bluuebunny/crossref_metadata_2025_split huggingface dataset:
Socioeconomic Disparities in Drugs and Substance Abuse: results from a Household Cross-sectional Survey in Murang’ a County, Kenya
Authors: Were Vincent Omondi , Okoyo Collins Omondi , Araka Sylvie Biyaki , Kanyi Henry Muriuki , Echoka Elizabeth Echoka , Mwandawiro Charles , Njomo Doris Wairimu 
Published: June 2020

Abstract
IntroductionDrugs and substance abuse has adverse health effects and substantial economic burden to the global economies and at the household level. There is, however, limited data on socio-economic inequalities disparities in drugs and substance abuse in low-to-middle income countries such as Kenya. This study aimed to assess the socio-economic inequalities in a selected county of central Kenya.MethodThe study design was cross-sectional, and data collection was conducted between November and December 2017. A total of 449 households with a least one person who uses any drugs or substance of abuse were randomly sampled from 4 purposively selected sub-locations of Murang’ a County, central Kenya. Structured questionnaires were used to collect data on types of drugs used, economic burden, and gender roles at the household level. Household socio-economic status (SES) was established ( low, middle, and high SES ) using principal component analysis f(PCA) from a set of household assets and characteristics. Multivariate logistic regression analysis was used to assess the association between SES, gender, and other factors on the uptake of drugs and substance of abuse.ResultsIndividuals in higher SES were more likely to use cigarettes ( OR = 2.13; 95%CI = 1.25–3.61, p = 0.005) or piped tobacco (OR = 11.37; 95% CI, 2.55–50.8; p-value = 0.001) than those in low SES. The wealthier individuals were less likely to use legal alcohol (OR = 0.39; 95%CI = 0.21–0.71, p = 0.002) than the poorest individuals. The use of prescription drugs did not vary with SES. A comparison of the median amount of money spent on acquiring drugs showed that richer individuals spent a significantly higher amount than the poorest individuals (Ksh 1500 vs. Ksh 1000, p = 0.0310). Deaths related to drugs and substance abuse were more likely to occur in middle SES than amongst the poorest households (OR = 2.96; 95%CI = 1.03–8.45).ConclusionSocioeconomic disparities exist in the use of drugs and substance abuse. The low-income individuals are at a higher risk of abuse and thus of economic burden due to catastrophic expenditure in acquiring the drugs. Cases of deaths were likely to occur in middle-income groups. Strategies to reduce drugs and substance abuse must address socio-economic inequalities through targeted approaches to individuals in low-income groups.
Access to health care for gaming disorder: A patient-centred approach to address the continuum of need
Authors: Park Jennifer J , Wilkinson-Meyers Laura , King Daniel L , Rodda Simone 
Published: June 2020

Abstract
Background

Problematic gaming, including its most serious form known as gaming disorder (GD) in the ICD-11, affects approximately 1–3% of the population and can have significant negative impacts on health and wellbeing. Research to determine the optimal health system responses to GD remains limited. This study aimed to identify and describe the key components of a patient-centred approach to prevention, early intervention, and treatment of GD.
Methods

Online interviews were conducted with 20 adults (90% male; Mage=23y) currently seeking help for GD-related issues. The interview protocol was guided by a health care access framework which investigated participants’ experiences and needs related to accessing professional support. Transcripts were analysed in Nvivo using qualitative content analysis to systematically classify participant data into the themes informed by this framework.
Results

Although the characteristics and resultant harms of GD were broadly recognised, participants indicated that these issues may not always be viewed by healthcare providers as a serious problem that requires intervention or that could be addressed through treatment. This highlights a significant barrier to access at the beginning of the patient journey when patients may perceive that they have a legitimate need for care and seek a relevant, tailored, and safe service to meet this need. Participants described the essential components of an effective health service for GD as including: valid and reliable screening tools for GD; practitioners with specialist knowledge of GD that includes, or is strongly informed by, lived experience of peers; and access to a multimodal system of intervention, including web-based and face-to-face options that allow gamers to transition between types and intensity of support.
Conclusion

A comprehensive health care approach for gaming disorder is currently in its infancy and there are numerous service access and delivery issues still to be resolved. This study highlights the importance of involving individuals with GD in developing solutions that are fit for purpose and address the spectrum of intervention needs. These findings recommend a stepped GD healthcare system that adheres to evidence-based practice tailored to each individual and the implementation of standard assessment and routine outcome monitoring.
Covid-19 Social Distancing Interventions by State Mandate and Their Correlation to Mortality
Authors: mccafferty sean , ashley sean 
Published: June 2020

Abstract
Purpose

Evaluate the correlation between state mandated social interventions and Covid-19 mortality

Design

Prospective design and retrospective analysis of Institute for Health Metrics and Evaluation (IHME) state data.

