bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and risk factors for HBV and HCV among incarcerated people who inject drugs in Iran: a cross sectional study
Authors: Moradi Ghobad , Mohamadi Parvin , Zareie Bushra , Rasouli Mohammad Aziz , Gouya Mohammad Mehdi , Jafari Saeede 
Published: October 2020

Abstract
Background: This study aimed at determining the prevalence of and risk factors for hepatitis B virus (HBV) and hepatitis C virus (HCV) among incarcerated people who inject drugs (PWID) in Iran in 2015-16. Methods : The required data was collected from a database provided by Iranian national bio-behavioral surveillance surveys (BBSSs) on 11988 prisoners selected from among 55 prisons in 19 provinces in 2015-16. The data on demographics and behavioral variables were collected through interviews and the status of exposure to HBV and HCV were determined using ELISA blood test. A total of 1387 individuals with a history of drug injection in their lifetime were enrolled into the study. Data were analyzed using the survey package in Stata/SE software, Version 14.0. Univariate and multivariate logistic regression tests were used to investigate the relationships between risk factors and outcomes.Results : The mean age of the incarcerated PWID was 36.83 ± 8.13 years. Of all the studied subjects, 98.46% were male and 50.97% were married. The prevalence of HCV and HBV among the subjects were 40.52% and 2.46%, respectively. The prevalence of HCV was associated with age≥30 years, being single, illiteracy and low level of education, prison term>5 years, history of piercing, and extramarital sex in lifetime (P<0.05). Conclusions : The prevalence of HCV is alarmingly high. In general, it is recommended to adopt measures to screen and treat patients with HCV and vaccinat incarcerated PWID without a history of vaccination against HBV.
Impact of changes in the methodology of external price referencing on medicine prices: discrete-event simulation
Authors: Vogler Sabine , Schneider Peter , Lepuschütz Lena 
Published: October 2020

Abstract
Background: Several governments apply the policy of external price referencing (EPR), which considers the prices of a medicine in one or more other countries for the purpose of setting the price in the own country. Different methodological choices can be taken to design EPR. The study aimed to analyse whether, or not, and how changes in the methodology of EPR can impact medicine prices.Methods: The real-life EPR methodology as of Q1/2015 was surveyed in all European Union Member States (where applicable), Iceland, Norway and Switzerland through a questionnaire responded by national pricing authorities. Different scenarios were developed related to the parameters of the EPR methodology. Discrete-event simulations of fictitious prices in the 28 countries of the study that had EPR were run over 10 years. The continuation of the real-life EPR methodology in the countries as surveyed in 2015, without any change, served as base case.Results: In most scenarios, after ten years, medicine prices in all or most surveyed countries were – sometimes considerably – lower than in the base case scenario. But in a few scenarios medicine prices increased in some countries. Consideration of discounts (an assumed 20% discount in five large economies and the mandatory discount in Germany, Greece and Ireland) and determining the reference price based on the lowest price in the country basket would result in higher price reductions (on average -47.2% and -34.2% compared to the base case). An adjustment of medicine price data of the reference countries by purchasing power parities would lead to higher prices in some more affluent countries (e.g. Switzerland, Norway) and lower prices in lower-income economies (Bulgaria, Romania, Hungary, Poland). Regular price revisions and changes in the basket of reference countries would also impact medicine prices, however to a lesser extent.Conclusions: EPR has some potential for cost-containment. Medicine prices could be decreased if certain parameters of the EPR methodology were changed. If public payers aim to apply EPR to keep medicine prices at more affordable levels, they are encouraged to explore the cost-containment potential of this policy by taking appropriate methodological choices in the EPR design.
Anakinra as rescue therapy to treat patients with severe COVID-19 refractory to tocilizumab
Authors: Alijotas-Reig Jaume , Esteve-Valverde Enrique , Ruiz-Hidalgo Domingo , Lopez-Sanchez Gabriel , Martinez-Valle Ferran , Trape-Pujol Jaume , Miro-Mur Francesc 
Published: October 2020

