bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tuberculosis Diagnosis Cascade in Blantyre, Malawi: A Prospective Cohort Study
Authors: Feasey Helena R A , Corbett Elizabeth L , Nliwasa Marriott , Mair Luke , Divala Titus H , Kamchedzera Wala , Khundi McEwen , Burchett Helen E D , Webb Emily L , Maheswaran Hendramoorthy , Squire S Bertel , MacPherson Peter 
Published: November 2020

Abstract
Background: Tuberculosis (TB) control relies on early diagnosis and treatment. International guidelines recommend systematic TB screening at health facilities, but implementation is challenging. We investigated completion of recommended TB screening steps in Blantyre, Malawi.Methods: A prospective cohort recruited adult outpatients attending Bangwe primary clinic. Entry interviews were linked to exit interviews. The proportion of participants progressing through each step of the diagnostic pathway were estimated. Factors associated with request for sputum were investigated using multivariable logistic regression.Results: Of 5,442 clinic attendances 2,397 (44%) had exit interviews. In clinically indicated participants (n=330) 203 (61.5%) were asked about cough, 35 (10.6%) of those were asked for sputum, 24 (7.3%) gave sputum and 1 (0.3%) received same-day results. Significant associations with request for sputum were: any TB symptom (aOR:3.20, 95%CI:2.02-5.06), increasing age (aOR:1.02, 95%CI:1.01-1.04 per year) and for HIV-negative participants only, a history of previous TB (aOR:3.37, 95%CI:1.45-7.81). Numbers requiring sputum survey (20/day) outnumbered diagnostic capacity (8-12/day).Conclusions: Patients were lost at every stage of the TB care cascade, with same day sputum submission following all steps of the diagnosis cascade achieved in only 7.3% if clinically indicated. Infection control strategies should be implemented, with reporting on early steps of the TB care cascade formalised. High-throughput screening interventions, such as digital CXR, that can achieve same-day TB diagnosis are urgently needed to meet WHO End TB goals.
Evaluation the Expression of Efflux Pump Genes “Tap &amp; P55 in Mycobacterium Tuberculosis Clinical Isolates in Fars, Iran
Authors: Khoob Fardis , Abadi Milad Shahini Shams , Hadi Nahal , Avazzadeh Farzaneh , Zarei Zahra 
Published: November 2020

Abstract
BackgroundThe increasing drug resistance in Mycobacterium tuberculosis isolates has become a global problem for tuberculosis therapy programs. Genetic mutations in rifampin (RIF), one of the key drugs in the treatment of tuberculosis are main mechanism of resistant to this drug in M. tuberculosis. Absence of mutation in target genes, other mechanisms such as efflux pump suggests possible role of drug resistant.The objective of this study was to find out mutations in rpoB genes in rifampin resistant isolates and to compare the expression level of tap and p55 efflux pump genes in non mutated isolates, mutated isolates in rpoB genes and susceptible isolates.MethodsIn this study, antimicrobial sensitivity test on first line drugs was performed on 200 M. tuberculosis isolates, obtained from TB center in Shiraz (IRAN) and genetic mutations were evaluated in rpoB gene in RIF resistant isolates by multiplex PCR, followed expression level evaluated by Real-time PCR.Resultsout of the 200 isolates tested, 23 (34.33%) showed resistant to RIF. 12 of 23 RIF resistant isolates have mutation in rpoB gene, and frequency of mutations in codons 516, 526 and 531 were 3 (25%), 4 (33.33%) and 5 (41.67%) respectively. The expression level of tap and p55 genes was considerably higher in resistant isolates which had no mutation compared to the expression level of genes in the isolates which had mutation in target genes.Conclusion﻿The accumulating data suggest the probable role of efflux pump in M. tuberculosis drug resistance, the validation of data needs further phenotypic assays of these pumps.
Effects of Early Corticosteroid Use in Patients With Severe Coronavirus Disease 2019: A Case Control Study
Authors: Hyun JongHoon , Kim Moo Hyun , Sohn Yujin , Cho Yunsuk , Baek Yae Jee , Kim Jung Ho , Ahn Jin Young , Choi Jun Yong , Yeom Joon Sup , Ahn Mi Young , Kim Eun Jin , Baek Ji-Hyeon , Kim Young Keun , Choi Heun , Jeong Su Jin 
Published: November 2020