Methods

Twelve European Union countries were selected on April 12, 2020 from IHME data which had clearly defined and dated establishment of statewide mandates for social distancing measures to include: School closures, stay at home orders, severe travel restrictions, and closure of non-essential businesses. The state Covid-19 mortality prevalence was defined as total normalized deaths to the peak daily mortality rate. The state mortality prevalence was correlated to the total number of mandates-days from their date of establishment to the peak daily mortality date. The slope of the maximum daily mortality rate was also correlated to mandate-days.

Results

The slope of standardized mortality per country did have a slight negative correlation to the total mandate days (R2 = 0.083, p= 0.36), though the negative correlation was not statistically significant. The standardized mortality prevalence to the peak mortality rate per country exhibited no discernable statistical correlation to the total mandate days (R2 = 0.004,p=0.85).

Discussion

The analysis appears to suggest a mandate effective reduction in the slope of the mortality rate, but no effective reduction in Covid-19 mortality to its defined initial peak when interpreting the mean-effect of the mandates as present in the data. The study is presented as a potential methodology to evaluate the effectiveness of state mandated social distancing policy.
Characteristics of Subtypes Within Microsatellite Instability-high Gastric Cancer Based on a Gene Signature Related to Immune Microenvironment Components
Authors: Wu Xiaolong , Gao Xiangyu , Xing Xiaofang , Wen Xianzi , Li Ziyu , Ji Jiafu 
Published: June 2020

Abstract
Background: Gastric cancer patients with microsatellite instability-high (MSI-H) status have a better clinical prognosis and higher response rate to immune checkpoint inhibitors. However, recent studies have suggested that some molecular pathways in MSI-H tumors could affect tumor immune microenvironment (TIME) components, thereby leading to immunotherapy resistance. We aimed to establish subtypes based on the TIME components of MSI-H gastric cancer and analyze the characteristics of each subtype. Methods: Cohorts from the Cancer Genome Atlas, the Asian Cancer Research Group, and Peking University Cancer Hospital were used for this study. CIBERSORT software was used to analyze the TIME components. A set of genes based on the TIME component characteristics, which we named the MSI-TIME signature, was defined using k-means cluster and differentially expressed gene analysis. Results: By using the MSI-TIME signature in the aforementioned cohorts for cluster analysis, the TIME subtypes within MSI-H gastric cancer (MSI-S1, MSI-S2) were established; the differences between the subgroups were reflected in multiple aspects. The MSI-S1 subtype was characterized by a high density of CD8+ T cells, high expression levels of immune checkpoint molecules including PD-L1, PD-L2, CTLA-4, and a high T-cell inflammation level. Patients with the MSI-S1 subtype could also benefit from adjuvant chemotherapy. In contrast, the WNT/β-catenin pathway was enriched in the MSI-S2 subtype. Conclusion: We found that patients with MSI-H gastric cancer showed very different TIME characteristics and could be divided into two subtypes accordingly. These results might benefit MSI-H gastric cancer patients developing individualized treatment strategies in the future.
A preliminary study of quantitative analysis of tissue perfusion using contrast-enhanced ultrasound in the evaluation of the severity of acute pancreatitis
Authors: Li Liang , Xu Xin , Wang Guangxia , Cui Yunfeng 
Published: June 2020

Abstract
Background

Acute pancreatitis (AP) is a lethal disease with high mortality. Early diagnosis and evaluation of the severity of pancreatitis is crucial for the prevention a treatment of AP. The clinical value of contrast-enhanced ultrasound (CEUS) in evaluating the severity of acute pancreatitis by quantitative analysis of the tissue perfusion and the areas of pancreatic parenchymal necrosis is little known.
Methods

