bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Multiple Imputation and Inverse Probability Weighting to Adjust for Missing Data in HIV Prevalence Estimates: A Cross-Sectional Study in Mwanza, North Western Tanzania.
Authors: MHIKE TINASHE , Todd Jim , Urassa Mark , Mosha Neema 
Published: January 2021

Abstract
Background Population surveys and demographic studies are the gold standard for estimating HIV prevalence. However, non-response in these surveys is of major concern especially if it is not random and complete case analysis becomes an inappropriate method to analyse the data. Therefore, a comprehensive analysis that will account for the missing data must be used to obtain unbiased HIV prevalence estimates. MethodsSerological samples were collected from participants who were resident in a Demographic Surveillance System (DSS) in Kisesa, Tanzania. HIV prevalence was estimated using three methods. Firstly, using the Complete case analysis (CCA), assuming data were Missing Completely at Random (MCAR). The other two methods, multiple imputations (MI) and inverse probability weighting (IPW), assumed that non-response was missing at random (MAR). For MI, a logistic regression model adjusting for age, sex, residence, and marital status was used to impute 20 datasets to re-estimate the HIV prevalence. Propensity for participating in the sero-survey and being tested for HIV given age, sex, residence, and marital status were generated using logistic regression models. Using the propensity scores, inverse probability weights were derived for participants who were tested for HIV.ResultsThe overall CCA HIV prevalence estimate was 6.6% (95% CI: 6.0-7.2), with 5.4% (95% CI: 4.6-6.3) in males and 7.3% (95% CI: 6.6-8.1) in females. Using MI, the overall HIV prevalence was 6.8% (95% CI: 6.2-7.5), 6.2% (95% CI: 5.1-7.3) in males and 7.4% (95% CI: 6.6-8.2) in females. Using IPW the overall HIV prevalence was 6.7% (95% CI: 6.1-7.4), with 5.5% (95% CI: 4.7-6.5) in males and 7.7% (95% CI: 7.0 - 8.6) in females. HIV prevalence differed significantly between age groups (p<0.001), with the highest estimate in males aged 35-39 and females aged 40-44, and lowest in both males and females aged 15-19 years.DiscussionThe results showed that both MI and IPW are reliable methods for estimating HIV prevalence in the presence of missing data. MI is superior to CCA and the IPW approaches as it had smaller standard errors and narrower 95% confidence intervals. Therefore, we recommend use of MI in estimating HIV prevalence to address the problem of varied types of missing data. However, further research is needed to determine the bias in estimates from MI and IPW.ConclusionsComplete case analysis underestimates HIV prevalence compared to methods that adjust for missing data. The best method to adjust for missing data in population surveys is through the use of multiple imputations.
Comparison Analysis of Childhood Body Mass Index Cut-offs in Predicting Adulthood Carotid Intima Media Thickness: Tehran Lipid and Glucose Study
Authors: Hosseinpanah Farhad , Seyedhoseinpour Amirhosein , Barzin Maryam , Mahdavi Maryam , Tasdighi Erfan , Dehghan Pooneh , Moghaddam Amin Momeni , Azizi Fereidoun , Valizadeh Majid 
Published: January 2021

Abstract
Background: The prevalence of obesity among children and adolescences have been increased, which can consequently increase the prevalence of metabolic and cardiovascular diseases later in life. The objective of this study is to compare the ability of different childhood body mass index cut-offs in prediction of carotid intima media thickness (CIMT) as an indicator of subclinical atherosclerosis. Methods: Participants were categorized into normal weight, overweight and obesity group, based on world health organization (WHO), center for disease control and prevention (CDC), international obesity task force (IOTF) and local IOTF cut-offs. After 18 years of follow up CIMT was measured. Akaike’s information criterion and relative efficiency were measured in order to compare regression models on the role of obesity on CIMT.Results: In this prospective cohort study, 1295 subjects aged 3 to 18 years old were enrolled. The overall prevalence of overweight was 15.4, 11.5, 16.3 and 14.1 along with obesity prevalence of 6.6, 8.5, 7.7 and 5.0 percent based on WHO, CDC, local IOTF and international IOTF criteria, respectively. CIMT was higher in obese compare to normal groups across all classification criteria. After regression analysis, international IOTF was the best to predict adulthood CIMT, followed by local IOTF and WHO. CDC had the least discriminatory ability. Conclusion: Due to the results of this study, IOTF could be a better tool in national and international surveillances of children in order to define overweight and obesity, which can help us to intervene more effectively in reducing the burden of cardiovascular diseases.
Facile Preparation and Highly Efficient Sorption of Magnetic Composite Graphene Oxide/Fe3O4/GC for Uranium Removal
Authors: Yang Aili , Wang Zhijun , Zhu Yukuan 
Published: January 2021

