bluuebunny/crossref_metadata_2025_split huggingface dataset:
How is China’s Health Development During 2012 to 2017? A Longitudinal Study Based on Comprehensive Evaluation and Linear Growth Model
Authors: Zhang Gangming , Mohammedhamid kelifa Mohammedosman , Tang Fang , Xu Jiaye , Shrestha Bhawana , Wang Peigang 
Published: May 2020

Abstract
Background: Since 2012, China has come into a new period of health development. This paper comprehensively described China’s health development and explored associated influencing factors during the last 6 years (2012-2017).Methods: Data for this study came from statistics yearbook and analysis unit were provincial regions. Comprehensive evaluation (principal component analysis and entropy weight method) was employed to calculate the comprehensive health index to evaluate the health. Then linear growth model was applied to explore factors that influenced the development.Results: Results showed that, since 2012, China’s health had a sustainable growth but inequities among provincial regions were still existing and becoming larger. For influencing factors, time was always a significant positive predictor ( ) and it was affected by geographical distributions ( ) and distance to Beijing ( ), which indicated that regions in central or far from Beijing had a lower growth. Among socioeconomics variables, urbanization level was the final factor ( ) that promoted China’s health development and caused development inequalities. Besides, health level was also influenced by the distance to Beijing ( ), regions near to Beijing had a higher health level.Conclusion: Time effect was the results of policy, during 2012 to 2017, China’s sustainable health development was brought by the policy effect and growth of urbanization level.Thus, it is crucial for one country to introduce suitable health policies and narrow the urban-rural gaps to improve its health. Distance to Beijing represented the potential political influence on health of one country’s capital due to the policy execution level which means that supervisions need to be strengthened for regions far from the capital. Besides, supports and supervisions also need to be enhanced in central regions. They were one of the reasons that caused development inequalities.
Serum concentration of polychlorinated biphenyls and risk of hepatocellular carcinoma: a case-control study in a highly polluted area in Italy
Authors: Donato Francesco , Moneda Marco , Portolani Nazario , Rossini Angelo , Molfino Sarah , Ministrini Silvia , Contessi Giovanni Battista , Pesenti Silvia , Palma Giuseppe De , Gaia Alice , Zanardini Elena , Sileo Claudio Vito , Magoni Michele 
Published: May 2020

Abstract
Background: Polychlorinated biphenyls (PCBs) are human carcinogens, based on sufficient evidence for melanoma and limited evidence for non-Hodgkin lymphoma and breast cancer. Few data are available for liver cancer, although PCBs cause it in rats and determined liver damage in poisoned people. We investigated the association between PCB serum levels and hepatocellular carcinoma (HCC) with a case-control study in a PCB-polluted area in North Italy.Methods: We enrolled prospectively 102 HCC incident cases and 102 age- and gender-matched hospital controls. Serum concentrations of 33 PCB congeners were determined by a gas chromatograph coupled to mass spectrometry.Results: Of the 102 HCC cases, 62 who had lost < 3 kg of body weight in past 3 years were included in the analysis (67.7% males, mean age 68 years). 69% of them (8% of controls) had one or more risk factors for HCC: past alcohol intake ≥60 g/day and/or HBV or HCV infection. The odds ratio (OR) for HCC for 3rd compared to 1st tertile of PCB distribution was 1.76 (95% confidence interval 0.62-5.03) for total PCB, adjusting for socio-demographic variables and risk factors for HCC by logistic regression. No differences were found restricting the analysis to HCC cases and controls with or without the main risk factors for HCC. For most PCB congeners, ORs > 1.5 or 2 were found, although the 95% CIs included the null value for almost all of them. Conclusions: This preliminary study suggests that PCBs might play a role in HCC development.Electronic word count for abstract: 252 words.
Cluster analysis of resistance combinations in Escherichia coli from different human and animal populations in Germany 2014-2017
Authors: Suwono Beneditta , Eckmanns Tim , Kaspar Heike , Merle Roswitha , Zacher Benedikt , Kollas Chris , Weiser Armin A. , Noll Ines , Feig Marcel , Tenhagen Bernd-Alois 
Published: May 2020