60 acute pancreatitis patients (AP group) and 30 volunteer (control group) were selected, the AP group was further divided into subgroup, the mild acute pancreatitis (MAP) group and the severe acute pancreatitis (SAP) group. All received CEUS examination, the differences of the parameters of time-intensity curve (TIC) between group AP and Control were analyzed. The receiver operating characteristics (ROC) curve of CEUS in diagnosing AP and SAP were drew, then calculated the best cut-off point of CEUS for the diagnosis of AP.
Results

Compared to group Control, there was a marked increase in AT and TTP, while a dramatic decrease in PI and AUC in group AP (all P < 0.05), no significant difference of WT and S was observed. After analysis of PI and AUC of those two subgroup AP patients, it was much higher in MAP group than SAP group, in contrast, the TTP decreased markedly(all P < 0.05), no significant difference of AT,WT and S was found. Next, we found that the sensitivity, specificity and diagnostic coincidence rate were 96.7%, 73.3% and 85.0% respectively, when the AUC ≤ 727.2dBs was used as the standard for the diagnosis of AP; and the sensitivity, specificity and diagnostic coincidence rate were 93.3%, 73.3%, and 83.3%, respectively when PI ≤ 11.41 dB was used as the standard for the diagnosis of SAP. Finally, we found that there was no significant difference in the detection of pancreatic parenchymal necrosis between CEUS and contrast-enhanced computed tomography (CECT).
Conclusions

CEUS could provide an objective and powerful basis for the early diagnosis of SAP, and also detect necrotic areas of pancreatic parenchyma early, quickly and accurately, which provide an available tool for clinic to early detection and assessment of the severity of acute pancreatitis.
Influence of Fossil Shell Flour Supplementation on Feed Preference, Body Condition Scores and Wool Parameters of Dohne Merino Wethers
Authors: Ikusika Olusegun , Mpendulo Conference Thando , Fon Fabian Nde , Zindove Titus Jairus , Okoh Anthony 
Published: June 2020

Abstract
Background: The abundance of fossil shell flour (FSF) globally has resulted in an increased interest in its use as a feed additive in sheep diets. This study evaluated the effects of varying inclusion levels of FSF on feed preference, body condition scores and wool parameters of Dohne Merino (DM) wethers. Methods: Twenty-four wethers, weighing 20 ± 1·5 kg on average were fed dietary food-grade fossil shell flour in a completely randomized design of four treatment with six wethers in each treatment. The wethers were fed a basal diet without FSF addition (control, 0%), or with the addition of FSF (2%, 4% or 6%) into the diet for 105 days.Results: Average daily weight gain and body condition score of 2%, 4% and 6 % FSF inclusion levels were higher (P < 0.05) than the control 0%. Wool yield, staple length, coefficient variation of the fibre diameter and fibre <15% of wethers supplemented with FSF were higher (P < 0.05) compared to the diet without FSF. Fibre diameter of the wethers supplemented with FSF were the same (P>0.05) as the control.Wethers preferred FSF supplemented diets to the control. The inclusion of FSF in the diet of DM wethers up to 6% DM showed improvement in the average daily gain and body condition scores, feed intake through preference, wool yield, and quality. Conclusion: The addition of FSF in the diets could be advantageous in Dohne-Merino wethers performance and production with the potential of increasing both the quantity and quality of wool.
Perianal and Perineal Rhabdomyosarcomas - A Retrospective Multicenter Study of 35 Cases
Authors: Guo Yaoyu , Hu Bang , Huang Dandan , Wang Xinhua , Li Juan , Zhang Di , Li Xueying , Chen Gong , Ren Donglin 
Published: June 2020

