bluuebunny/crossref_metadata_2025_split huggingface dataset:
Initiation into street, challenges, means of survival and perceived strategies to alleviate its plights among street children in Addis Ababa, Ethiopia 2019 A phenomenological study design
Authors: Chimdessa Ayana Fite 
Published: June 2020

Abstract
Background: There has been a major discrepancy in defining the term street children-where various stakeholders define in different ways. In spite of increasing in number, the life and health of street children is becoming a global concern. Even though a wide range of policies and strategies are available, they are poorly designed with helpless implementation. This made street children defenseless to harassments and denial of social protection services.Methodology: A phenomenological study design was employed to explore difficulties of the street children and perceived strategies to prevent and alleviate plights. The study was conducted from January to March 2019. A Time-Space Sampling (TSS) was used to recruit participants. Pre-tested interview guide was used for data collection. Data was analyzed by using framework analysis software. Results: A total of 103 street children took part in the study. Complexity of push and pull factors pose to risk of flee into the street. Street children are facing widespread challenges i.e. social network fragmentation, child trafficking, harassments and shortage of coverage of basic needs. Furthermore, absences of comprehensive and contextualized strategies and less political value for this group worsening it. Thus, street children have been considered as felon, out laws and having a mentality of committing crime by both law keeping bodies and society. This in turn, affecting street children’s’ acceptance by their community and get legal protection under the law and made them more risk to denial of social protection services. To win street life struggles, they use different survival mechanisms by forming small group. Income Generating Activities (IGAs), shelter, community support, child protection, access to health education, health services, life coaching and by less extent reintegration are positively perceived strategies to address their problems. Conclusion: Lack/poorly designed policies and strategies targeting street children has made them prone to health and social problems. Furthermore, stigma by community, limited resources, lack of comprehensive standards and absence of political value of interventions exacerbating it. Therefore, call for different stakeholders in supporting to design and implement clear, case based and contextualized strategic policies to address and prevent plights; by considering positively perceived street children’s proposed strategies.
Prognostic factors for the short-term mortality of patients with rheumatoid arthritis admitted to intensive care units
Authors: Fujiwara Toshifumi , Tokuda Kentaro , Momii Kenta , Shiomoto Kyohei , Tsushima Hidetoshi , Akasaki Yukio , Ikemura Satoshi , Fukushi Jun-ichi , Maki Jun , Kaku Noriyuki , Akahoshi Tomohiko , Taguchi Tomoaki , Nakashima Yasuharu 
Published: June 2020

Abstract
Background: Patients with rheumatoid arthritis (RA) have high mortality risk and are frequently treated in intensive care units (ICUs). Methods: This was a retrospective observational study. This study included 67 patients (20 males, 47 females) with RA who were admitted at the ICU of our institution for ≥48 h between January 2008 and December 2017. We analyzed the 30-day mortality of these patients and the investigated prognostic factors in RA patients admitted to our ICU.Results: Upon admission, the median age was 70 (range, 33–96) years, and RA duration was 10 (range, 0–61) years. The 5-year survival after ICU admission was 47%, and 30-day, 90-day, and 1-year mortality rates were 22%, 27%, and 37%, respectively. The major reasons for ICU admission were cardiovascular complications (24%) and infection (40%) and the most common ICU treatments were mechanical ventilation (69%), renal replacement (25%), and vasopressor (78%). In the 30-day mortality group, infection led to a fatal outcome in most cases (67%), and nonsurvival was associated with a significantly higher glucocorticoid dose, updated Charlson’s comorbidity index (CCI), and acute physiology and chronic health evaluation (APACHE) II score. Laboratory data obtained at ICU admission showed that lower platelet number and total protein and higher creatinine and prothrombin time international normalized ratio (PT-INR) indicated significantly poorer prognosis. The multivariate Cox proportional hazard model revealed that nonuse of csDMARDs, high updated CCI, increased APACHE II score, and prolonged PT-INR were associated with a higher risk of mortality after ICU admission.Conclusion: Our study demonstrated that the nonuse of csDMARDs, high updated CCI, elevated APACHE II score, and coagulation abnormalities predicted poorer prognosis in RA patients admitted to the ICU.
Inferring the votes in a new political landscape. The case of the 2019 Spanish Presidential elections.
Authors: Grimaldi Didier , Diaz Javier , Arboleda Hugo 
Published: June 2020