Abstract
Background

Recent findings on Antibiotic Resistance (AR) have brought renewed attention to the comparison of data on AR from human and animal sectors. This is however, a major challenge since the data is not harmonized. This study performs a comparative analysis of phenotypical AR data from different routine surveillance and monitoring systems in Germany. Escherichia coli data were used as a model to describe the similarities based on the resistance patterns in human and different animal populations in Germany. Method: Data on E. coli isolates were collected from 2014 to 2017 from human clinical isolates, non-clinical isolates from food-producing animals and food, and clinical isolates from food-producing and companion animals from national routine surveillance and monitoring for AR in Germany. Four antibiotics - ampicillin, cefotaxime, ciprofloxacin and gentamicin - were chosen for the analysis. Resistant isolates were defined according to EUCAST clinical breakpoints for humans. Based on the 16 possible resistance combinations to these four antibiotics, cluster analysis was performed using hierarchical clustering with Euclidian and average distance. All analyses were performed with the software “R”.
Result

Data of 333,496 E. coli isolates were included in this study. Forty-one different human and animal populations were included in the cluster analysis. Three main clusters were detected. Within these three clusters, all human populations (intensive care unit (ICU), general ward and outpatient care) showed similar relative frequencies of the resistance combinations and clustered together. They demonstrated similarities with clinical isolates from different animal populations and most isolates from pigs from both non-clinical and clinical isolates. Isolates from healthy poultry demonstrated similarities in relative frequencies of resistance combinations and clustered together. However, they clustered separately from the human isolates. All isolates from different animal populations with low relative frequencies of resistance combinations clustered together and likewise separately from the human populations.
Conclusion

Cluster analysis facilitated the comparison of phenotypical AR data across human and animal sectors. It indicated linkage among human isolates and with isolates from various animal populations based on the resistance combinations in E. coli. Further analyses based on these findings might promote a better one-health approach for AR in Germany.
Differences in clinical features of HIV/HCV co-infected individuals compared with HCV mono-infected individuals in Southern Thailand
Authors: Pongmanee Werapon , Chamroonkul Naichaya , Piratvisuth Teerha 
Published: May 2020

Abstract
Objectives

HIV/HCV co-infection is associated with more aggressive liver than HCV mono-infection. However, there are limited data in Thailand. This study was done to compare demographic data, basic laboratory results and hepatic fibrosis between HIV/HCV co-infected patients and HCV mono-infected patients in a major tertiary care center in Southern Thailand.

Methods

This was a cross-sectional single center 2-year retrospective study of HCV-treatment-naïve HIV/HCV co-infected patients and HCV mono-infected patients in Songklanagarind Hospital in Southern Thailand. The records of demographic data, basic laboratory results and hepatic fibrosis information were noted from all eligible patients.

Results

Data from 151 treatment-naïve HCV infected patients during the years 2018-2019 were collected. 51(34%) patients had HIV/HCV co-infections. Genotype 3a was predominant in HCV mono-infected patients(51%), while genotype 1a was predominant in HIV/HCV co-infected patients(35%). The median BMI in HCV mono-infected patients was higher than in HIV-HCV co-infected patients(23.1, IQR 20.3-24.8 vs 20.7, IQR 18.9-22.1, p<0.001). In multivariate analysis, HIV/HCV co-infected patients had higher alcohol consumption(AOR 24.9, p< 0.001), higher rates of unsafe sex(AOR 18.6, p=0.004) and MSM (AOR 8.48, p=0.006), and higher percents of genotype 1a(AOR 8.48, p=0.006) and HCV-RNA(AOR 2.3, p=0.035), while HIV/HCV co-infected individuals were less likely to be married (AOR 0.02, p<0.001), had higher median BMI(AOR 0.82, p=0.02), a higher rate of hepatic steatosis as assessed by controlled attenuation parameter (CAP)(AOR 0.98, p=0.02) and hepatic fibrosis as assessed by FibroScan 502(AOR 0.91, p<0.001) than HCV mono-infected patients. In HIV/HCV co-infected individuals, hepatic fibrosis as evaluated by liver stiffness measurement was not correlated with level of CD4 in our study.