Abstract
Purpose: Perianal/perineal rhabdomyosarcoma (PRMS) is rare, easy to be misdiagnosed and has poor prognosis. This study was designed to analyze the clinical, diagnostic, pathological and prognostic features of PRMS, and to explore its therapeutic modality.Methods: Clinical data of PRMS patients in the Sixth Affiliated Hospital and the Cancer Center of Sun Yat-sen University and related Chinese literatures published between 1987 and 2018 were described and analyzed. Chi-square test was used to test the differences between groups. The Kaplan-Meier methods were used to estimate and compare survival rates.Results: 35 patients, 20 identified in the Chinese literatures and 15 of our center from 1997 to 2019, were included in this study. 34 cases presented as perianal mass and one presented as inguinal mass. 20 patients complained about pain and 16 cases were misdiagnosed as perianal abscess, in which pain was found related to misdiagnosis (p＜0.05). The average time from symptoms to pathological diagnosis was 3.1 months. 13 cases were categorized into IRS group III/IV and 20 cases into stages 3/4. 14 Cases were diagnosed as embryonal rhabdomyosarcoma pathologically and 9 as alveolar rhabdomyosarcoma. Five patients survived for more than two years, three of them survived for more than five years. The overall survival rates of two years and five years were 32% and 24% respectively, in which misdiagnosis contributes to poor prognosis (p＜0.05). MRI showed that PRMS was closely related to external anal sphincter in 10 cases. Conclusion: PRMS is easy to be misdiagnosed, which could lead to worse outcome. Patients with painful perianal mass should be evaluated to exclude PRMS. MRI shows PRMS is closely related to external anal sphincter. Comprehensive therapy including radical operation and chemotherapy is recommended.
Association Between Dietary Diabetes Risk Reduction Score and Chronic Kidney Disease in Adults: Tehran Lipid and Glucose Study
Authors: Asghari Golaleh , Mirmiran Parvin , Ramezan Marjan , Farhadnejad Hossein , Tahmasebinejad Zhaleh , Azizi Fereidoun 
Published: June 2020

Abstract
Aims: To examine the association of dietary diabetes risk reduction score (DDRRS) with chronic kidney disease (CKD) among an Iranian population.Methods: We followed-up 2076 ≥ 20 years old participants of Tehran Lipid and Glucose Study (2006-2008), who were initially free of CKD for 5.98 years. Dietary diabetes risk reduction score was calculated on the basis of scoring eight components using a valid and reliable 168-item food frequency questionnaire. CKD was deﬁned as estimated glumerular filtration rate (eGFR) <60 mL/min/1.73 m2. A Cox proportional hazard regression model was used to assess association between the quartiles of DDRRS and incidence of CKD.Results: Mean ± SD age of the study population (53% women) was 37.6 ± 12.61 years. A total of 357 incident cases of CKD were reported. The median (25-75 interquartile range) of DDRRS was 20 (18-22). After adjustment for age, sex, smoking status, total energy intake, body mass index, hypertension, diabetes, eGFR, and physical activity, individuals in the highest versus lowest quartile of DDRRS were 33% less likely to have CKD (OR: 0.67; 95% CI: 0.48-0.96, P for trend: 0.043).Conclusion: Our findings suggest an inverse association between DDRRS and risk of incident CKD in the fourth versus first quartile of DDRRS.
The magnitude and associated factors of Helicobacter pylori infection among adult dyspeptic patients attending Bokoji Hospital, Southeast Ethiopia
Authors: Kenea Dagaga , Negawo Mesfin , Lemessa Firaol , Tejineh Solomon 
Published: June 2020

Abstract
Background: Helicobacter pylori infection is the most common chronic bacterial infection and there were approximately 4.4 billion individuals with H pylori infection worldwide. Among those, hundreds of millions of people develop peptic ulcer disease during their lifetime and still tens of millions might progress to gastric cancer. Hence, early information is very important to prevent upper gastrointestinal complications. Consequently, the current study aimed to assess the magnitude and associated risk factors of Helicobacter pylori infection among adult dyspeptic patients attending Bokoji hospital, Southeast Ethiopia. Methods: A hospital-based cross-sectional study involving 348 adult dyspeptic patients attending Bokoji hospital was carried out from July 16 to October 31, 2019. About 50 mg of fresh stool and 60 µl of capillary blood were collected from each dyspeptic patient and analyzed for detection of Helicobacter pylori antigens, presence of intestinal parasites and ABO blood grouping respectively. Data were entered using Epi Info 7 and Statistical analysis was done using SPSS version 21 and a p-value less than 0.05 was considered as statistically significant. Results: The overall magnitude of Helicobacter pylori infection was 47.7%. The magnitude of H. pylori infection was almost two times higher in patients who do not have a habit of handwashing after toilet visit than those who wash their hand's habit of handwashing after visiting toilet (AOR 2.241, 95% CI (1.410, 3.563) and alcohol drinking habit (AOR 1.796, 95% CI (1.087, 2.968). Conclusions: The magnitude of H. pylori was high in the study area and associated with handwashing habits after toilet use and alcohol drinking habits. Therefore, the community could be educated on the handwashing habit to minimize H. pylori infections.
A Novel Five-gene Signature Predicts Overall Survival in Hepatocellular Carcinoma
Authors: Wang Zhigang , Pan Leyu , Guo Deliang , Luo Xiaofeng , Tang Jie , Yang Weihua , Gu Yang , Pan Yuxuan 
Published: June 2020

