bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inequity in health care needs, health service use and financial burden of medical expenditures in China: results from a consecutive household monitoring study in Jiangsu Province
Authors: Jiang Weixi , Xu Xiaolin , Tang Shenglan , Xu Ling , Zhang Yaoguang , Elbers Chris , Cobelens Frank , Yan Lijing 
Published: August 2019

Abstract
Background: Although public medical insurance covers over 95% of the population in China, disparities in health service use and out-of-pocket (OOP) health expenditure across income groups are still widely observed. This study aims to investigate the socio-economic disparities in perceived health care needs, informal care, formal care and payment for health care and explore their equity implication.

Methods: We assessed healthcare needs, service use and payment in 400 households in rural and urban areas in Jiangsu, China, and included only the adult sample (N=925). One baseline survey and 10 follow-up surveys were conducted during the 7-month monitoring period, and the Affordability Ladder Program (ALP) framework was adopted for data analysis. Negative binomial/zero-inflated negative binomial and logit regression models were used to explore factors associated with perceived care needs and with the use of three types of health service (self-treatment, outpatient and inpatient care). Two-part model and logit regression were conducted to explore factors associated with OOP health expenditure and the likelihood of incurring catastrophic health expenditure (CHE).

Results: Rural residence was significantly associated with more perceived health care needs, more self-treatments, higher probability of using outpatient and inpatient service, more OOP health expenditure and higher likelihood of incurring catastrophic expenditure (P<0.05), after adjusting for other variables. Compared to Urban Employee Basic Medical Insurance (UEBMI), enrollment in New Rural Cooperative Medical Scheme (NRCMS) or Urban Resident Basic Medical Insurance (URBMI) was correlated with lower possibility of ever using outpatient service, but more times of outpatient visits when people were at risk of using outpatient service (P<0.05). NRCMS/URBMI was also associated with higher likelihood of incurring CHE with reference to UEBM (OR=2.02, P<0.05), and this effect was only significant for the rural population in the separate analysis of the rural and urban sample.

Conclusions: The rural population perceived more health care needs, had a higher probability of using both informal and formal health care services, and had more OOP health expenditure and a higher likelihood of incurring CHE in Jiangsu. The inequity mainly exists in health care financing, and may be partially addressed through improving the benefit packages of NRCMS/URBMI.
Treatment outcomes of tuberculosis in patients with lung cancer: a retrospective analysis
Authors: CHAI MEI , Shi Qingming 
Published: August 2019

Abstract
Background

Lung tuberculosis (TB) and cancer have a complex relationship. Data concerning TB treatment in lung cancer patients are still incomplete. The aim of this study was to investigate the clinical characteristics and treatment responses of lung tuberculosis in lung cancer patients.

Methods

In a retrospective cohort study, lung cancer patients with tuberculosis were identified between January 2013 and December 2016. These patients were divided into a TB treatment group and a TB nontreatment group. Age- and sex-matched lung cancer patients without tuberculosis were selected as control subjects. The clinical courses and responses of patients with and without tuberculosis were examined and compared.

Results

A total of 98 consecutive lung cancer patients were diagnosed with lung tuberculosis (47 patients in the TB treatment group and 51 patients in the TB nontreatment group). Fifty-one lung cancer patients without TB were enrolled as control subjects. Most patients in the three groups were elderly, had advanced non-small cell lung cancer and had tumor burdens. Compared with patients in the TB nontreatment group, the patients in the TB treatment group had more active TB (66% vs. 5.9%, p < 0.001) and were newly diagnosed (55.3% vs. 23.5%, p < 0.001). The anti-cancer chemotherapy response rate in the TB nontreatment group was not different from that in the TB treatment group (58.8% vs. 76.6%, p = 0.061), but it was significantly lower than that in the lung cancer group (58.8% vs. 88.2%, p < 0.001). The median survival times of patients in the TB treatment group, TB nontreatment group and cancer patients (control group) were not different (56, 55 and 58 weeks, respectively). No significant differences in serious side effects of chemotherapy were observed among the three groups.