Abstract
Objective. To evaluate the role played by anakinra in the treatment of patients with severe COVID-19 who fail to “accepted” standard of care and tocilizumab.Methods. We conducted a retrospective cohort study assessed in Althaia Health Network University and Vall d’Hebrón University Hospital, in Barcelona, Spain. We included patients with confirmed RT-PCR for SARS-CoV-2, moderate-to-severe acute respiratory distress syndrome [PaO2:FiO2] (PAFI) ≤200 mmHg, and hyperinflammation. All of them were primarily managed with non-invasive ventilation outside of the ICU and received standard of care with hydroxychloroquine, lopinavir/ritonavir, azithromycin, and enoxaparin supplemented with tocilizumab. These patients received an additional administration of 100 mg subcutaneous anakinra twice a day (low-dose) or every 6-8 hours (medium-dose). Mechanical ventilation-free survival, ICU admission, respiratory function changes (PAFI), inflammatory markers, and survival were analyzed.Results. Clinical and respiratory improvements were already present at 48 hours post-anakinra. PAFI increased 105.2% at 48 hours over anakinra administration and 166.9% at day 7. Respiratory function improvement was significant at day 7 (p<0.0001) with 10/12 (83%) responders having a PAFI ≥ 200 mm Hg. Despite of this improvement, inflammatory markers lasted to decrease. Two patients required ICU and temporary mechanical ventilation. No patients died and no adverse effects related to anakinra appeared. Short-time follow-up showed no relapses.Conclusions. In severe ARDS related to SARS-CoV-2 refractory to standard of care plus tocilizumab, low-to-moderate doses of anakinra as a rescue therapy showed effectiveness and safety, avoiding mechanical ventilation and deaths.
Covid-19 and Cost of Living in Developing Countries
Authors: Diwambuena Josue , Musimwa Ishara , Tsasa Jean-Paul K. 
Published: October 2020

Abstract
We document some evidence about effects of the Covid-19 pandemic on the cost of living in developing countries. We use data from the National Statistical Office of the Democratic Republic of Congo (DRC). Data are in weekly frequency. We propose a simple two-step strategy to evaluate the Covid-19 effect on the cost of living in the DRC. We consider two types of households: a typical household for the DRC and a typical household for Kinshasa –Kinshasa is the national capital and the largest city of the DRC. Then we compute the quasi-causal effect and the volatility differential for each household type. We show: First, in absolute terms, the consumption basket for a typical household in Kinshasa exhibits both a higher quasi-causal effect and a higher volatility differential than those observed from the consumption basket of a typical household for the whole country (i.e. the DRC). Second, in relative terms, the consumption basket for a typical household in Kinshasa exhibits higher quasi-causal effects than that for a typical household only in prices of food and non-alcoholic beverages and in prices of transport. Finally and more importantly, unlike developed countries where consumers spent more on food and other groceries during the pandemic, our results suggest that in response to the Covid-19 crisis, both the typical household in DRC and the typical household in Kinshasa spent more on health and communication. These findings highlight deep structural differences between developed countries, where health insurance is functional, and developing countries where patients generally face a deficit or lack of viable health insurance. Moreover, we argue expenditures on communication increased in response mainly to the lockdown measures, mobility restrictions or closing of national borders.
Alveolar-to-arterial oxygen gradient: role in the management of COVID-19 infection mild population
Authors: Farina Gabriele , Gianstefani Alice , Salvatore Veronica , Anziati Martina , Baldassarri Francesca , Beleffi Michelle , Cannizzaro Alfredo Maria , Casadei Elena , Fantini Jacopo , Tubertini Eleonora , Nava Stefano , Giostra Fabrizio 
Published: October 2020