Abstract
The avalanche of personal and social data circulating in Online Social Networks over the past 10 years has attracted a great deal of interest from Scholars and Practitioners who seek to analyse not only their value, but also their limits. Predicting election results using Twitter data is an example of how data can directly influence the politic domain and it also serves an appealing research topic. This article aims to predict the results of the 2019 Spanish Presidential election and the voting share of each candidate, using Tweeter. The method combines sentiment analysis and volume information and compares the performance of five Machine Learning algorithms. Several data scrutiny uncertainties arose that hindered the prediction of the outcome. Consequently, the method develops a political lexicon-based framework to measure the sentiments of online users. Indeed, an accurate understanding of the contextual content of the tweets posted was vital in this work. Our results correctly ranked the candidates and determined the winner by means of a better prediction of votes than official research institutes.
Development and validation of a scoring system for predicting cancer patients at risk of extended-spectrum b-lactamase-producing Enterobacteriaceae infections.
Authors: Martinez-Valencia Alvaro Jose , Martínez Brian J Gómez , Ayala Anita M Montañez , Garcia Katherin , Pedraza Ricardo Sánchez , Cetina Leydy Jiménez , Rincón Julio Cesar Gómez , Maldonado Sonia Isabel Cuervo 
Published: June 2020

Abstract
Background: Extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) infections are frequent and highly impact cancer patients. We developed and validated a scoring system to identify cancer patients harboring ESBL-PE at the National Institute of Cancer of Colombia. Methods: We retrospectively analyzed medical records of 1695 cancer patients. Derivation phase included 710 patients admitted between 2013 to 2015, ESBL-PE positive culture (n = 265) paired by month and hospitalization room with Non-ESBL-PE (n = 445). A crude and weighted score was developed by conditional logistic regression. The model was evaluated in a Validation cohort (n = 985) with the same eligibility criteria between 2016 to 2017. Results: The score was based on eight variables (reported with Odds Ratio and 95% confidence interval): Hospitalization ≥7 days (5.39 [2.46 - 11.80]), Hospitalization during the previous year (4 , 87 [2.99 - 7.93]), immunosuppressive therapy during the previous 3 months (2.97 [1.44-6.08]), Neutropenia (1.90 [1.12 - 3.24]), Exposure to Betalactams during previous month (1.61 [1.06 - 2.42]), Invasive devices (1.51 [1.012 - 2.25]), Neoplasia in remission (2.78 [1.25 - 1.17]), No chemotherapy during the previous 3 months (1.90 [1.22 - 2.97]). The model demonstrated an acceptable discriminatory capacity in the Derivation phase, but poor in the Validation phase (Recipient Operating Characteristic Curve: 0.68 and 0.55 respectively). Conclusions: Cancer patients have a high prevalence of risk factors for ESBL-PE infection. The scoring system did not adequately discriminate patients with ESBL-PE. In a high-risk population, other strategies should be sought to identify patients at risk of resistant ESBL-PE infection.
Global Incidence of Necrotizing Enterocolitis: a Systematic Review and Meta-Analysis
Authors: Alsaied Amer , Islam Nazmul , Thalib Lukman 
Published: June 2020

Abstract
Background: Necrotizing Enterocolitis (NEC) is a major cause of morbidity and mortality in the Neonatal Intensive Care Unit (NICU), yet the global incidence of NEC has not been systematically evaluated. We conducted a systematic review and meta-analysis of cohort studies reporting the incidence of NEC in infants with Very Low Birth Weight (VLBW).Methods: The databases searched included PubMed, MEDLINE, the Cochrane Library, EMBASE and grey literature. Eligible studies were cohort or population-based studies of newborns including registry data reporting incidence of NEC. Data were extracted from the selected papers included incidence of NEC cases and size of population at risk, author and publication details, follow up period covered by the study, location and setting of the study and whether it was VLBW infants or preterm infants. Additionally, risk of bias assessment of the included studies were carried out using a validated tool. Bias adjusted Quality Effect Model (QEM) were used to pool the estimates. In the presence of substantial heterogeneity, Random Effect Models (REM) were used as an additionally sensitivity analyses. The heterogeneity between studies were evaluated using the Cochrane Q statistics and Higgin’s I2 value. Subgroup analysis and meta-regression were used to explore the sources of heterogeneity. Funnel plots as appropriate for ratio measures were used to assess publication bias. Results: A systematic and comprehensive search of databases identified 27 cohort studies reporting the incidence of NEC. The pooled estimate of the global incidence of NEC was 6.0% (95% CI: 4.0%-9.0%). There were substantial heterogeneity (I2 = 100%) between studies. Funnel plots showed no evidence of publication bias.Conclusion: Seven out of 100 of all VLBW infants in NICU are likely to develop NEC. However, there were considerable heterogeneity between studies. High quality studies assessing incidence of NEC along with associated risk factors are warranted.
Echography analysis altered in musculoskeletal, heart and liver associated with endothelial dysfunction of obese rat
Authors: Coria Alejandra Martínez , Estrada-Cruz Norma Angélica , Ordoñez María Inés Pérez , Montes-Cortes Daniel H. , Manuel-Apolinar Leticia 
Published: June 2020