Conclusion

Both anticancer and antituberculosis treatments can be safely and effectively administered in lung cancer patients with tuberculosis. Attention should be paid to the risk of tuberculosis in lung cancer patients in tuberculosis high-burden countries.
Use of SOPARC to assess physical activity in parks: can race/ethnicity, observation settings, and target area conditions affect reliability?
Authors: Marquet Oriol , Hipp J. Aaron , Alberico Claudia , Huang Jing-Huei , Fry Dustin , Mazak Elizabeth , Lovasi Gina S. , Floyd Myron F. 
Published: August 2019

Abstract
Background

Since its introduction in 2006, the SOPARC protocol has become a fundamental tool to quantify park visitor behaviors and characteristics. We tested SOPARC reliability when assessing race/ethnicity, physical activity, contextual conditions at the time of observation, and conditions of target areas to understand its utility when trying to account for individual characteristics of users.Methods

We used 4,725 SOPARC observations completed simultaneously by two independent observers to evaluate intraclass correlation and agreement rate between the two observers when trying to assess gender, age group, race/ethnicity, and level of physical activity of urban park users. Observations were in 20 New York City parks during Spring and Summer 2017 within the PARC 3 project.Results

Observers counted 25,765 park users with high interobserver reliability (ICC=.94; Agr=.75). Reliability scores were negatively affected by the population being observed, the intensity of physical activity, and the conditions and settings of the target area at the time of observation. Specific challenges were found when assessing the combination of physical activity and race/ethnicity.Conclusions

SOPARC training should aim to improve reliability when assessing concurrent measures; physical activity, race/ethnicity, age, and gender. Similarly, observing active areas and areas that can be congested with people require more observation practice hours.
Development and validation of the Espaijove.net mental health literacy (EMHL) test for Spanish adolescents
Authors: Castellvi Pere , Casanas Rocio , Arfuch Victoria-Mailen , Moreno Juan-José Gil , Torres María Torres , García-Forero Carlos , Ruiz-Castañeda Dyanne , Alonso Jordi , Lalucat-Jo Lluís 
Published: August 2019

Abstract
Background There is evidence of the effectiveness of implementing Mental Health Literacy (MHL) programs in improving mental health knowledge and reducing the stigma. However, there are substantial limitations in the instruments of measurement of mental health literacy. This study aimed to develop and validate the EspaiJove.net MHL test (EMHL) for Spanish adolescents assessing its psychometric properties.Methods The development of the EMHL as a maximum performance test was conducted using item pool generation and pilot study. Content generation was assessed according item relevance by mental health professionals’ and comprehensive and non-offensiveness by adolescents’ focus groups. A convenience sample of high school students aged 13-15y (n=355) participated in the validity study. Reliability was assessed with internal consistency and test-retest. Convergent validity was evaluated comparing effect size among known groups with different levels of mental health knowledge, correlation with mental health-related instruments, and item discrimination index.Results A final version of 35-item EMHL test was obtained with two parts: (i) 1st part consist of binary choice format (yes/no) for the identification of mental disorders; (ii) The part 2 has multiple choice questions with four possible answer options based on the thematic contents of the EspaiJove.net program. Internal consistency was acceptable in the 1st part (Cronbach’s alpha=0.744; Guttman’s lambda 2=0.773) and almost acceptable in the 2nd part (Cronbach’s alpha=0.615; Guttman’s lambda 2=0.643). The test-retest evaluation supported the stability of the test (1st part, ICC= 0.578; 2nd part, ICC= 0.422), no ceiling and floor effects were found. The EMHL test scores discriminated known groups with different levels of mental health knowledge, it is associated with a reduction of related-stigma, emotional symptoms, conduct problems and bullying behaviours and anxiety/depression and self-care quality of life (p<0.05), and it shows a strong discrimination index in almost all items (D≥0.40).Conclusions The EMHL test is a relevant measure for mental health prevention and promotion adapted to Spanish context taking into account the opinion of adolescents, using a non-offensive and adolescent-adapted vocabulary with acceptable validity and stability for assessing MHL levels in adolescents.
Self-reported confidence in patient safety competencies among Chinese nursing students: a multi-site cross-sectional survey
Authors: huang fei fei , shen xiaoying , Chen Xue Lei , he liping , Huang Sufen , li jingxiu 
Published: August 2019