Abstract
COVID-19 infection is frequently associated with radiological diagnosis of interstitial pneumonia and alteration in gases exchange. We decided to test arterial blood gas assay parameters, in particular alveolar-to-arterial oxygen gradient (AaDO2), in predicting the need of hospitalization, the survival rate and in identifying pneumonia in patients with SARS-CoV-2 infection.We conducted an observational prospective study in one of the Emergency Department of our city. We included consecutive patients with symptoms likely related to SARS-CoV-2 infection, confirmed either with positive nasal pharyngeal swabs and/or with suggestive radiological findings. Areas under the curve of the receiver operator characteristic curve were computed to predict need of hospitalization and the presence of pneumonia. Survival curves were analyzed using a Log-rank test. P-value less than 0.05 were considered statistically significant.We enrolled 825 patients; the final population was composed by 530 patients. Most of them were hospitalized due to complications, the mortality was 14% but no death occured in the ED. It results that a threshold for AaDO2 of 27 could predict the need of hospitalization as well as a threshold for AaDO2 of 24 could identify the presence of pneumonia. Survival curves revealed that patients with a value of AaDO2 less than or equal to 40 had a better survival. We suggest the application of ABG parameters, in particular AaDO2, during the first assessment of COVID-19 patients in the ED, because they could be additional tools to help the emergency physician to evaluate the clinical severity of patients.The study was approved by our local ethics committee with the number 551/2020/Oss/AOUBo.
Substances use and its association with socio-demographic, family, and environment-related factors among technical and vocational education and training College students in Ataye, Ethiopia.
Authors: wubetu abate dargie , Getachew Sintayehu , Negash Wassie 
Published: October 2020

Abstract
Background: Legal substances use is prevalent in Ethiopia. Substance use can have several health problems that are potentially harmful to educational performance, social issues, psychological and physical wellbeing. This study aimed to know the prevalence of lifetime and last month’s substance use and its associated factors among technical and vocational education and training College students in Ataye town. Methods: An institution-based cross-sectional study was conducted from 1 March to last May 2019. Participants were selected using a simple random sampling technique. Data collected by using a structured and pretested interviewer-administered questionnaire. Data collected by five trained diploma nurses with close supervision. Odds ratio with their 95% confidence interval, and p-value less than 0.05 used to declare the statistical significance of associated factors. Results: Four hundred eighty-three individuals participated in the study, which was a response rate of 94%. The prevalence of lifetime legal substance use was 32.5% (95% CI: 28.2, 36.5). The prevalence of last month's legal substances use was 21.9% (95% CI= 18.2, 25.5). Among lifetime legal substance users, the majority (25.5%) chewed khat. The others, (19.5%) drunk alcohol, and, 15.3% smoked cigarettes in a lifetime. Lifetime cannabis and cocaine users were 2.5%, and 7.2% respectively. Among last month's legal substance users, (21.9%) chewed khat followed by alcohol drinking (16.6%), and cigarette smoking (15.3%). In the last month, 1.2% and 3.3% of students used cannabis and cocaine respectively. Multivariate logistic regression showed that being male, having a divorced family, living greater than twenty years in the town, having substance user family members, having intimate friend substance users, and easy availability of substances were independent predictors of lifetime legal substances use. Conclusions: The prevalence of last month and lifetime legal substance use at Ataye Technical and Vocational Education and Training ( TVET ) college students were analogous with most studies done in Ethiopia. It is advisable if the college administrators work together with town administrators to mitigate the problem including closing substance use houses around the school. Overall, Substance use among adolescents should get further emphasis to lower the prevalence.
Disinfectant Wipes Transfer Clostridioides difficile Spores from Contaminated Surfaces to Uncontaminated Surfaces during the Disinfection Process
Authors: Nkemngong Carine A. , Chaggar Gurpreet K. , Li Xiaobao , Teska Peter J. , Oliver Haley F 
Published: October 2020

Abstract
Background: Pre-wetted disinfectant wipes are increasingly being used in healthcare facilities to help address the risk of healthcare associated infections (HAI). However, HAIs are still a major problem in the US with Clostridioides difficile being the most common cause, leading to approximately 12,800 deaths annually in the US. An underexplored risk when using disinfectant wipes is that they may cross-contaminate uncontaminated surfaces during the wiping process. The objective of this study was to determine the cross-contamination risk that pre-wetted disinfectant towelettes may pose when challenged with C. difficile spores. We hypothesized that although the tested disinfectant wipes had no sporicidal claims, they will reduce spore loads. We also hypothesized that hydrogen peroxide disinfectant towelettes would present a lower cross-contamination risk than quaternary ammonium products.
Methods: We evaluated the risk of cross-contamination when disinfectant wipes are challenged with C. difficile ATCC 43598 spores on Formica surfaces. A disinfectant wipe was used to wipe a Formica sheet inoculated with C. difficile . After the wiping process, we determined log 10 CFU on previously uncontaminated pre-determined distances from the inoculation point and on the used wipes.
Results: We found that the disinfectant wipes transferred C. difficile spores from inoculated surfaces to previously uncontaminated surfaces. We also found that wipes physically removed C. difficile spores and that hydrogen peroxide disinfectants were more sporicidal than the quaternary ammonium disinfectants.
Conclusion: Regardless of the product type, all disinfectant wipes had some sporicidal effect but transferred C. difficile spores from contaminated to otherwise previously uncontaminated surfaces. Disinfectant wipes retain C. difficile spores during and after the wiping process.
FABP7 is a potential biomarker to predict response to neoadjuvant chemotherapy for breast cancer&nbsp;
Authors: Xie Qin , XIAO Ying-sheng , JIA Shi-cheng , ZHENG Jie-xuan , DU Zhen-chao , CHEN Yi-chun , CHEN Mu-tong , LIANG Yuan-ke , LIN Hao-yu , Zeng De 
Published: October 2020