Abstract
Background: Modern imaging plays a central role in the care of obese patients, with an integral focus on its use and accessibility in individuals into this condition with alterations of various organs. Objective. To perform an echographical analysis of musculoskeletal system disorders, endothelial dysfunction and the left ventricle in obese rats. Methods. Sprague Dawley rats (250±5 g) were used and divided in two groups: control group (C) fed with a standard diet, and the obese group (Ob) fed with a hyper caloric diet of high fructose-fat for 4 months. Body weight, cholesterol, triglycerides, glucose, inflammatory cytokines and adhesion molecules (ICAM-1, VCAM-1) were measured. Additionally, two-dimensional echocardiography, abdominal ultrasound and musculoskeletal system studies were performed in the lower extremities.Results. Body weight in the Ob group was increased compared to the control group, (p <0.001); in addition, increased glucose, cholesterol and triglycerides were found in the Ob group vs the C group, (p<0.05), and as well as increased adhesion molecules ICAM-1 and, VCAM-1 (p<0.01). On ultrasound, 75% of the Ob group presented, showed 75% fatty liver and distal joint abnormalities. Conclusion. Endothelial dysfunction and changes at the level of the musculoskeletal system with the presence of joint cysts in the posterior region of the distal joint of the lower extremities and fat liver were observed in obese rodents.
Household Expenditures And Direct Medical Costs Among Older Adults In Ghana: Evidence From WHO-SAGE Wave 2
Authors: Blankson Paa-Kwesi , Hewlett Sandra Ama , Ndanu Thomas Akuetteh , Amoah Gyaami , Boamah Matthew Owusu , Tormeti Daniel , Ampofo Patrick , Mensah George , Minicuci Nadia , Kowal Paul , Lartey Margaret , Biritwum Richard , YAWSON ALFRED 
Published: June 2020

Abstract
Background: The Ghanaian population aged 60 years and older will almost double to reach 14% of the total population by 2050. Ascertaining the pattern of health expenditures among this growing population group is important to inform policy makers about the targets for financial risk protection as part of achieving Universal Health Coverage (UHC) by 2030. This study aimed to estimate household expenditures among older adults and determine their direct medical costs.Methods: The World Health Organization's Study on global AGEing and adult health (SAGE) Wave 2 was conducted in China, Ghana, India, Mexico, Russian Federation, and South Africa between 2014 and 2015, as a follow-up to Wave 0 in 2003 to 2004 and Wave 1 in 2007 to 2010. Survey questions explored sources of income and total directhousehold expenditures in the year preceding the interview. SAGE Ghana was implemented using face-to-face interviews in a nationally representative sample of persons aged 50+ years with a comparison sample of younger adults aged 18–49 years. Findings: Analyses included a total of 4,735 participants, with 1,948 (43.8%) males and 2,787 (56.2%) females, with a mean age of 57.6 (±16.7). The average annual household expenditure was US$ 2,458 (±7,374). Older adults had higher expenditure levels at US$ 2,501 (±8,307), as compared to younger adults, US$ 2,309 (±3,056). Direct health-related and food costs accounted for 10% and 35% respectively of the total household expenditure. The prevalence of catastrophic health expenditure in households of older adults in Ghana was 7.5% (95% CI 6.0% - 9.3%).Conclusion: These updated estimates on household expenditure among older adults provide needed evidence to support the inclusion of social protection mechanisms in the national ageing agenda. The National Health Insurance reduced the burden of direct health expenditure for households with older adults.
Effects of β-carotene intake on the risk of fracture: A Bayesian meta-analysis
Authors: Charkos Tesfaye Getachew , Liu Yawen , Oumer Kemal Sherefa , Vuong Ann M , Yang Shuman 
Published: June 2020