Abstract
In this work, we reported for the first time a novel magnetic composite graphene oxide/Fe3O4/glucose-COOH (GO/Fe3O4/GC) that was facilely prepared from glucose through the hydrothermal carbonization and further combination with graphene oxide (GO). The chemical and structural properties of the samples were investigated. By the batch uranium adsorption experiments, the magnetic composite GO/Fe3O4/GC exhibits an excellent adsorption performance and fast solid-liquid separation for uranium from aqueous solution. GO/Fe3O4/GC (the maximum adsorption capacity (Qm) was 390.70 mg g-1) exhibited excellent adsorption capacity and higher removal rate (> 99%) for U(VI) than those of glucose-COOH (GC) and magnetic GC (MGC). The effect of the coexisting ions, such as Na+, K+, Mg2+, Ca2+, and Al3+, on the U(VI) removal efficiency of GO/Fe3O4/GC was examined. The equilibrium sorption and sorption rate for the as-prepared adsorbents well fit the Langmuir model and pseudo second-order kinetic model, respectively. The thermodynamic parameters (ΔH0 = 11.57 kJ mol-1 and ΔG0 < 0) for GO/Fe3O4/GC indicate that the sorption process of U(VI) was exothermic and spontaneous. Thus, this research provides a facile strategy for the preparation of the magnetic composite with low cost, high efficiency and fast separation for the U(VI) removal from aqueous solution.
Cost-utility Analysis of a Consensus and Evidence-based Medication Review to Optimize and Potentially Reduce Psychotropic Drug Prescription in Institutionalized Dementia Patients
Authors: Mesquida Mireia Massot , Folkvord Frans , Seda Gemma , Lupiáñez-Villanueva Francisco , Toran-Monserrat Pere 
Published: January 2021

Abstract
BACKGROUND: Growing evidence shows the effects of psychotropic drugs on the evolution of dementia. Until now, only a few studies have evaluated the cost‑effectiveness of psychotropic drugs in institutionalized dementia patients. This study aims to assess the cost‑utility of intervention based on consensus between specialized caregivers involved in the management of dementia patients for optimizing and potentially reducing the prescription of inappropriate psychotropic drugs in this population. This analysis was conducted using the Monitoring and Assessment Framework for the European Innovation Partnership on Active and Healthy Ageing (MAFEIP) tool.METHODS: The MAFEIP tool builds up from a variety of surrogate endpoints commonly used across different studies in order to estimate health and economic outcomes in terms of incremental changes in quality adjusted life years (QALYs), as well as health and social care utilization. Cost estimates are based on scientific literature and expert opinion; they are direct costs and include medical visits, hospital care, medical tests and exams and drugs administered, among other concepts. The healthcare costs of patients using the intervention were calculated by means of a medication review that compared patients' drug‑related costs before, during and after the use of the intervention. The cost‑utility analysis was performed from the perspective of a health care system with a time horizon of 12 months.RESULTS: The tool calculated the incremental cost‑effectiveness ratio (ICER) of the intervention, revealing it to be dominant, or rather, better (more effective) and cheaper than the current (standard) care. The ICER of the intervention was in the lower right quadrant, making it an intervention that is always accepted even with the lowest given Willingness to Pay (WTP) threshold value (€15,000). CONCLUSIONS: The results of this study show that the intervention was dominant, or rather, better (more effective) and cheaper than the current (standard) care. This dominant intervention is therefore recommended to interested investors for systematic application.
Intradialytic Arrhythmias Among Patients with End Stage Renal Disease on Maintenance Hemodialysis at Muhimbili National Hospital
Authors: Adam Wailesy , Nagu Tumaini , Mutagaywa Reuben , Kisanga Onesmo 
Published: January 2021