Abstract
BackgroundCoronavirus disease 2019 (COVID-19) is associated with acute respiratory distress syndrome, and corticosteroids have been considered as possible therapeutic agents. However, there is limited literature on the appropriate timing of corticosteroid administration to obtain the best possible patient outcomes.MethodsA retrospective multicenter study was designed to explore the effects of early corticosteroid use on clinical outcomes in 7 tertiary hospitals in South Korea. Twenty-two patients with severe COVID-19 were enrolled, and they were all treated with corticosteroids. ResultsOf the 22 patients who received corticosteroids, 12 patients (55%) were treated within 10 days from diagnosis. There was no significant difference in the baseline characteristics. The initial PaO2/FiO2 ratio was 168.75. The overall case fatality rate was 25%. The mean time from diagnosis to steroid use was 4.08 days and the treatment duration was 14 days in the early use group, and 12.80 days and 18.50 days in the late use group, respectively. The PaO2/FiO2 ratio, C-reactive protein level, and cycle threshold value improved over time in both groups. In the early use group, the time from onset of symptoms to discharge (32.4 days vs 60.0 days, P = 0.030), time from diagnosis to discharge (27.8 days vs 57.4 days, P = 0.024), and hospital stay (26.0 days vs 53.9 days, P = 0.033) were shortened.ConclusionsAmong patients with severe COVID-19, the early use of corticosteroids resulted in a significant improvement in the time to favorable clinical outcomes.
National Public Health Institutes: A Scoping Review
Authors: Myhre Sonja Lynn , French Steve Diaz , Bergh Anne 
Published: November 2020

Abstract
Background. During the last century, national public health institutes (NPHIs) emerged to address enduring and emergency public health challenges. Outbreaks have often compelled countries to establish NPHIs. Likewise, the Covid-19 pandemic may inspire countries to create or strengthen NPHIs. Despite their historic legacies and contributions to public health, no review of NPHI literature has been published to date. The aim of this scoping review is to provide an overview of the NPHI literature published since 2000 and map characteristics of articles including format, authorship, geographic focus, methods, language, and focal topic. We also investigate whether the NPHI literature addresses public health capacity building domains. Finally, the study identifies gaps and areas for future research. Methods. The scoping review was guided the Arksey and O’Malley methodological framework and utilized the PRISMA-ScR checklist. The search was conducted in Medline OVID and Scopus databases. Data extraction involved mapping article characteristics and reviewing public health capacity building framework domains. Results. The search yielded 5731 records. A total of 43 articles met the study eligibility criteria. Articles were published in English, Spanish, French and Russian including diverse perspectives and experiences emanating from more than 20 countries in Africa, Europe, North America and South America. Most articles were formatted as commentaries. Only three reported methods or collected primary data. Articles topics included organizational structure, networks, research, funding, and governance. Conclusion. Findings reveal a longstanding international interest in leveraging NPHIs to address complex public health challenges. Lack of studies reporting methods reveals the need for future research to utilize quantitative and qualitative methods. The NPHI literature addresses topics concerning public health capacity building which underscores NPHIs’ ability to tackle global and national public health threats. Many articles in this review recommend investment in NPHIs as a strategy to respond to crises and strengthen countries’ public health systems.
Development and Performance Assessment of Novel Machine Learning Models to Predict Pneumonia&nbsp;After Liver Transplantation
Authors: Chen Chaojin , Yang Dong , Gao Shilong , Zhang Yihan , Chen Liubing , Wang Bohan , Mo Zihan , Yang Yang , Hei Ziqing , Zhou Shaoli 
Published: November 2020

Abstract
Background Pneumonia is the most frequently encountered postoperative pulmonary complications (PPC) after orthotopic liver transplantation (OLT), which cause high morbidity and mortality rates. We aimed to develop a model to predict postoperative pneumonia in OLT patients using machine learning (ML) methods. Methods Data of 786 adult patients underwent OLT at the Third Affiliated Hospital of Sun Yat-sen University from January 2015 to September 2019 was retrospectively extracted from electronic medical records and randomly subdivided into a training set and a testing set. With the training set, six ML models including logistic regression (LR), support vector machine (SVM), random forest (RF), adaptive boosting (AdaBoost), extreme gradient boosting (XGBoost) and gradient boosting machine (GBM) were developed. These models were assessed by the area under curve (AUC) of receiver operating characteristic on the testing set. The related risk factors and outcomes of pneumonia were also probed based on the chosen model.Results 591 OLT patients were eventually included and 253 (42.81%) were diagnosed with postoperative pneumonia, which was associated with increased postoperative hospitalization and mortality (P< 0.05). Among the six ML models, XGBoost model performed best. The AUC of XGBoost model on the testing set was 0.734 (sensitivity: 52.6%; specificity: 77.5%). Pneumonia was notably associated with 14 items features: INR, HCT, PLT, ALB, ALT, FIB, WBC, PT, serum Na+, TBIL, anesthesia time, preoperative length of stay, total fluid transfusion and operation time. Conclusion Our study firstly demonstrated that the XGBoost model with 14 common variables can predict postoperative pneumonia in OLT patients.
Providing An Optimized Model to Detect Driver Genes From Heterogeneous Cancer Samples, Using Restriction in Subspace Learning
Authors: EBADI Ali Reza , Soleimani Ali , GHADERZADEH3 ABDULBAGHI 
Published: November 2020