Abstract
Background Nursing interns are an important backup force for nursing professionals, so efforts to strengthen their patient safety (PS) competencies are a major priority. To do so requires assessing the strengths and weaknesses of Chinese nursing students’ PS competence and identifying the influencing factors.
Methods This was a multi-site, cross-sectional, web-based study that was carried out between September 2018 and January 2019.
Participants A national online survey was completed by 732 Chinese undergraduate nursing students.
Main outcome measures Our primary outcome factor was the Health Professional Education in Patient Safety Survey score. We also collected socio-demographic and clinical practice-related characteristics as independent variables.
Results Chinese undergraduate nursing students were fairly confident in their clinical safety skills but less confident in what they learned about sociocultural or context-dependent aspects of PS and speaking up about PS, including effective communication and understanding human and environmental factors. Less than half of the students felt that they could approach someone engaging in unsafe practice and were reluctant to voice concern about adverse events. We observed significant differences in PS competence between students from different regions, across different PS learning styles (self-study and classroom theoretical study), with different self-assessed PS competence levels, and with experiences of adverse events( p <0.05). These factors accounted for almost 15% of the total variance in PS competence scores (adjusted R 2 =0.15， p =0.00).
Conclusions The results of this study provide a better understanding of PS competence among final-year nursing students. Our findings may help nursing educators or healthcare organizations to cultivate and improve PS competence by establishing documented policies or by improving the efficacy of intervention.
Pneumococcal disease: a retrospective cohort study on associated factors and risk factors for mortality among hospitalised adults in Singapore
Authors: Tay Min Zhi , Chan Tyson , Kyaw Win Mar , Chow Angela , Ho Hanley J 
Published: August 2019

Abstract
Background: Streptococcus pneumoniae infections can lead to severe morbidity and mortality, especially in patients with invasive pneumococcal disease (IPD). This study assesses factors associated with pneumococcal disease, and risk factors for mortality among hospitalised adults in Singapore.Methods: Retrospective study of patients with pneumococcal disease, based on streptococcal urinary antigen testing and/or sterile site cultures positive for S. pneumoniae , admitted to a tertiary hospital from 2015-2017. IPD and non-IPD cases were compared against a control group of patients, admitted over the same period but with negative results for the abovementioned tests.Results: We identified 496 pneumococcal disease cases, of whom 92 (18.5%) had IPD. The mean age of cases was 69.1±15.4yrs, and 65.5% were male. Compared with controls (N=9,181), IPD patients were younger (mean age 61.5±16.3yrs, vs 72.2±16.1yrs in controls; p<0.001) and with less co-morbidities [median Charlson’s score 1 (IQR 0-4), vs 3 (1-5) in controls; p<0.001]. IPD patients also had the highest proportions with intensive care unit (ICU) admission (20.7%), inpatient mortality (26.1%) and longest median length of stay [9 (8-17) days]. On multivariate analysis, IPD was negatively associated with prior pneumococcal vaccination (adjusted odds ratio=0.20, 95%CI 0.06–0.69; p=0.011). Risk factors for mortality among pneumococcal disease patients were ICU admission, diagnosis of IPD, age ≥85yrs and Charlson’s score >3.Conclusion: Patients with pneumococcal disease (especially IPD) were younger and had less co-morbidities than controls, but had higher risk of severe clinical outcomes and mortality. Pneumococcal vaccination was negatively associated with IPD and should be encouraged among high-risk patients.
Percutaneous nephrolithotomy vs. retrograde intrarenal surgery for renal stones larger than 2cm in patients with a solitary kidney: A systematic review and a meta-analysis
Authors: Jiang Kehua , Luo Guangheng , Hu Jianxing , Zhu Jianguo , Sun Fa 
Published: August 2019