Abstract
BackgroundArrhythmias are responsible for almost 2 out of 3 cardiac deaths among patients on hemodialysis. We report the prevalence and risk factors for clinically significant arrhythmias among end stage renal disease (ESRD) patients on maintenance dialysis at a tertiary dialysis facility in Tanzania. MethodsCross-sectional study, involving consenting adults with ESRD was conducted September 2019 to February 2020. Arrhythmias were assessed using standard 5-leads Holter electrocardiography placed 15 minutes before dialysis and connected throughout dialysis. Clinically Significant Arrhythmias (CSA) was defined as ectopic beats in excess of 10 per hour or any of the ventricular tachycardia or Pause lasting for at least 2.5 seconds or paroxysmal supraventricular tachycardia or atrial flutter or atrial fibrillation. ResultsA total of 71 (44.4%) participants had CSA. Factors associated with increased risk for CSA were: age older than 60 years (OR 34; 95% CI: 5.15-236; P< 0.001), intradialytic blood pressure change of ≥ 10mmHg (OR 3.85; 95% CI: 1.27-11.7; P=0.017) and the presence of Left Ventricular Hypertrophy (OR 5.84; 95% CI: 1.85-18.4; P< 0.01). On the contrary, three dialysis sessions per week (OR 0.14; 95% CI: 0.03-0.67; P=0.013) and use of beta-blockers (OR 0.18; 95% CI: 0.05-0.68; P=0.011) were significantly associated with a decreased risk of CSA. ConclusionClinically significant arrhythmias are not uncommon in ESRD patients undergoing maintenance haemodialysis. We recommend increasing vigilance for CSA among older patients (>60 years) as well as those with left ventricular hypertrophy. Beta blockers among hypertensive ESRD patients with ventricular hypertrophy could be helpful.
LUAD And LUSC Cancer Classification, Biomarker Identification, and Pathway Analysis Using Overlapping Feature Selection Methods
Authors: Dhahbi Joseph M. , Chen joe w. 
Published: January 2021

Abstract
Lung cancer is one of the deadliest cancers in the world. Two of the most common subtypes, lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC), have drastically different biological signatures, yet they are often treated similarly and classified together as non-small cell lung cancer (NSCLC). LUAD and LUSC biomarkers are scarce and their distinct biological mechanisms have yet to be elucidated. Many studies have attempted to improve traditional machine learning algorithms or develop novel algorithms to identify biomarkers, but few have used overlapping machine learning or feature selection methods for cancer classification, biomarker identification, or pathway analysis. This study proposes selecting overlapping features as a way to differentiate between cancer subtypes, especially between LUAD and LUSC. Overall, this method achieved classification results comparable to, if not better than, the traditional algorithms. It also identified multiple known biomarkers, and five potentially novel biomarkers with high discriminating values between the two subtypes. Many of the biomarkers also exhibit significant prognostic potential, particularly in LUAD. Our study also unraveled distinct biological pathways between LUAD and LUSC.
The Impact of the COVID-19 Pandemic on Child Health and Well-Being: Are Children “Slipping through the Net”? A Qualitative Study of Frontline Emergency Care Staff
Authors: Conlon Ciara , McDonnell Thérèse , Barrett Michael , Cummins Fergal , Deasy Conor , Hensey Conor , McAuliffe Eilish , Nicholson Emma 
Published: January 2021

Abstract
BackgroundThe COVID-19 pandemic and subsequent public health guidance to reduce the spread of the disease have wide-reaching implications for children’s health and wellbeing. Furthermore, paediatric emergency departments (EDs) have rapidly adapted provision of care in response to the pandemic. This qualitative study utilized insight from multidisciplinary frontline staff to understand 1) the changes in paediatric emergency healthcare utilization during COVID-19 2) the experiences of working within the restructured health system. MethodsFifteen semi-structured interviews were conducted with frontline staff working in two paediatric EDs and two mixed adult and children EDs. Participants included emergency medicine clinicians (n = 5), nursing managerial staff (n=6), social workers (n=2) and nursing staff (n = 2). Thematic Analysis (TA) was applied to the data to identify key themes. ResultsThe pandemic and public health restrictions have had an adverse impact on children’s health and psychosocial wellbeing, compounded by difficulty in accessing primary and community services. The impact may have been more acute for children with disabilities and chronic health conditions and has raised child protection issues for vulnerable children. EDs have shown innovation and agility in the structural and operational changes they have implemented to continue to deliver care to children, however resource limitations and other challenges must be addressed to ensure high quality care delivery and protect the wellbeing of those tasked with delivering this care.Conclusions The spread of COVID-19 and subsequent polices to address the pandemic has had wide-reaching implications for children’s health and wellbeing. The interruption to health and social care services is manifesting in myriad ways in the ED, such as a rise in psychosocial presentations. As the pandemic continues to progress, policy makers and service providers must ensure the continued provision of essential health and social services, including targeted responses for those with existing conditions.
Amplifying the heat shock response ameliorates pathology in mouse and human models of ALS and FTD.
Authors: Ahmed Mhoriam , Spicer Charlotte , Harley Jasmine , Petersen Nikolaj , Taylor Paul , Jensen Thomas , Hanna Michael , Patani Rickie , Greensmith Linda 
Published: January 2021

