bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary Care Provider Uptake of Intensive Behavioral Therapy for Obesity in Medicare Patients, 2012-2017
Authors: Ozoor Mounira , Gritz Mark , Dolor Rowena J , Holtrop Jodi S , Luo Zhehui 
Published: September 2020

Abstract
Background: The delivery of Intensive Behavioral Therapy for obesity (IBT) by primary care providers (PCPs) has been covered by Medicare to support elderly obese individuals (BMI > 30 kg/m2) in managing their weight since 2011 for individual therapy and 2015 for group therapy. We sought to understand patterns of uptake of IBT for obesity services among PCPs serving the Medicare population across the U.S. Methods: We used the Centers for Medicare and Medicaid Services Provider Utilization and Payment Data from 2012 to 2017 to extract all PCPs who served more than 10 Medicare beneficiaries in each of the six-year period for form a longitudinal study. The procedure codes G0447 and/or G0473 were used to identify PCPs who provided IBT and their characteristics were compared by the IBT-using status. Results: Of the 452,127 eligible PCPs who served Medicare patients in all six years, only 0.9% were found to be IBT utilizers in at least one year from 2012 through 2017 (147 always users, 988 early adopters, and 3,062 late adopters). IBT utilizing providers shared a few common characteristics: they were more likely to be male, internal medicine and family practice providers, saw a higher number of unique Medicare beneficiaries, and practiced in the South and Northeast regions. The proportions of patients with hypertension, diabetes or hyperlipidemia were similar between IBT and non-IBT providers. Conclusions: Very few primary care providers continuously bill IBT services for Medicare patients. Further investigation is needed to identify barriers to the uptake of IBT services among PCPs. Trial registration: not applicable.
Multilevel modelling, prevalence, and predictors of hypertension in Ghana: Evidence from Wave 2 of the World Health Organization’s Study on Global AGEing and adult health
Authors: Aheto Justice Moses Kwaku , Dagne Getachew A. 
Published: September 2020

Abstract
Background

Hypertension is a major public health issue, a critical risk factor for cardiovascular diseases and stroke, especially in developing countries where the rates remain unacceptably high. In Africa, hypertension is the leading driver of cardiovascular disease and stroke deaths. Identification of critical risk factors of hypertension can help formulate targeted public health programmes and policies aimed at reducing the prevalence and its associated morbidity, disability, and mortality. This study attempts to develop multilevel binary logistic regression model, an in-depth statistical model to identify critical risk factors of hypertension to inform interventions aimed at improving cardiovascular health outcomes among adults.
Methods

This study used data on 4667 individuals aged ≥ 18 years from the nationally representative World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 2 conducted in 2014/2015. Multilevel regression modelling was applied on final sample of 4381 individuals residing in 3790 households to identify critical risk factors for hypertension based on systolic blood pressure (SBP) (i.e. SBP > 140 mmHg).
Results

A total of 1273(27.3%) were hypertensive. Critical risk factors for hypertension identified were aged ≥ 50 years (OR = 5.4, 95% CI: 4.11–7.09), obese (OR = 1.51, 95% CI: 1.19–1.91), currently married (OR = 0.75, 95% CI: 0.64–0.89), individuals in moderate (OR = 1.38, 95% CI: 1.15–1.65) or bad/very bad health state (OR = 1.35, 95% CI: 1.0-1.83) and moderate difficulty with self-care (OR = 1.64, 95% CI: 1.1–2.44). Strong unobserved household-level residual variations were found. The results from the variation analyses showed that over 12% of variance in hypertension could be attributable to residual household-level variations.
Conclusion

Hypertension remains high in Ghana. Addressing the problem of obesity, targeting specific interventions to those aged over 50 years, and improvement in the general health of Ghanaians are paramount to reducing the prevalence and its associated morbidity, disability, and mortality. Lifestyle modification in the form of dietary intake, knowledge provision supported with strong public health message and political will could be beneficial to the management and prevention of hypertension.
Health services availability and readiness for COVID-19 case surge in hospitals of Nepal
Authors: Bhattarai Suraj , Dhungana Jaya , Ensor Tim , Shrestha Uttam Babu 
Published: September 2020