Abstract
Extracting the drivers from genes with mutation, and segregation of driver and passenger genes are known as the most controversial issues in cancer studies. According to the heterogeneity of cancer, it is not possible to identify indicators under a group of associated drivers, in order to identify a group of patients with diseases related to these subgroups. Therefore, the precise identification of the related driver genes using artificial intelligence techniques is still considered as a challenge for researchers. In this research, a new method has been developed using the subspace learning method, unsupervised learning, and with more constraints. Accordingly, it has been attempted to extract the driver genes with more precision and accurate results. The obtained results show that the proposed method is more efficient for more genes compared to other methods. The p-value of the proposed method was 9.21e-7 better than previous methods for 200 genes. The results show that the p. value of the proposed method is about 2.7 times less than the driver sub method, indicating that the proposed method can identify driver genes in cancerous tumors with greater accuracy and reliability.
Trademark Background Analysis Method Based on Human Cognition of Visual Psychology
Authors: Hung Kuo-Ming , Chen Li-Ming , Chen Ting-Wen 
Published: November 2020

Abstract
Trademark is a symbol that can be seen everywhere in life. In the case of effective use of trademark, people can quickly identify the organization, its image and reputation, so that the trademark owner can obtain resources for maintenance and development. However, there are unfair competitors in the market that would imitate similar trademarks to steal or damage the reputation and interests of the original trademark owners. Failure of preventing counterfeit trademarks from affecting the interests of others will make developers hard to develop novel technologies that contribute to the progress of the country and society due to insufficient or scarce resources. In the past research in this field,many studies have proposed protection methods for protecting trademark interests. These related studies have obtained excellent results in the search and analysis of trademarks. Nevertheless, some unfair competitors use the human cognition of visual psychology in the human vision system (HVS) to circumvent similar methods of trademark images to steal or damage the credit and interests of the original trademark owners. In order to deter unfair competitors or the abuse of such confusing trademarks, this article proposes a method for trademark background analysis. This article also proposes a method to generate a large amount of background trademark data. Then, we use that large amount of generated data for training neural networks that can analyze trademarks that are easily confused due to background. Eventually, we use the testing independent data for system verification. This experiment uses two common deep learning network architecture for testing. The experimental results show that the proposed system can achieve a true positive rate (TPR) over 98% in the face of this confusing trademark plagiarism method. And the comparison result is better than existing methods. This result confirms that the system proposed in this article can prevent infringement problems that used background.
The Influence of Medical Insurance and Social Security Cards on The Floating Population's Settlement Intention
Authors: Li Yulin , Huang Lingling , Xiang Li , Dou Dongmei 
Published: November 2020

Abstract
Background: There are many studies on the factors influencing the floating population's intentions to settle down. Medical insurance and social security cards are an important incentive for the floating population to live a stable life in their current residence, but there are limited studies on the influence of medical insurance and social security cards on settlement intentions. Therefore, the purpose of this paper was to study the impact of basic medical insurance for urban employees and the decision as to whether to apply for individual social security cards on the settlement intentions of the floating population. As the willingness to settle has increased, the development of health management and public health in the place of residence has improved. Methods: Based on the 2017 survey data from the dynamic monitoring of China's floating population, we explored the influence of basic medical insurance for urban employees and social security cards on the floating population's settlement intentions with binary logistic regression and structural equation models. Additionally, this study also examined the comprehensive causal relationship, with social integration as the mediator variable.Results: The settlement intention of members of the floating population after participating in basic medical insurance for urban employees was 23.2 percent higher than that of those who did not participate. The decision as to whether to apply for a personal social security card is related to their settlement intention. The standardized regression coefficients among social insurance and security, social integration, and settlement intention were positive values, and the Z values of the overall effect, indirect effect, and direct effect were all greater than 1.96; the confidence interval of the indirect effect did not include 0. We found that this model is a partial intermediary model, with an intermediary ratio of 10.66 percent. Conclusions: This article highlights the important impact of basic medical insurance for urban employees and individual social security cards on the floating population. The conclusions of this study provide suggestions for the government to use when designing policies to enhance the settlement intentions of the floating population and to improve the development of public health undertakings.
Unsheltered homeless and unstably housed adults have higher levels of stress and more health risk factors than sheltered homeless adults
Authors: Ra Chaelin K. , Hébert Emily T. , Alexander Adam , Kendzor Darla E. , Suchting Robert , Businelle Michael S. 
Published: November 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. This study aimed to empirically examine whether shelter status the previous night was related to current stress, recent utilization of shelter-based mental health services, and current health risk factors.Methods: Data were collected at multiple homeless shelters in 2016 in the Oklahoma City area (N=575). All participants completed assessments of demographic characteristics, including age, sex, race, marital status, years of education, and incarceration history and victimization. Multiple linear and logistic regression analyses were conducted to examine relations between homelessness subgroups and outcomes (shelter-based service utilization, health risk factors, and stressors). Results: Results indicated that the sheltered group was younger and more likely to be White than the unsheltered group, had higher levels of education, and reported more lifetime months in jail 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.Conclusion: 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.
Delphi consensus on strategies in the management of opioid-induced constipation in cancer patients
Authors: Sarrió Regina Gironés , Calsina-Berna Agnès , García Adoración Gozalvo , Esparza-Miñana José Miguel , Ferrer Esther Falcó , Porta-Sales Josep 
Published: November 2020

