climate issues in mind, and to enhance communications and coordination among various highway users and stakeholders. This commentary envisages the deployment of vehicle-to-everything (V2X) technologies to bring about transformative changes and substantial benefits in terms of enhanced winter safety and resilience on highways. At the center of the commentary is a conceptualized design of next-generation highways in cold climates, including the existing infrastructure entities that are appropriate for possible upgrade to connected infrastructure (CI) applications, to leverage the immensely expanded data availability fueled by better spatial and temporal coverage. The commentary also advances the idea that CI solutions can augment the sensing capabilities and confidence level of connected or autonomous vehicles. We then briefly explore the application scenarios of VII system, and conclude with some discussion of the paradigm shift towards V2X applications and a look to the future in terms of identified research needs in the arena of CI. We hope to inspire dialogues and synergistic collaborations among various stakeholders of the VII revolution, because the specific challenges call for systematic, holistic, and multidisciplinary approaches accompanied by concerted efforts in the research, development, pilot testing, and deployment of CI technologies.
Attachment Disorder Symptoms and Prosocial Behavior in Middle Childhood: The Role of Secure Base Script Knowledge
Authors: Cuyvers Bien , Vervoort Noortje , Bosmans Guy 
Published: June 2020

Abstract
Background: Children with attachment disorder show prosocial behavior problems. Prosocial behavior problems are an operationalization of the symptom of inhibited and emotionally withdrawn behavior in children with attachment disorder symptoms. However, the underlying mechanism between attachment disorder symptoms and prosocial behavior problems is still unclear and findings in literature are mixed.Methods: The current study investigated the role of children’s attachment representations in this association. Attachment representations reflect knowledge about a cognitive script regarding the attachment figure as a source for support (Secure Base Script). We tested whether secure base script knowledge 1) mediates or 2) moderates the link between attachment disorder symptoms and prosocial behavior problems in 67 children (6-11 years; 83.1% boys) recruited from special education schools for children with behavioral problems. Children completed a pictorial Secure Base Script Test. Their attachment disorder symptoms were assessed during an interview with the primary caregivers. Primary caregivers and teachers filled out a prosocial behavior questionnaire about the child. Results: Results did not support the mediation hypothesis, but evidence for the moderation hypothesis was found. Secure base script knowledge attenuated the negative association between attachment disorder symptoms and prosocial behavior.Conclusions: These findings contribute to the discussion about the link between attachment representations and attachment disorders.
Genome-wide Identification of the Aspergillus oryzae GATA Transcription Factor Gene Family and expression Analysis under Temperature or Salt Stresses
Authors: Jiang Chunmiao , He Bin , Zhang Zhe , Hu Zhihong , Long Chuannan , Zeng Bin 
Published: June 2020

Abstract
Background

GATA transcription factors (TFs) are transcriptional regulatory proteins that contain a characteristic type-IV zinc finger and recognize the conserved GATA motif in the promoter region. Previous studies demonstrate that GATA TFs are involved in the regulation of diverse growth processes and various environmental stimuli stresses. Although the analysis of GATA TFs involved in abiotic stress have been performed in model plants and some fungi, information regarding GATA TFs in A. oryzae is extremely poor.
Results

Therefore, we identified seven GATA TFs from A. oryzae 3.042 genome, and named AoAreA, AoAreB, AoLreA, AoLreB, AoNsdD, AoSreA in correspondence to fungal orthologs, including a novel AoSnf5 with 20-residue between the Cys-X2-Cys motifs which was found in Aspergillus for the first time. Six known A. oryzae GATA TFs were classified into six subgroups, while the novel AoSnf5 also clustered into NSDD subgroups together with AoNsdD in the NJ_tree of all Aspergillus GATA TFs. Conserved motifs demonstrated that GATA TFs with similar motif compositions clustered into one subgroup, which suggests they might have similar genetic functions and further confirms the accuracy of the phylogenetic relationship of Aspergillus GATA TFs. The expression patterns of seven A. oryzae GATA TFs exhibited diversity under temperature and salt stresses. The expression analyses of AoLreA and AoLreB demonstrates AoLreA mainly played role in salt stress and AoLreB did under temperature stress. AoSreA was shown to positively regulate the expression of AoCreA and might act as a negative regulator in temperature and high salt stress response. In addition, the AoNsdD, AoSnf5, AoAreB, and AoAreA strongly responsed to salt stresses, while AoAreB and AoAreA showed opposite expression trends at high temperature. Overall, the expression patterns of these A. oryzae GATA TFs under distinct environmental conditions provided useful information for the further analysis of GATA TFs in regulation of various abiotic stress in A. oryzae.
Conclusion

In conclusion, the comprehensive analysis data of A. oryzae GATA TFs will provide insights into the critical role of A. oryzae GATA TFs in resistance to temperature and salt stresses in A. oryzae.