Abstract
Background

As with other coronavirus-affected countries, Nepal’s medical community also expressed concerns regarding the government’s public health strategies and hospital readiness in response to increasing COVID-19 case surge. To gauge such response, we assessed service availability and readiness status in hospitals situated across seven provinces.
Methods

A web-based observational study was conducted between March 24 and April 07 in 110 hospitals, all of which were later designated as COVID-19 clinics or hospitals by Nepal Government. An electronic survey link was sent out to the clinicians working at the frontline in those hospitals. One response per hospital was analyzed. Hospitals were divided into small, medium, and large based on the total number of beds (small:15 or less; medium:16–50; large:>50), and further categorized into public, private, and mixed based on the ownership.
Results

Out of 110 hospitals, 81% (22/27) of small, 39% (11/28) of medium, and 33% (18/55) of large hospitals had not allocated isolation beds for COVID-19 suspects or cases. Majority of medium (89%; 25/28), and 38% of large hospitals did not have a functional intensive care unit (ICU) at the time of study. Nasopharyngeal (NP)/throat swab kits were available in one-third (35/110), whereas viral transport media (VTM), portable fridge box, and refrigerator were available in one-fifth (20%) of the hospitals. Only one hospital (large/tertiary) had a functional PCR machine. Except for General practitioners, other health cadres—crucial during pandemics, were low in number. On IPC measures, the supplies of simple face mask, gloves and hand sanitizers were adequate in the majority of hospitals, however, N95-respirators and PPE-suits were grossly lacking. Government’s COVID-19 support was unevenly distributed across provinces; health facilities in provinces 2, 4, and 5 received fewer resources than others.
Conclusions

Our findings alerted the Nepalese and other governments to act early and proactively during health emergencies and not wait until the disease disrupts their health systems. Other countries with similar economy levels may undertake similar surveys to measure and improve their pandemic response.
Immunoinformatics Approach for Designing Multiple Epitope-Based Vaccine against Human Metapneumovirus Utilizing its Fusion Protein.
Authors: Ahmed Ibtihal A , Alnour Mosab Y , Eisa Nafisa M , Adam Esameldeen A , Omer Faiza A , Osman Maali A , Albagi Sahar O , Hassan Mohammed A 
Published: September 2020

Abstract
BackgroundHuman Metapneumovirus is a major cause of acute respiratory infections especially in children besides it’s responsible for substantial hospitalizations associated with significant morbidity and treatment cost. Hence vaccination is required. Consequently, we aim to predict effective, safe, and universal epitope-based peptides vaccine against the HMPV using its Fusion Protein via the Immunoinformatics approach since there are no licensed vaccines or antiviral treatments yet.To achieve this goal, various Immunoinformatics databases and web servers, including, the Immune Epitope Database used the Allergen FP v.1.0, and ToxinPred web servers as well as Phyre2 web portal for the modeling of peptide 3D structure and molecular docking study on Cresset Flare software.Result According to the results, the peptide GSTVYYPN was the best predicted B-cells epitopes. Moreover, the peptide VIYMVQLPI with population coverage 48.27% in class(C) I, 35.12% in (C)II, and the peptides LIGVYGSSV with 44.03% in C II, YTNVFTLEV with 61.92% in class I were the best-predicted T-cells epitopes that will interact effectively with the MHC I and MHC II molecules respectively.Conclusions We recommend the use of them, the highest coverage, and the best -combined allele’s bindings of immunogenic multiple peptide vaccines. Also, experimental studies recommend validating the results.
Predictive Factors for the Post Embolization Fever after TACE for Hepatocellular Carcinoma Patients: A Single-Center Study in China.
Authors: TIAN Dan , LI Xiaoyu , LV Qianzhou 
Published: September 2020