Abstract
Background: Opioid-induced constipation (OIC) is a frequent and bothersome adverse event related with opioid therapy in cancer patients. Despite the high prevalence, medical management of OIC is often uncertain. The current project aimed to investigate expert opinion on OIC management and provide practical recommendations to improve the clinical approach of OIC in cancer patient.Methods: A modified Delphi method was conducted involving 46 different physicians experts in OIC. Using a structured questionnaire of 67 items this project intended to seek consensus on aspects related to diagnosis, treatment, and quality of life of cancer patients suffering with OIC.Results: After two rounds, a consensus was reached in 91% of the items proposed, all in agreement. Agreement was obtained on OIC definition (95.7%). Objective and patient-reported outcomes included in that definition should be assessed routinely in clinical practice. Responsive to symptom changes and easy-to-use assessment tools were recommended (87.2%). Successful diagnosis of OIC requires increase clinicians awareness of OIC and proactivity to discuss symptoms with their patients (100%). Successful management of OIC requires individualization of the treatment (100%), regular revaluation once is established, and keeping it for the duration of opioid treatment (91.5%). Oral Peripherally Acting µ-Opioid Receptor Agonists (PAMORAs), were considered good alternatives for the treatment of OIC in cancer patients (97.9%). This drugs and laxatives can be co-prescribed if OIC coexist with functional constipation.Conclusions: The panelists, based on their expert clinical practice, presented a set of recommendations for the management of OIC in cancer patients.
Hepatic encephalopathy increases the risk of hip fracture: a nationwide cohort study
Authors: Yeh Kuang-Ting , Yu Tzai-Chiu , Lee Ru-Ping , Wang Jen-Hung , Liu Kuan-Lin , Peng Cheng-Huan , Chen Hao-Wen , Chen Ing-Ho , Hsu Chung-Yi , Wu Wen-Tien 
Published: November 2020

Abstract
Background: Osteoporotic hip fracture is a common general health problem with a significant impact on human life because it debilitates the patients and largely decreases their quality of life. Early prevention of fractures has become essential in recent decades. This can be achieved by evaluating the related risk factors, as a reference for further intervention. This is especially useful for the vulnerable patient group with comorbidities. Hepatic encephalopathy (HE), a major complication of liver cirrhosis, may increase the rate of falls and weaken the bone. This study evaluated the correlation between hepatic encephalopathy and osteoporotic hip fracture in the aged population using a national database.
Methods: This retrospective cohort study used data from Taiwan’s National Health Insurance Research Database between 2000 and 2012. We included people who were older than 50 years with hepatic encephalopathy or other common chronic illnesses. Patients with and without hepatic encephalopathy were matched at a ratio of 1:4 for age, sex, and index year. The incidence and hazard ratios of osteoporotic hip fracture between the both cohorts were calculated using Cox proportional hazard regression models.
Results: The mean age of the enrolled patients was 66.5 years. The incidence ratio of osteoporotic hip fracture in the HE group was significantly higher than that in the non-HE group (68/2496 [2.7%] vs 98/9984 [0.98%]). Patients with HE were 2.15-times more likely to develop osteoporotic hip fractures than patients without HE in the whole group. The risk ratio was also significantly higher in female and older individuals. The results were also similar in the comorbidity subgroups of hypertension, diabetes mellitus, hyperlipidemia, senile cataract, gastric ulcer, and depression. Alcohol-related illnesses seemed to not confound the results of this study.
Conclusions: HE is significantly associated with an increased risk of osteoporotic hip fractures, and the significance is not affected by the comorbidities in people aged more than 50 years. The cumulative risk of fracture increases with age.