Abstract
Background: Epidemiological studies examining the association between β-carotene intake and risk of fracture has reported inconsistent findings. We conducted a meta-analysis to investigate the association between β-carotene intake and risk of fracture using a Bayesian approach. Methods: We systematically searched PubMed, EMBASE and Cochrane library databases for relevant articles that were published until December 2019. We also identified studies from reference lists of articles identified from the clinical databases. The Bayesian random-effects model was used to synthesize data from individual studies. Results: Nine studies with a total of 190,545 men and women, with an average age of 59.8 years, were included in this meta-analysis. For β-carotene intake, the pooled risk ratio (RR) of any fracture was 0.67 (95% Credible Interval (CrI): 0.51-0.82; heterogeneity: P = 0.66, I2 =0.00 %) and 0.63 (95%CrI: 0.44-0. 82) for hip fracture. By study design, the pooled RRs were 0.55 (95% CrI: 0.14-0.96) for case-control studies and 0.82 (95% CrI: 0.58-0.99) for cohort studies. By geographic region, the pooled RRs were 0.58 (95% CrI: 0.28-0.89) for studies conducted in China, and 0.86 (95% CrI: 0.35-0.1.37) 0.91(95% CrI: 0.75-1.00) for studies conducted in the United States and Europe, respectively. By gender, the pooled RRs were 0.88 (95% CrI: 0.73-0.99) for males and 0.76 (95% CrI: 0.44-1.07) for females. There was a 95% probability that β-carotene intake reduces risk of hip fracture and any type of fracture by more than 20%. Conclusions: The present meta-analysis suggests that β-carotene intake was inversely associated with fracture risk, which was consistently observed for case-control and cohort studies. Randomized controlled trials are warranted to confirm this relationship.
Prognostic Value of Circulating Tumour Cells detected with the CellSearch System in Esophageal Cancer Patients: A Systematic Review and Meta-Analysis
Authors: Li Yiding , Wu Guiling , Yang Wanli , Wang Xiaoqian , Duan Lili , Niu Liaoran , Zhang Yujie , Liu Jinqiang , Hong Liu , Fan Daiming 
Published: June 2020

Abstract
Background: Esophageal carcinoma (EC) is the seventh-most prevalent tumor in the world, which is still one of the primary causes of tumor-related death. Identifying noteworthy biomarkers for EC is particularly significant in guiding effective treatment. Recently, circulating tumor cells (CTCs) in peripheral blood (PB) were intensively discussed as prognostic markers in patients with EC. However, an ongoing controversy still exists regarding the prognostic significance of CTCs determined by the CellSearch system in EC sufferers. This meta-analysis was designed to approach this topic. Methods: We systematically conducted searches using PubMed, Medline, Web of Science and the Cochrane Library for relevant studies, which were published through February 20, 2020. Using the random-effects model, our study was performed in Review Manager software, with odds ratios (ORs), risk ratios (RRs), hazard ratios (HRs) and 95% confidence intervals (CIs) as the effect values. Results: Totally 7 articles were finally included in this study. For clinicopathological characteristics, the pooled results on TNM stage indicated that the III/IV group had higher rate of CTCs compared with the I/II group (OR=1.36, 95% CI: 0.68-2.71, I2=0%). Incidence of CTCs was higher in patients with T3/T4 stage (OR=2.92, 95% CI: 1.31-6.51, I2=0%) and distant metastasis group (OR=5.18, 95% CI: 2.38-11.25, I2=0%) compared to patients with T1/T2 stage or non-metastatic group. The pooled analysis revealed that CTC positivity detected in EC patients was correlated with poor overall survival (OS) (HR=2.83, 95% CI:1.99-4.03, I2=0%) and relapse-free survival (RFS) (HR=4.71, 95% CI:2.73-8.13, I2=0%). When pooling the estimated RR, a poor therapeutic response to chemoradiotherapy was discovered in patients with CTC positivity (RR=1.99, 95% CI:1.73-2.29, I2=60%). Conclusions: In summary, our meta-analysis demonstrated that CTCs positivity determined by the CellSearch system are correlated with the prognosis of EC patients and might indicate a poor therapeutic response to chemotherapy in EC patients.
Identifying Integration and Differentiation in a Hospital’s Logistical System: A social network analysis of a case study
Authors: Ham Annelies van der , Merode Frits Van , Ruwaard Dirk , Raak Arno Van 
Published: June 2020