Conclusions

HIV/HCV co-infected individuals were associated with genotype 1a, unsafe sex, single status and low BMI, while HCV mono-infected individuals were associated with high CAP and high hepatic fibrosis. Large-scale cohort studies are needed to confirm these results, especially hepatic fibrosis in this era of high-fat food consumption.
Cost-effectiveness analysis of initial nonoperative management versus emergency laparoscopic appendectomy for acute complicated appendicitis in Japan
Authors: Sugiura Kiyoaki , Suzuki Keiichi , Umeyama Tomoshige , Omagari Kenshi , Hashimoto Takeo , Tamura Akihiko 
Published: May 2020

Abstract
Background: Although evidence regarding the safety and efficacy of nonoperative management is growing, the best treatment strategy for acute complicated appendicitis remains controversial. In this study, we performed a cost-effectiveness analysis of operative management with emergency laparoscopic appendectomy (ELA) alone as the first-line therapy in complicated appendicitis patients in a municipal hospital in Japan.Methods: We constructed a Markov model to compare treatment strategies for complicated appendicitis with emergency laparoscopic appendectomy in otherwise-healthy adults. Health outcomes were measured in quality-adjusted life years (QALYs) gained, and cost-effectiveness was evaluated using an incremental cost effectiveness ratio (ICER). Model variables were abstracted from a literature review, and from data from the hospital records of Tochigi Medical Center. Uncertainty surrounding model parameters was assessed via one-way- and probabilistic-sensitivity analyses. Threshold analysis was performed using the willingness-to-pay threshold set at the World Health Organization's criterion of ¥12 million.Results: Operative management cost ¥677,570 per patient. Nonoperative management without interval laparoscopic appendectomy (ILA) cost ¥109,257 more than operative management and produced only 0.005 more QALYs. Nonoperative management without ILA cost ¥26,049 more than operative management, and also yielded only 0.005 additional QALYs. The ICER for both nonoperative managements were > ¥12 million/QALY in the probabilistic sensitivity analysis.Conclusions : Nonoperative management with ILA and Nonoperative management without ILA were not cost-effective strategies compared with operative management to treat complicated appendicitis. Operative management remains the standard of care, but nonoperative management deserves serious consideration as a treatment option in complicated appendicitis.
COVID-19: Repeated video-watching vs. combined video-watching and live demonstration as training to health care providers for donning and doffing personal protective equipment
Authors: Li Yongxing , Wang Yong , Li Yuhui , Zhong Ming , Liu Huihui , Wu Caineng , Gao Xiaoqiu , Xia Zhengyuan , Ma Wuhua 
Published: May 2020

Abstract
Background

During the COVID-19 pandemic, not only was there a lack of personal protective equipment (PPE) for health care workers but a dearth in training in respect of its donning and doffing. This study compared two training methods for donning and doffing PPE in order to teach health care workers how to do so more effectively and quickly.
Method

A total of 48 health care workers were recruited and randomly divided into two groups. Group A watched a 10-minute demonstration (demo) video repeated four times, while Group B watched the same demo video twice followed by a 10-minute live demo twice. The learning time of both groups was the same, and an examination was performed immediately after the completion of training. The examination scores of Group A and Group B were recorded according to the checklist (Appendix 1). The time taken for the participants to don and doff PPE, their satisfaction with the training, and the confidence to don and doff PPE were analyzed.
Results

The average score of Group B was better than that of Group A, with a mean (SD) of 94.92 (1.72) vs. 86.63 (6.34), respectively (P < 0.001). The average time spent by Group B to do the examination was shorter than that of Group A, with a mean (SD) of 17.67 (1.01) vs. 21.75 (1.82), respectively (P < 0.001). The satisfaction and confidence of Group B were higher than those of group A (P < 0.001).
Conclusions

Compared with repeated video-watching learning, the video-watching plus a live demonstration teaching method is more suitable for health care workers to learn how to put on and remove personal protective equipment.
Association between echinococcosis-specific health literacy and behavioral intention to prevent echinococcosis among herdsmen on the Tibet Plateau in China
Authors: Zhao Jie , Dawa Yangzong , Deji Cuo , Deng Bentai , Leng Bao , Li Zengyue , Chen Wanli , Wang Jiangya , Zhang Yuxin , Ake Zhong , Wang Jiwei , Shi Lizheng 
Published: May 2020