Abstract
Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) are now widely considered to be part of a disease spectrum with the identification of common pathological features and genetic causes. However, despite these advances, there remains no effective therapy for these conditions. In this study we demonstrate that mice expressing mutant valosin containing protein (VCP) develop an ALS/FTD-like phenotype in the spinal cord and brain, and treatment with arimoclomol, a pharmacological amplifier of the cytoprotective heat shock response ameliorates this phenotype. Moreover, the beneficial effects of arimoclomol are seen in both fibroblasts and iPSC-derived motor neurons from patients. Importantly, we show the pathological changes targeted by arimoclomol in our experimental models are present in post-mortem FTD patient tissue. Together with previous data demonstrating the efficacy of arimoclomol in SOD1-ALS models, our findings suggest that arimoclomol may have therapeutic potential not only in non-SOD1 ALS but also for the treatment of FTD.
Manure Application Affects Soil Bacterial Community Structure in the Maize-wheat Rotation System of North China Plain
Authors: Liu Gaoyuan , He Ailing , Du Jun , Yang Huanhuan , Yang Zhanping , Zhang Yuting 
Published: January 2021

Abstract
A 2-year maize-wheat rotation experiment was conducted to clarify the characteristics of soil bacterial community under reduced fertiliser-N application rate on the North China Plain. Treatments were conventional fertilisation (CF), 80% fertiliser-N input (80%N) and 80% fertiliser-N plus manure input (80%NM) in the wheat season, while the fertilisation regimes of previous maize were consistent. Results showed that 80%NM increased wheat ear·m-2 and 1,000-grain weight by 5.1% and 7.5%, and it also increased soil C/N ratio (by 29.1%) and dissolved organic N content (by 41.6%), compared with CF, although the difference in crop yields between treatments was not significant. Values of soil bacterial α-diversity parameters (observed species, chao1 estimator, evenness and Shannon’s diversity index) were improved under 80%NM, but not under 80%N. Compared with CF, 80%NM increased the abundance of phyla Firmicutes and Gemmatimonadetes but decreased the abundance of phylum Acidobacteria. Redundancy analysis indicated that organic C, dissolved organic N and C/N ratio were major environment variables affecting the distribution of bacterial phyla. These results suggest that manure application can improve soil fertility and productivity under reduced fertiliser-N application rate.
Central Mucoepidermoid Carcinoma Arising Directly From a Glandular Odontogenic Cyst of the Mandible: A Case Report
Authors: Maruyama Satoshi , Mori Taisuke , Yamazaki Manabu , Abé Tatsuya , Ryo Eijitsu , Kano Hiroyuki , Hasegawa Go , Tanuma Jun-ichi 
Published: January 2021

Abstract
BackgroundCentral mucoepidermoid carcinoma (MEC) is a rare salivary gland tumor that affects the jaw bone. Glandular odontogenic cyst (GOC) is also a rare odontogenic developmental cyst with glandular differentiation. GOC shares some histological features with central MEC, and a pre-existing GOC can develop into central MEC. Here, we present a rare case of central MEC developed directly from a pre-existing GOC of the mandible. Case presentationA 67-year-old Japanese man presented with a cystic lesion in the right third molar region. Histologically, the biopsy specimen demonstrated both typical of a GOC component lined with non-keratinized squamous epithelium and a recognizable component of central MEC consisting of polycystic nests with mucous cells, intermediate cells, and epidermoid cells in the cyst wall. The immunohistochemistry for cytokeratin (CK) profile results demonstrated that while both central MEC and GOC expressed CKs 7, 14, 18, and 19, interestingly CK13 was only expressed in GOC. Fluorescence in-situ hybridization (FISH) revealed the rearrangement of the Mastermind like (MAML)-2 gene in both MEC and GOC components. Conclusions﻿Our case suggests that central MEC and GOC may be in the same spectrum of diseases caused by rearrangement of the MAML-2 gene. At the same time, the expression profile of CK13 was completely different in both central MEC and GOC. This also suggests that central MEC is a distinct tumor from GOC. Thus, we demonstrated the rare case that central MEC may have originated directly from the GOC.
Phase 2b Open-label Randomized Controlled Trial to Evaluate the Efficacy, Safety and Tolerability of N-acetylcysteine in Reducing Adverse Drug Reactions among Adults Treated for Multidrug-resistant Tuberculosis in Tanzania. (Trial Acronym NAC Trial).
Authors: Mpagama Stellah George George , Mvungi Happiness C , Mbelele Peter M , Semvua Hadija H , Liyoyo Alphonce A , de Guex Kristen P , Sloan Derek J , Kibiki Gibson S , Boeree Martin J , Phillips Patrick PJ , Heysell Scott K 
Published: January 2021