Abstract
Background Integration, the coordination and alignment of tasks, has been promoted widely in order to improve the performance of hospitals. Both organization theory and social network analysis offer perspectives on integration. This exploratory study research aims to understand how a hospital’s logistical system works, and in particular to what extent there is integration and differentiation. More specifically, it first describes how a hospital organizes logistical processes; second, it identifies the agents and the interactions for organizing logistical processes, and, third, it establishes the extent to which tasks are segmented into subsystems, which is referred to as differentiation, and whether these tasks are coordinated and aligned, thus achieving integration.Methods The study is based on case study research carried out in a hospital in the Netherlands. All logistical tasks that are executed for surgery patients were studied. Using a mixed method, data were collected from the Hospital Information System (HIS), documentation, observations and interviews. These data were used to perform a social network analysis and calculate the network metrics of the hospital network.Results This paper shows that 23 tasks are executed by 635 different agents who interact through 31,499 interaction links. The social network of the hospital demonstrates both integration and differentiation. The network appears to function differently from what is assumed in literature, as the network does not reflect the formal organizational structure of the hospital, and tasks are mainly executed across functional silos. Nurses and physicians perform integrative tasks and two agents who mainly coordinate the tasks in the network, have no hierarchical position towards other agents. The HIS does not seem to fulfill the interactional needs of agents. Conclusions This exploratory study reveals the network structure of a hospital. The cross-functional collaboration, the integration found, and position of managers, coordinators, nurses and doctors suggests a possible gap between organizational perspectives on hospitals and reality. This research sets a basis for further research that should focus on the relation between network structure and performance, on how integration is achieved and in what way organization theory concepts and social network analysis could be used in conjunction with one another.
GHG displacement factors of harvested wood products: the myth of substitution
Authors: LETURCQ Philippe 
Published: June 2020

Abstract
Abstract

Background: A currently held idea is that substituting wood for fossil fuels and energy intensive materials reduces greenhouse gas emissions. This is supported by the values usually attributed to the displacement factors that normalise the emission reduction to the wood carbon mass (typically, 0.5 tC/tC for fossil fuel substitution, 2 tC/tC for building material substitution). These values are based on the “carbon neutrality” assumption of harvested wood, which is claimed valid as long as forests are sustainably managed, but holds true in static conditions only. Harvesting disturbs forest growth and wood carbon storage for a long term. Therefore, the carbon footprint of harvested wood and related displacement factors must be assessed as time-dependant quantities, and the effect of substitutions should be appreciated relatively to specific time horizons. In this study, the meaning, values and use of the displacement factors are reconsidered according to this new line of thinking.

Results: When taking into account the forest carbon dynamics, the presumed values of the displacement factors under the carbon neutrality assumption are achieved only in steady-state conditions, a very long time after harvest. Shortly after harvest, and even for time horizons comparable with climatic deadlines, the transient values of these factors appear much less than the steady-state values, and may even be negative. This is especially the case for the substitution of wood for fossil fuels which first increases the carbon emission for the same energy released. An additional weakness of the ordinary concept of displacement lies in possible misevaluations of carbon benefits from substitution, especially when large sectors of wood products are concerned or when the market conditions are disregarded. Corrective measures are proposed for this.

Conclusions: The use of inadequate constant values of displacement factors under the carbon neutrality assumption and the supposition that wood substitution for other fuels or materials is always possible and effective leads to overestimations of carbon benefits. These overestimations erroneously incite the increase in harvesting and wood utilisation, which may be counter-productive for climate change mitigation objectives, especially when wood is used as a fuel.

Keywords: Forest carbon, Harvested wood products, Carbon accounting, Carbon neutrality, Sequestration parity, Energy and material substitution, Displacement factors, Climate change mitigation.