Abstract
Background: Early prediction of response to neoadjuvant chemotherapy (NAC) is critical in choosing appropriate chemotherapeutic regimen for patients with locally advanced breast cancer. Herein, we sought to identify potential biomarkers to predict the response to neoadjuvant chemotherapy for breast cancer patients.Methods: Three genomic profiles acquired by microarray analysis from subjects with or without residual tumors after NAC downloaded from the GEO database were used to screen the differentially expressed genes (DEGs). An array of public databases, including ONCOMINE, cBioportal, Breast Cancer Gene Expression Miner v4.0, and the Kaplan Meir-plotter, etc., were used to evaluate the potential functions, related signaling pathway, as well as prognostic values of FABP7 in breast cancer. Anti-cancer drug sensitivity assay, real-time PCR, ﬂow cytometry and western-blotting assays were used to investigate the function of FABP7 in breast cancer cells and examine the relevant mechanism.Results: Two differentially expressed genes, including FABP7 and ESR1, were identified to be potential indicators of response to anthracycline and taxanes for breast cancer. FABP7 was associated with better chemotherapeutic response, while ESR1 was associated with poorer chemotherapeutic effectiveness. Generally, the expression of FABP7 was significantly lower in breast cancer than normal tissue samples. FABP7 mainly high expressed in ER-negative breast tumor and might regulate cell cycle to enhance chemosensitivity. Moreover, elevated FABP7 expression increased the percentage of cells at both S and G2/M phase in MDA-MB-231-ADR cells, and decreased the percentage of cells at G0/G1 phase, as compared to control group. Western-blotting results showed that elevated FABP7 expression could increase Skp2 expression, while decrease CDH1 and p27kip1 expression in MDA-MB-231-ADR cells. In addition, FABP7 was correlated to longer recurrence-free survival (RFS) in BC patients with ER-negative subtype of BC treated with chemotherapy. Conclusion: FABP7 is a potential favorable biomarker and predicts better response to NAC in breast cancer patients. Future study on the predictive value and detail molecular mechanisms of FABP7 in contribution to chemosensitivity in breast cancer is warranted.
Evaluating antimicrobial appropriateness in a tertiary care pediatric ICU in Saudi Arabia: A retrospective cohort study
Authors: Kazzaz Yasser M , AlTurki Haneen , Aleisa Lama , Alahmadi Bashaer , Alfattoh Nora , Alattas Nadia 
Published: October 2020