Abstract
Background Fever is one of the main symptoms for post-embolism syndrome (PES). This study aimed to determine and validate a model to predict fever after transcatheter arterial chemoembolization (TACE) in patients receiving platinum as the main regimen. Materials and Methods Clinical data of HCC patients who underwent TACE with platinum was retrospectively collected in the Fudan University Zhongshan Hospital during January 2016 to January 2018. According to post-TACE medical records, patients were divided into fever group and non-fever group. Predictive factors were selected by multivariate logistic regression. The receiver operating characteristic (ROC) curve were then performed to detect accuracy and discriminative ability of these factors using the derivation cohort and an independent validation cohort.Results Fevers were detected in 44 of 252 patients. Demographics, laboratory data were statistically similar within fever group and non-fever group. Strongest predictors identified in multivariate logistic regression included Iopiodol emulsion dose (OR, 1.081; 95%CI, 1.006-1.162), number of hepatoprotectants (OR, 0.619; 95%CI, 0.419-0.914), K+ (OR, 2.992; 95%CI, 1.225-7.308), and albumin-bilirubin (ALBI) grade (OR, 2.249; 95%CI, 1.040-4.862). Furthermore, the area under the ROC curve of derivation cohort and validation cohort were 0.798 and 0.874 respectively, which indicated comparative stability and discriminative ability of this model. Conclusions Iopiodol emulsion dose, number of hepatoprotectants, K+, and ALBI grade are strong predictors for PEF. The multivariate logistic model of these factors shows a discriminative ability to predict PEF in the validation cohort.
Inter-vertebral Height, Inter-vertebral Foramen Height and Range of Motion are Associated&nbsp;with&nbsp;Redundant Nerve Roots in Lumbar Spinal Stenosis
Authors: Bo Deng , Hua Fan Shao , Bing Feng Xin , Hong Zhenghua 
Published: September 2020

Abstract
Background: To analyze the relational factors influencing the formation of cauda equina redundant nerve roots (RNRs) of the lumbar spinal stenosis.Methods: A retrospective study of 116 patients with lumbar spinal stenosis were treated in our department from January 2016 to June 2019. Magnetic resonance imaging (MRI) was performed to observe the shape and morphology of the redundant nerve roots of the cauda equina.We divided patient into (RNRs) group and non-RNRs( NRNRs) group based on the presence or absence of RNRs on sagittal T2-weighted MR. We analyzed the demographic characteristics, preoperative back pain visual analogue scale (VAS) scores ,preoperative leg pain VAS scores, and preoperative Oswestry disability index(ODI) scores, and also analyzed the rate of spondylolisthesis and ligamentum flavum hypertrophy. Simultaneously,the inter-vertebral height, intervertebral foramen height, inter-vertebral height +vertebral height, median sagittal diameter at the inter-vertebral space level(DIW-MSD),median sagittal diameter at the pedicel level(DV-MSD),ROM of the stenotic segment, were statistically analyzed for clinical and radiological significance.Results : Of a total 116 total patients,there were no statistically significant differences in either gender [RNRs group (n = 42, 18/24 female) and NRNR group (n = 74, 38/36 female)], age, BMI index, preoperative back pain VAS score , preoperative leg pain VAS score and preoperative ODI score(p> 0.05);however, there were statistically significant differences regard to the duration of symptoms and the rate of spondylolisthesis and ligamentum flavum hypertrophy (p<0.05);the inter-vertebral height,Intervertebral foramen height, inter-vertebral height+vertebral height, DIW-MSD ,ROM of the stenotic segment were also significantly different between the group (p<0.05).Conclusions:The inter-vertebral height, inter-vertebral foramen height, inter-vertebral height + vertebral height, DIW-MSD and ROM of the stenotic segment were the crucial factors related to RNRs in lumbar spinal stenosis.
Clinicopathological Features and Treatment of Thymic Lymphoepithelioma-Like Carcinoma: Two Case Reports and Literature Review
Authors: Guan Xin , Zhang Di , Han Yang , Li Qingchang , Wang Enhua , Wu Guangping , Zhao Huanyu 
Published: September 2020

Abstract
Background: Lymphoepithelioma-like carcinoma (LELC) is rare in the thymus, which is easy to be misdiagnosed. To improve its clinicopathological knowledge, we describe two cases of thymic LELC, and investigate their clinicopathological features (microscopical and immunohistochemical features), treatment and follow-up data with a review of previously published cases. Case presentation: Two patients in the First Affiliated Hospital of China Medical University underwent complete surgical resection for thymic LELC. In both, they were treated with chemotherapy or radiotherapy after operation. Histologically, tumor cells were arranged in nest-like patterns or stripe-shaped infiltration in collagen fibrous interstitial tissue containing lymphocytes. And the tumor cells were diffusely positive for broad spectrum pan-cytokeratin (CK), CK19, CD5, CD117, epithelial membrane antigen (EMA) and p63, focally positive for CD20, and negative for TdT. Recent clinical reexamine showed that the two patients were alive with no signs of recurrence.Conclusion: We report two cases of thymic LELC with a review of previously published cases to summarize the knowledge of their clinicopathological characteristics, which is necessary for the accurate diagnosis and clinical treatment.
Non-unitary superconductivity in the monolayer of orthorhombic CoSb
Authors: Li Wei , Xu Xuguang , Wei Xinyuan , Jin Wentao , Zou Muyuan , Yuan Tianzhong 
Published: September 2020