Abstract
Background: The safety and feasibility of percutaneous nephrolithotomy (PCNL) compared with retrograde intrarenal surgery (RIRS) are debated. This systematic evaluation was performed to obtain comprehensive evidence with regard to the treatment outcomes of PCNL compared with RIRS for management of renal stones in patients with solitary kidney.
Methods: A systematic search of Medline, Embase, Pubmed, and the Cochrane Library was performed to identify studies that compared PCNL with RIRS. Outcomes of interest included perioperative variables, complications, and stone-free rate (SFR).
Results: 4 studies assessing PCNL vs. RIRS were included for meta-analysis. Although patients underwent PCNL have higher initial SFR than RIRS (OR: 3.72, 95% CI:2.38 to 5.83; P＜0.001), patients underwent RIRS have less intraoperative blood loss (dropped Hb: WMD= 3.49 g/L, 95% CI:2.83 to 4.15; P＜0.001), lower blood transfusion rates (OR= 5.31, 95% CI:1.36 to 20.68; P=0.02), and higher incidence rate of steinstrasse (OR:0.20, 95% CI:0.04 to 0.91; P=0.04). All the other calculated results including operation time (WMD: -9.87 minute, 95% CI:-30.11 to 10.37; P=0.34), final SFR (OR:1.65, 95% CI:0.80 to 3.42;P=0.18) and overall complications (OR:1.22, 95% CI:0.78 to 1.93; P=0.38) are similar between the two groups.
Conclusions: Our results indicate that PCNL has higher initial SFR than RIRS in the treatment of renal stones in patients with a solitary kidney; the overall complications were comparable in both groups. However, RIRS, with less blood loss and transfusion rate, may be an alternative in selected patients.
Synthesis of a Novel Curcumin Derivative as a Potential Imaging Probe in Alzheimer’s Disease Imaging
Authors: Sturzu Alexander , Sheikh Sumbla , Kalbacher Hubert , Nägele Thomas , Weidenmaier Christopher , Wegenast-Braun Bettina M. , Schilling Nadine , Ernemann Ulrike , Heckl Stefan 
Published: August 2019

Background:
Curcumin has been of interest in the field of Alzheimer’s disease. Early studies
on transgenic mice showed promising results in the reduction of amyloid plaques.However, curcumin is
very poorly soluble in aqueous solutions and not easily accessible to coupling as it contains only phenolic
groups as potential coupling sites. For these reasons only few imaging studies using curcumin bound
as an ester were performed and curcumin is mainly used as nutritional supplement.

Methods:
In the present study we produced an aminoethyl ether derivative of curcumin using a nucleophilic
substitution reaction. This is a small modification and should not impact the properties of curcumin
while introducing an easily accessible reactive amino group. This novel compound could be used to
couple curcumin to other molecules using the standard methods of peptide synthesis. We studied the
aminoethyl-curcumin compound and a tripeptide carrying this aminoethyl-curcumin and the fluorescent
dye fluorescein (FITC-curcumin) in vitro on cell culture using confocal laser scanning microscopy and
flow cytometry. Then these two substances were tested ex vivo on brain sections prepared from transgenic
mice depicting Alzheimer-like β-amyloid plaques.

Results:
In the in vitro CLSM microscopy and flow cytometry experiments we found dot-like unspecific
uptake and only slight cytotoxicity correlating with this uptake. As these measurements were optimized
for the use of fluorescein as dye we found that the curcumin at 488nm fluorescence excitation was not
strong enough to use it as a fluorescence marker in these applications. In the ex vivo sections CLSM
experiments both the aminoethyl-curcumin and the FITC-curcumin peptide bound specifically to β-
amyloid plaques.

Conclusion:
In conclusion we successfully produced a novel curcumin derivative which could easily be
coupled to other imaging or therapeutic molecules as a sensor for amyloid plaques.
Nigella sativa L., Supplementary Plant with Anticholinesterase Effect for Cognition Problems: A Kinetic Study
Authors: Ansari Mehdi , Mandegary Ali , Mosalanejhad Niloofar , Asadi Amir , Sharififar Fariba 
Published: August 2019

Background:
The average lifespan and the aging population are rising worldwide. So
Neurodegenerative Disease (ND) will be one of the most common challenges associated with this
population and would be more prevalent in future. The use of Acetylcholinesterase (AChE) inhibitors
is one of the most important strategies for memory impairment. Medicinal plants are the most
known natural source for accessing the new therapeutic agents.

Objective:
In this work, we aimed to study in vitro anticholinesterase effect of different concentrations
(10, 100, 250, 500, 750 and 1000 μg/ml) of total extract of N. sativa (NTE) and its separated
fractions and to study the kinetic of AChE enzyme in the presence of two concentrations of NTE
(10 and 100 μg/ml).