Abstract
Background: Inappropriate antibiotic utilization is associated with the emergence of antimicrobial resistance (AMR) and a decline in antibiotic susceptibility in many pathogenic organisms isolated in intensive care units. Antibiotic stewardship programs (ASPs) have been recommended as a strategy to reduce and delay the impact of AMR. A crucial step in ASPs is understanding antibiotic utilization practices and quantifying the problem of inappropriate antibiotic use to support a targeted solution. We aim to characterize antibiotic utilization and determine the appropriateness of antibiotic prescription in a tertiary care pediatric intensive care unit.Methods: A retrospective cohort study was conducted at King Abdullah Specialized Children’s Hospital (KASCH), Riyadh, Saudi Arabia, over a 6-month period. Days of therapy (DOT) and DOT per 1000 patient-days were used as measures of antibiotic consumption. The appropriateness of antibiotic use was assessed by two independent pediatric infectious disease physicians based on the Centers for Disease Control and Prevention 12-step Campaign to Prevent Antimicrobial Resistance Among Hospitalized Children.Results: During the study period, 497 patients were admitted to the PICU, accounting for 3009 patient-days. A total of 274 antibiotic courses were administered over 2553 antibiotic days. Forty-eight percent of antibiotic courses were found to be nonadherent to at least 1 CDC step. The top reasons were inappropriate antibiotic choice (empirical or definitive) and inappropriate prophylaxis durations. Cefazolin and vancomycin contributed to the highest percentage of inappropriate DOTs.Conclusions: Antibiotic consumption was high with significant inappropriate utilization. These data could inform decision-making in antimicrobial stewardship programs and strategies. The CDC steps provide a more objective tool and limit biases when assessing antibiotic appropriateness
Recent epidemiology of patients with Gastro-Entero-Pancreatic Neuroendocrine Neoplasms (GEP-NEN) in Japan: a population-based study
Authors: Masui Toshihiko , Ito Tetsuhide , Komoto Izumi , Uemoto Shinji , group JNETS project study 
Published: October 2020

Abstract
Background: The worldwide prevalence and incidence of neuroendocrine neoplasms (NEN) have been increasing recently, although few studies have analyzed data on the current situation of NENs in Japan. Here, the Japan Neuroendocrine Tumor Society (JNETS) planned to investigate the recent incidence and distribution of these tumors using data from the national cancer registry started in 2016. This study examined the incidence and distribution of primary sites as well as rate of advanced disease from this population-based registry.Methods: A retrospective, population-based study using data from the national cancer registry in Japan (NCR) was conducted to evaluate patients with gastro-entero-pancreatic NEN (GEP-NEN) in 2016. Associated population data were used to determine annual age-adjusted incidences.Results: A total of 6735 individuals were diagnosed with GEP-NEN in Japan in 2016. Annual onset incidence was 0.70/100,000 for pancreatic NEN and 2.84/100,000 for gastrointestinal NEN. NEN in the ileum accounted for only 1% of total GEP-NENs in Japan. Most NENs in the esophagus or lungs were neuroendocrine carcinomas (NECs), while the majority of those in the duodenum, ileum, appendix and rectum were grade 1 neuroendocrine tumors (NETs). Median age at initial diagnosis was in between 60 to 65. Tumors in the duodenum, appendix and rectum were mostly limited to local, while those in the esophagus, stomach and colon tended to show distant metastasis. In Japan, initial treatment for GEP-NENs was resection even if the tumor was NEC.Conclusions: This is the first report of a national registry-based incidence and distribution of GEP-NEN in Japan. These data will serve as an important first step to determining the exact etiology and trends for this pathology in Japan.
Google analytics of a pilot study to characterize the visitor website statistics and implicate for enrollment strategies in Medical University
Authors: Chen Szu-Chieh , Tsao Thomas Chang-Yao , Lue Ko-Huang , Tsai Yafang 
Published: October 2020

Abstract
Background: Due to decreasing fertility rates in Taiwan, colleges and universities face significant difficulties in maintaining student attendance. This study aims to investigate students in the higher education market and explore their online behavior patterns in relation to university departmental websites to provide response strategies with the aim of potentially increasing enrollment.Methods: We used Google Analytics (GA) tools to analyze two departmental websites from a medical university between February 1 and July 30, 2018. We also observed website patterns during relevant periods for three college admission routes (Stars Program, Personal Application, and Admission by Examination and Placement).Results: Visitors were mostly between 18 and 24 years of age during the three visiting date ranges for the two departments analyzed. The visitor groups were mainly freshmen at the university, and secondarily their parents. The majority of visitors visited “Homepage,” “Subject Credits,” “Course Planning,” “Teacher Lineup,” and “Certificate of Subjects.” The overall timing of daily page views varied depending on academic events.Conclusions: Results suggest that the department should consider enhancing the presentation of its featured courses on the web page or distinguish their course characteristics from those of competing departments in the curriculum to ensure clear market segmentation. It is recommended that each department consider the obtainable data online and identify suitable high schools to visit to attract potential students and improve student willingness to choose this university.