Abstract
Background: Hepatocellular carcinoma (HCC) is one of the most common challenges for public health worldwide. Due to its complex molecular and great heterogeneity, the effectiveness of existing HCC risk prediction models is unsatisfactory. Hence, more accurate prognostic models are pressingly needed. Materials and methods: Differentially expressed mRNAs (DEMs) between HCC and normal tissues were identified after downloading GSE1450 from gene omnibus (GEO) database. We randomly divided all patients into training and testing sets. Univariate Cox regression, lasso Cox regression and multivariable Cox regression analysis were used to constructed the prognostic gene signature in training set. Our study utilized Kaplan-Meier plot, time-dependent receiver operating characteristic (ROC), multivariable Cox regression analysis with clinical information, nomogram and decision curve analysis (DCA) to evaluate the predictive ability for overall survival of the novel gene signature in training, testing and whole sets. We also validated the prognostic capacity of the five-gene signature in an external validation set. The information of mutation of each gene was explored on cBioPortal online website. We performed gene set enrichment analysis (GSEA) to explore underlying mechanisms in the high and low risk group. Finally, quantitative real-time PCR was conducted to validate the expression tendency between 12 paired HCC and adjacent normal tissues. Results: Our study constructed a novel five-gene signature (CNIH4, SOX4, SPP1, SORBS2 and CCL19) for predicting overall survival of HCC. Time-dependent ROC curve indicated admirable ability in survival prediction in two datasets. Multivariable Cox regression analysis indicated that both this five-gene signature and TNM stage were two independent prognostic factors for overall survival of HCC patients. Combined with TNM stage clinical pathological parameters, the predictive capacity of nomogram had a decent improvement. The mutation of the five genes had no obvious variation. Plenty pathways were enriched by GSEA, including cell cycle and various metabolism. Furthermore, the mRNA levels of these five genes had signiﬁcantly diﬀerent expressions between HCC tissues and adjacent normal tissues by quantitative real-time PCR. Conclusions: A five-gene prognostic model and nomogram were constructed and validated for predicting prognostic of HCC patients. And the five-gene risk score with TNM stage models might help various HCC patients to customize individual therapies.
Purposeful collaboration: Enriching lives for people with Parkinson’s disease
Authors: Carroll Vincent , Deutschmann Kirsten , Andrews Jessica 
Published: June 2020

Abstract

This project was presented at the 2018 ANNA conference. Funding to support the author’s conference attendance was received from Parkinson’s New South Wales and Mid North Coast Local Health District.

Background: Individuals with Parkinson’s disease (PD) have more hospital admissions, longer hospital stay, more complications and worse outcomes compared with similar patients without PD. Limited understanding about PD among healthcare professionals and medication management are key issues for individuals with PD.

Methods: This study presents a collaborative clinical practice improvement project that was implemented in a hospital in New South Wales, Australia (September 2015 to May 2018) to resolve issues for patients with PD on admission to hospital. Innovative interventions were implemented to address specific issues identified in the study setting, including an emergency department patient tracking icon, early referral to pharmacists and measures to ensure on-time medication administration and avoidance of contraindicated medications. Qualitative and quantitative data were collected through focus group discussions with PD support group members, surveys involving nurses and patients/carers and a chart audit. Data were analysed using descriptive statistics.

Results: These initiatives resulted in practice improvements including identification of 100% of patients with PD presenting/admitted to hospital within 4 hours of presentation/admission, a 19% increase in patients receiving medications on time, an 89% reduction in prescription of contraindicated medications and reduced length of hospital stay. In addition, 80% of patients/carers reported they were very satisfied with their medication management.

Conclusion: Patient safety was improved and clinical staff expressed satisfaction with care provision. The initiatives were also standardised across the hospital in a clinical guideline for the care of patients with PD.