Abstract
Ferromagnetism and superconductivity are generally considered to be antagonistic phenomena in condensed matter physics. Here, we theoretically study the interplay between the ferromagnetic and superconducting orders in a recent discovered monolayered CoSb superconductor with an orthorhombic symmetry and net magnetization, and demonstrate the pairing symmetry of CoSb as a candidate of non-unitary superconductor with time-reversal symmetry breaking. By performing the group theory analysis and the first-principles calculations, the superconducting order parameter is suggested to be a triplet pairing with the irreducible representation of 3B2u, which displays intriguing nodal points and non-zero periodic modulation of Cooper pair spin polarization on the Fermi surface topologies. These findings not only provide a significant theoretical insight into the coexistence of superconductivity and ferromagnetism, but also reveal the enhancement of exotic spin polarized Cooper pairing by ferromagnetic spin fluctuations in a triplet superconductor.
Analysis of Risk Factors Progression of Preterm Delivery Using Electronic Health Records
Authors: Safi Zeineb , Venugopal Neethu , Ali Haytham , Makhlouf Michel , Boughorbel Sabri 
Published: September 2020

Abstract
Background: Preterm deliveries have many negative health implications on both mother and child. Identifying the population level factors that increase the risk of preterm deliveries is an important step in the direction of mitigating the impact and reducing the frequency of occurrence of preterm deliveries. The purpose of this work is to identify preterm delivery risk factors and their progression throughout the pregnancy from a large collection of Electronic Health Records (EHR). Results: The study cohort includes more than 60,000 deliveries in the USA with the complete medical history from EHR for diagnoses, medications, procedures and demographics. We propose a temporal analysis of risk factors by estimating and comparing risk ratios at different time points prior to the delivery event. We selected the following time points before delivery: 9, 6, 3 and 1 month(s). We did so by conducting a retrospective cohort study of patient history for a selected set of mothers who delivered preterm and a control group of mothers that delivered full-term. We analyzed the extracted data using a logistic regression model. The results of our analyses showed that the highest risk ratio corresponds to history of previous preterm delivery. Other risk factors were identified, some of which are consistent with those that are reported in the literature, others need further investigation. Conclusions: The comparative analysis of the risk factors at different time points showed that risk factors in the early pregnancy related to patient history and chronic condition, while the risk factors in late pregnancy are specific to the current pregnancy. Our analysis unifies several previously reported studies on preterm risk factors. It also gives important insights on the changes of risk factors in the course of pregnancy.
Editing and Expression of miR-589-5p as an Important Biomarker in Colorectal Cancer
Authors: Yue Yuanyi , Zhang Qiang , Xiao Li 
Published: September 2020

Abstract
Objectives: Colorectal cancer (CRC) is recognized as the third most common cancer worldwide. Recently, emerging evidence showed that microRNA (miRNA) A-to-I editing plays crucial roles in cancer prognosis as well as cancer therapy. However, the relationship between CRC and miRNA editing remains not fully understood. Herein, we presented the first comprehensive analysis of miRNA editing events in CRC. Methods: Using patient data from The Cancer Genome Atlas (TCGA), we performed editing events and detected the expression levels of miR-589-5p. Results: we identified both editing events and the expression levels of miR-589-5p are significantly associated with Consensus Molecular Subtyping (CMS), especially for CMS4. The editing and expression levels of miR-589-5p impact almost completely different sets of gene expression, indicating the edited miR-589-5p plays a different role in CRC progression, compared to the wildtype miR-589-5p. Conclusions: In conclusion, our study provided the first association of miRNA editing and CRC. We demonstrated that expression and editing level of miR‑589‑5p may work as a novel biomarker for both prognosis and diagnosis in CRC.
Postpartum Death in Malaysia 2013 - 2019 A Case Control Study
Authors: Daud Faiz , Bahari Nor Izyani , Ahmad Norfazilah , Asis Siti Harirotul Hamrok 
Published: September 2020