Abstract
Background

Echinococcosis is considered a neglected zoonotic disease. It has been an major worldwide health problem primarily affecting pastoral and poor rural communities with weak infrastructures, limited economic resources and poor sanitation. In general, the population in these poor areas has a low level of health literacy. This study aims to examine the association between echinococcosis-specific health literacy(ES-HL) and behavioral intention to prevent echinococcosis(BIPE) among herdsmen on the Tibet Plateauin in China.
Methods

A cross-sectional study of 401 Tibetan herdsmen was conducted in Gande country of Qinghai Province, China. Participants were recruited from August to September 2018 and from February to March 2019. A self-developed questionnaire was used to measure demographic information, ES-HL and BIPE. Hierarchical regression analysis was done to identify the factors associated with BIPE.
Results

In the hierarchical regression analysis, we entered age, sex, education level, marital state and family monthly income per capita into model 1 which explained a significant amount of variance in BIPE (Adjusted R2 change = 0.029, P = 0.006), and sex(β= -0.125, P = 0.013) and family monthly income per capita(β= -0.133, P = 0.009) were found to be associated with BIPE. Then three factors of ES-HL was added to Model 1 to create Model 2. In Model 2, the two factors of ES-HL, perceived echinococcosis information support (β = 0.229, P < 0.001) and echinococcosis-specific self-management ability (β = 0.252, P < 0.001), were significantly associated with BIPE, while the information acquisition and evaluation ability factor (β = 0.093, P = 0.089) was not found to be associated with BIPE. The model improved significantly when ES-HL was included (Model 2) explaining 25.8% of variance of BIPE(Adjust R2 change = 0.229, P < 0.001)
Conclusions

ES-HL is an important predictor of whether individuals take preventive actions against echinococcosis. ES-HL promotion action project should be developed aiming at different target population to enhance some of the specific abilities needed to prevent echinococcosis.
Multivariate Multiscale Entropy: An Approach to Estimating Vigilance of Driver
Authors: Ahammed Kawser , Ahmed Mosabber Uddin 
Published: May 2020

Abstract
This research has been done using recently introduced multivariate multiscale entropy method with a view to
estimating vigilance of drivers during driving in simulated environment. In this driving simulation experiment,
twenty one subjects including twelve men and nine women were participated. Multivariate multiscale entropy
(MMSE) has been applied to this multimodal Seed dataset for estimating vigilance from electroencephalogram
(EEG) and electrooculogram (EOG) signals in order to build a vigilance detection system. The experimental
MMSE analysis curves show statistically signi cant di erences (p < 0.01) in terms of complexity among brain
EEG signals, forehead EEG signals and EOG signals. Moreover, the di erence in the multivariate sample
entropy across all scales in awake (1.0828 0.4664), tired (0.7841 0.3183) and drowsy (0.2938 0.1664)
states are statistically signi cant (p <0.01). Also, the support vector machine (SVM), a machine learning
technique, has discriminated the cognitive states (awake, tired and drowsy) with the promising classi cation
accuracy of 76.2%. As a result, the MMSE analysis of cognitive states can be implemented practically for
vigilance detection by building a programmable vigilance detection system .
Urban Malaria Prevalence and Its Associated Risk Factors: The Case of Batu Town, East Shoa, Oromia Regional State, Ethiopia
Authors: Hassen Jifar , Dinka Hunduma 
Published: May 2020