Methods:
Maceration method was used for NTE preparation and different fractions of Petroleum
Ether (PTE), Chloroform (CHF) and Methanol (MF). NTE, fractions and the main component of
the plant, Thymoquinone (TQ), were assayed for AChE inhibition, using Ellman’s method. Kinetic
study of the AChE enzyme was studied in the presence of NTE at 10 and 100 μg/ml using Linweaver-
Burk plot too.

Results:
NTE and all the separated fractions inhibited AChE enzyme in a concentration-dependent
manner. The greatest inhibition was shown by CHF and PEF fractions (86.97% and 79.99% at 1000
μg/ml, respectively). With less intensity, NTE, TQ and MF exhibited 76.32%, 68.98 % and 48.39%
enzyme inhibition at 1000μg/ml, respectively. The least IC50 value was due to CHF fraction in
AChE inhibition (98.28 ± 6.74 μg/ml).
Kinetic profile exhibited the mixed mode of AChE inhibition by NTE. This indicates that a particular
substance could not be responsible for AChE inhibition, and probably a collection of phytochemicals
are involved in this process.

Conclusions:
N. sativa is a good candidate for seeking the new anticholinesterase agent and could
be considered as a good supplement for the health of the elderly.
ONLINE PERSPECTIVES ON ASEAN-JAPAN RELATIONS: Study of ASEAN-related Japanese Tweets
Authors: Pratidina Indah Santi 
Published: August 2019

ASEAN targets internal integration and strong external relations with its partner countries. Japan has stressed its long-standing support for ASEAN. The year 2013 saw the 40th anniversary of Japan-ASEAN relations when Japanese state actors put considerable efforts into marking this anniversary. Although Japan remains one of ASEAN's largest trading partners and sources of foreign direct investment, recent years has witnessed power relations dynamic in the region with China and South Korea actively engaging as well. State actors’ statements on ASEAN-Japan relations had been the heavy focus of scholars interested in the field. However, insights from all levels of society are important for a more comprehensive observation. An analysis of social media, and in particular Twitter, offers one way to accomplish this purpose. The total of 3.29 million tweets containing the word “ASEAN” were collected from November 2013 to December 2015. From the dataset, it was identified that tweets using Japanese language are the third highest in volume after Indonesian and English. Content analyses were conducted to answer the questions on how ASEAN as an entity is viewed by the populations of its partner countries; which aspects of the integration project attract Twitter users’ interests also, in the relation to strong external relations that ASEAN want to pursue, which countries are mentioned in the tweets and on which aspects? Using keywords from the Blueprints of ASEAN Community’s integration aspects, the tweets were categorized as related to economics, political-security and socio-cultural topics. Countries mentioned in the dataset were counted and then categorized according to these aspects as well. The study finds economic and political-security themed tweets are the largest in volume with heavy mentioning of Japan, China and South Korea. Results suggest that online conversations about ASEAN are still strongly influenced by government and mainstream media’s agenda.
Editorial Foreword For IKAT, Number 2
Authors: Reid Anthony 
Published: August 2019

It is a pleasure to introduce this second issue of the enterprising new journal, IKAT. It is breaking new ground in opening Indonesia to its region, and establishing a high standard of scholarly publication in English. It is good to see Southeast Asians taking up the challenge of understanding their own region. As the Orientalist tradition of Europe weakens, institutions and individuals in the region must take up the challenge of understanding, preserving and analysing Southeast Asian cultures, many of them endangered. Southeast Asian Studies must return to Southeast Asia, and IKAT is certainly helping this process.
Remembering the Forgotten Past: A Case Study of Bali's First Governor, Anak Agung Bagus Sutedja
Authors: Wijaya Nyoman 
Published: August 2019

This article explores the way forgetting and remembering a dark past takes place in Balinese society. To do so, it takes the case of Anak Agung Bagus Sutedja, the first Governor of Bali, who was appointed in 1959 but 'disappeared' in 1965 or 1966. He has been systematically forgotten by Balinese society and, more specifically, by and within the academic community of Udayana University. Applying a historical approach, this article argues that the process of forgetting in the community is deeply entangled with the New Order's embodied official narratives about the 1965 tragedy