Abstract
Background: Information regarding factors associated with postpartum death enhances the understanding of the root cause of the problem; hence, facilitate the formation of effective remedial measure. Literatures on postpartum death in Malaysia are limited despite the increasing trend of mortality in the state of Selangor. This study aimed to determine the associated factors with postpartum death in Malaysia. Method: A case-control was conducted using data from the Selangor State Health Department. All 114 postpartum death cases that were notified to the health department from 2013 to 2016 were selected. Controls (ratio case 1: control 4) were mothers who survived six weeks of postpartum within the same year range and selected via simple random sampling. A set of datasheets was used to gather information on; i) socio-demographic characteristics, ii) past medical/surgical history and iii) obstetrics history. Analyses were conducted using IBM Statistical Product and Service Solution Statistics Version 25.Results: The odds of postpartum deaths were almost three times higher among the non-Malaysian citizen (aOR 2.78, 95% CI: 1.35-5.72). The presence of medical/ surgical problems was associated with a 3-fold increase in the odds of postpartum death (aOR 3.22, 95% CI: 1.85-5.61). The odds of death were nine times higher for those who delivered in non-health facilities (home/en-route) (aOR 9.13,95% CI: 2.05-40.77) than those delivered in health facilities. Women who attended antenatal care at government health facilities and practised family planning had low odds for postpartum deaths [(aOR 0.35, 95% CI: 0.20-0.64) and (aOR 0.46, 95% CI: 0.25-0.85), respectively. Conclusions: Postpartum deaths could be prevented reduce by ensuring adequate health service delivery to the non-citizen, enhanced medical care on underlying medical/surgical illness and restrict delivery in non-health facilities. This reduction can be achieved by promoting attendance to antenatal care in government health facilities and practicing family planning. Future health programme aimed to curb this death should be designed with emphasis on education to these target group as early as pre-pregnancy and throughout the antenatal period.
A Novel Artificial Intelligence based Hybrid Maximum Power Point Tracking Technique for Solar Photovoltaic System
Authors: Khan Mohammad junaid 
Published: September 2020

Abstract
Backgrounds: Solar photo-voltaic (PV) arrays have non-linear characteristics with distinctive maximum power point (MPP) which relies on ecological conditions such as solar radiation and ambient temperature. In order to obtain continuous maximum power (MP) from PV arrays under varying ecological conditions, maximum power point tracking (MPPT) control methods are employed. MPPT is utilized to extract MP from the solar PV array, high-performance soft computing techniques can be used as an MPPT technique. Results: In order to show the feasibility and performance of the proposed Artificial Intelligence based Perturbe and Observe (AIAPO) MPPT controller, a simulation analysis has been carried out using the PV system. Combined results with different MPPT systems for power, voltage and current waveforms are the output values increase to 272.4W, 157V and 1.74A respectively. Using proposed AIAPO MPPT provides more accurate and stable result as compared to Perturbe and Observe (PO), Fuzzy Logic (FL) and Artificial Neural Network (ANN) based MPPT Technique. As per the experimentation performed by various MPPT techniques are carried out for PV system which are clearly indicating that the comparative analysis of power, voltage and current performance of PV system (i.e. have been recorded 272.4W, 157V and 1.74A) using proposed MPPT method which is better than the PO based MPPT (i.e. 169.1W, 127V, 1.43A), FL based MPPT technique (i.e. 256.9W, 152V, 1.69A) and ANN based MPPT technique (i.e. 265W, 154V, 1.71A) correspondingly. Conclusions: The aim of this paper is to track MPP from the solar PV array by the proposed hybrid controller for irradiation changes and comparing results with PO, FL and ANN based MPPT controllers. Different MPPT techniques have been used to compute MPP and improved efficiency of the PV panel. AIAPO, ANN, FL and PO MPPT methods have been chosen to obtain this objective. Simulation results showing that the system in which proposed control method has been used gives better performance and reduce fluctuations of the MPP as compared to PO, FL and ANN based MPPT technique at rapid changes of irradiation. In order to fabricate a reliable and real time hybrid system, there is a massive scope of research to develop multi-input renewable energy systems.