Abstract
Background: Adverse drug reactions (ADRs) frequently occur in patients using second-line anti-tuberculosis medicine for treatment of multidrug resistant tuberculosis (MDR-TB). ADRs contribute to treatment interruptions which can compromise treatment response and risk acquired drug resistance to critical newer drugs such as bedaquiline, while severe ADRs carry considerable morbidity and mortality . N-acetylcysteine (NAC) has shown promise in reducing ADRs for medications related to TB in case series or randomized controlled trials in other medical conditions. We therefore designed a pilot clinical trial to study the protective effect of NAC among people treated for MDR-TB with second-line anti-TB medications. Methods: This is a phase 2b randomized open label clinical trial with 3 treatment arms including a control arm , an interventional arm of NAC 900mg daily , and an interventional arm of NAC 900mg twice-daily administered during the intensive phase of MDR-TB treatment. Patients initiating MDR-TB treatment will be enrolled at Kibong’oto National Center of Excellence for MDR-TB in the Kilimanjaro region of Tanzania . The minimum anticipated sample size is 66 ; with 22 participants in each arm. ADR monitoring will be performed at baseline and daily follow-up over 24 weeks including blood and urine specimen collection for hepatic and renal function and electrolyte abnormalities, and electrocardiogram. Sputum will be collected at baseline and monthly thereafter and cultured for mycobacteria as well as assayed for other molecular targets of Mycobacterium tuberculosis . Adverse drug events will be analysed over time using mixed effect models. Mean differences between arms in change of the ADRs from baseline (with 95% confidence intervals) will be derived from the fitted model. Discussion: Given that NAC promotes synthesis of glutathione, an intracellular antioxidant that combats the impact of oxidative stress , it may protect against medication induced oxidative damage in organs such as liver, pancreas, kidney and cells of the immune system. This randomized controlled trial will determine if NAC leads to fewer ADRs, and if this protection is dose dependent. Fewer ADRs among patients treated with MDR-TB may significantly improve treatment outcomes for multidrug regimens that necessitate prolonged treatment durations. Trial registration: PACTR202007736854169 Registered 03 July 2020 https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=12163
A Comparative Study of Objective Outcome Measures Used in Clinical Trials of Freezing of Gait&nbsp;
Authors: Revuelta Gonzalo , Embry Aaron , Elm Jordan , Jenkins Shonna , Lee Philip , Kautz Steve 
Published: January 2021

Abstract
Background: Freezing of gait (FOG) is notoriously difficult to quantify, leading to multiple metrics utilized as outcomes for clinical trials. The instrumented timed up a go and the many parameters that can be derived from it are commonly used as objective markers of gait severity in FOG trials, however it is unknown if they represent FOG severity. Objective: To determine the specificity and responsiveness of objective surrogate markers of FOG severity commonly utilized in FOG studies. Methods: Markers compared included: velocity, step/stride length, step/stride length variability, TUG, and turn duration. Data was collected in four conditions (ON and OFF dopaminergic drugs, with and without a dual task). Unified Parkinson’s Disease rating scale (UPDRS) was administered in the ON and OFF states. Results: 33 subjects were recruited (17 PD subjects without FOG (PD-control), and 16 subjects with PD and dopa-responsive FOG PD-FOG). The UPDRS motor scores were: 24.9 for the PD-control group in the ON state, 24.8 for the FOG group in the ON state, 42.4 for the FOG group in the OFF state. Significant mean differences between the ON and OFF conditions were observed with all surrogate markers (p<0.01). However, only dual task turn duration and step variability showed trends toward significance when comparing PD-control and ON-FOG (p=0.08). Test-retest reliability was high (ICC >0.90) for all markers except standard deviations. Step length variability was the only marker to show an area under the ROC curve analysis >0.70 comparing ON-FOG vs. PD-control. Conclusions: Multiple candidate surrogate markers for FOG severity showed responsiveness to levodopa challenge, however, most were not specific for FOG severity.