Abstract
Background- Malaria is one of the leading causes of morbidity and mortality particularly in sub-Saharan Africa including Ethiopia. Approximately, 68% of its population is at a risk of malaria infection and nearly three-fourth of the Ethiopia landmass is considered as malarious. Most of the malaria related researches are being conducted in the rural areas; however, urban malaria should be also targeted without which malaria elimination is impossible. Therefore, the aim of this study was to assess the prevalence of malaria and its associated risk factors in Batu town, Oromia Regional state, Ethiopia.Methods – Finger pricked blood samples were collected from 356 febrile individuals visiting health facilities in Batu town from April to July, 2018 supplemented with questionnaire survey to assess socio-demographic and risk factors associated with malaria infection.Results – In the current study an overall prevalence of 17.13% (61/356) malaria infection was observed of which 50.8% (31/61) were positive for P. vivax, 45.95% (28/61) were positive for P. falciparum and 3.3% (2/61) were mixed infections of P. falciparum and P. vivax. Males (32 (9%)) were more infected with malaria than females (29 (8.2%)). Sex had no statistical significance association with malaria (χ2 = 2.026, P = 0.155). Logistic regression analysis revealed that individuals who possessed ITN (OR = 0.38, 95% CI (0.194, 0.743) and P = 0.005) and whose houses were sprayed with insecticides (OR = 0.18, 95% CI (0.097, 0.34) and P <0.001) were found less likely to get malaria infection. Individuals living closer to stagnant water had more chance of malaria infection than those who were found at a distant from stagnant water (OR = 0.34, 95% CI (0.19, 0.59) and P<0.001).Conclusion- The current study revealed that malaria is still public health problem in Batu town, which might indicate the same in other urban areas of the country. Therefore, in order to get the national picture about the prevalence of urban malaria and its associated risk factors, we recommend large scale investigation of the situation.
The importance of COVID-19 testing to assess socioeconomic fatality drivers and true case fatality rate. Facing the pandemic or walking in the dark?
Authors: Ibarra-Armenta Cristina Isabel , Alarcon-Osuna Moises Alejandro 
Published: May 2020

Abstract
Up to date, European and other developed countries became the centre of the pandemic. While the COVID-19 spread to developing countries and less developed regions, seems to be still very low. The Case Fatality Rate (CFR) differs a lot among countries, genetics, health systems, population characteristics as well as public health and social measures (lockdown measures) are believed to be the determinants of such diversity. Through an Ordinal Probit, Cross Section and Panel data models for 71 countries, it is shown that the nations applying more tests per million inhabitants are also those reporting more cases and deaths, yet greater testing helped to reduce CFR; while, health infrastructure and population health indicators could not be confirmed as drivers for CFR. The Stringency Index showed a negative correlation with the number of deaths. Our main finding is that, the pandemic concentration on developed nations is highly related with their ability and resources for tracking the pandemic. Three additional conclusions are drawn: first, the true CFR and its drivers at national levels cannot be estimated without increasing the number of tests per million inhabitants; second, there is an under-identification of cases and/or deaths and the countries applying more tests, are most clearly identifying the reality of the pandemic, while countries with less cases, are actually still walking in the dark; third lockdown measures have been effective at reducing the number of deaths.
Work motivation and job satisfaction among health workers at primary health facilities: a cross-sectional study from Nepal
Authors: Khanal Pratik , Choulagai Bishnu P , Acharya Pawan , Onta Sharad 
Published: May 2020

Abstract
BackgroundWork motivation and job satisfaction are linked with the performance and retention of health workforce. Primary health facilities, mostly comprising mid-level health workers, serve the majority of the population in Nepal. The aim of the study was to assess the determinants of job satisfaction in relation to socio-demographics, job characteristics and work motivation status among health workers working in primary health facilities. MethodsA cross-sectional study was conducted in Jhapa district in Eastern Nepal covering 40 primary health facilities. The data collection involved 151 self-administered questionnaire interviews and 16 in-depth interviews with health workers. Mean differences in work motivation among those satisfied and unsatisfied with their job was examined using t tests. Logistic regression with 95% confidence interval at p<0.05 was used for identifying associated factors with job satisfaction. Thematic analysis was done to analyze qualitative data. ResultsAmong the study participants, 78.2% were either auxiliary health workers or auxiliary nurse midwives. The median employment period of health workers was 174 months. On the 5-point Likert scale, the mean score of work motivation was highest for team work (3.99) and lowest for financial motivation (2.21). Higher age of health workers and satisfaction with career development, and financial motivation were significantly associated with job satisfaction. The qualitative findings also revealed that the majority of the health workers were not satisfied with the existing career development opportunities, availability of resources in health facility, or financial motivation. ConclusionSatisfaction with career development and financial motivation significantly increased job satisfaction among health workers. Resource availability in health facility, recognition of work and management support affected work motivation and job satisfaction of health workers. A focus on improving work environment through increased financial motivation and career development opportunities as well as investing in primary health facilities with increased resource support is recommended to improve job satisfaction.