bluuebunny/crossref_metadata_2025_split huggingface dataset:
The safety and efficacy of irreversible electroporation versus tamsulosin in the treatment of benign prostatic obstruction: study protocol and rationale for a randomized controlled trial
Authors: Song Qi-Xiang , He Biming , Gao Xu , Xu Chuanliang , Sun Yinghao , Wang Haifeng 
Published: September 2019

Abstract
Background Though transurethral resection of the prostate is still considered to be the ‘‘gold standard’’ procedure for benign prostatic obstruction (BPO), the reported post-operative complication rate is not uncommon. The emerging of minimally invasive focal ablative therapies provide an alternative option for patients who are dissatisfied with medical treatment yet do not willing to take the interventional procedures. Irreversible electroporation (IRE) is a novel focal therapy which can accurately ablate the target tissues with minimum damage to the surrounding structures. The application of IRE in selected patients with prostate cancer has yielded promising results, but no report on BPO has been published. Methods/design This is a single-centered, prospective, randomized controlled trial to evaluate the effectiveness and safety of IRE in treating BPO compare with tamsulosin. We aim to recruit BPO patients who are currently taking tamsulosin but without absolute indications for surgical intervention. Eligible subjects will undergo a 3-day treatment free washout period, followed by baseline assessment. After randomized into IRE group and tamsulosin (0.2mg orally once daily) group, subjects will be followed-up for up to 24 months. The primary clinical outcome is the change in maximum flow rate from baseline at 6 months. Other assessments, including symptom questionnaires, ultrasound, prostatic specific antigen, prostate magnetic resonance image and pressure-flow study, will be carried out at different time points during follow-up. Any perception or patient-reported adverse events in both treatment arms will be documented. Data will be analyzed by a specialist who is blinded to the medical status and treatment modality in order to minimize the potential bias. Discussion This is the first randomized controlled trial evaluating the feasibility of IRE for the treatment of BPO. The outcomes of this study will provide high level of evidence to determine its true clinical value.
A Walk in the Park: Models of BMI with Green Space Density and Footpaths
Authors: Carthy Philip , Lyons Sean , Nolan Anne 
Published: September 2019

Abstract
Background : While exposure to urban green spaces has been associated with various physical health benefits, the evidence linking these spaces to lower BMI, particularly among older people, is mixed. We suggest that dimensions of green space accessibility, which are generally unobserved in the existing literature, may be a source of this volatility in results. Methods: We conduct a cross-sectional study combining data from The Irish Longitudinal Study on Ageing and detailed land use information. We proxy respondents’ exposure to green spaces at their residential addresses in network buffers, which are adjusted to account for the density of local footpaths. Generalised linear models are used to test the association between exposure to accessible green space and BMI. Results: Relative to the third quintile, exposure to the two lowest quintiles of green space, as measured within a 1600m accessible network buffer, is associated with slightly higher BMI (marginal effect for lowest quintile: 0.88; 95% CI: 0.24-1.53; marginal effect for second quintile: 0.61; 95% CI: 0.02-1.2). The results, however, are not robust to small changes in how green space is measured and no statistically significant association between green spaces and BMI is found under other variants of our regression model. Conclusion : The relationship between green spaces and BMI among older adults is highly sensitive to the characterisation of local green space. While footpath availability offers a partial explanation to some unintuitive empirical results previously found in the literature, our results suggest that there remains some other unobserved factor which mediates the relationship between green spaces and weight status.
Evaluation of the national surveillance of Legionnaire’s disease in Norway, 2008-2017
Authors: Wolff Cecilia , Lange Heidi , Feruglio Siri , Vold Line , MacDonald Emily 
Published: September 2019

Abstract
Background In Norway, Legionnaire’s disease is reportable upon clinical suspicion to public health authorities and mandatorily notifiable through the Norwegian surveillance system for communicable diseases (MSIS) for both clinicians and laboratories. In the summer of 2017, several European countries reported high notification rates for Legionnaire’s disease, which was not observed in Norway. We evaluated MSIS to assess if it meets its objectives of detecting cases and trends in incidence of Legionnaire’s disease.Methods We retrieved MSIS data from 2008 to 2017 and calculated timeliness as days from sampling to notification, and internal completeness for key variables as the proportion of observations with a value. Where possible, we assessed internal validity on the presence of a plausible value. To estimate external completeness and validity we linked MSIS with hospital reimbursement claims in the Norwegian Patient Registry. To assess acceptability and representativeness, we surveyed doctors in 39 hospitals on their units’ diagnostic and notification procedures, and use of MSIS.Results There were 438 notified cases. Internal completeness and internal validity were high for key variables (≥95%). The median delay from sampling to notification was 4 days. There were 73 patients in MSIS only, 70 in the Norwegian Patient Registry only, and 351 in both registers. The external completeness of MSIS was 83% (95% CI 80-86%). For external validity, the positive predictive value of MSIS was 83% (95% CI 79-86%). Forty-seven respondents from 28 hospitals described testing procedures. These were inconsistent: 29 (62%) reported no systematic application of criteria for requesting legionella testing. Eighteen (38%) reported testing all patients with suspected pneumonia and a travel history. Thirty-one (66%) found the notification criteria clear.Conclusions Our results suggest that the surveillance in MSIS can detect changes in incidence of Legionnaire’s disease over time, by place and person, but likely does not detect every case diagnosed in Norway. We recommend wider investigation of diagnostic procedures in order to improve representativeness and awareness of MSIS notification criteria among clinicians in order to improve acceptability of the surveillance. We also recommend a more comprehensive assessment of whether patients only registered in the Norwegian Patient Registry were true Legionnaire’s disease cases.
Catastrophic health expenditure: A comparative study between hypertensive patients with and without complication in rural Shandong, China
Authors: Zhang Xinyi , Xu Qiongqiong , Guo Xiaolei , Jing Zhengyue , Sun Long , Li Jiajia , Zhou Chengchao 
Published: September 2019

Abstract
Background Some previous studies have assessed catastrophic health expenditure (CHE) in households with hypertensive patients, but few have examined the difference of CHE in hypertensive patients with and without complications. The purpose of this study is to compare the prevalence and determinants of CHE between hypertensive patients with and without complications.Methods The data were draw from a cross-sectional study conducted in four rural counties of Shandong Province in China in 2016, including 3,113 hypertensive patients. CHE was defined as out-of-pocket payments for hypertensive care that equaled or exceeded 40% of the household capacity to pay. We employed Chi-square test to explore associated factors and logistic regression model to identify the determinants of CHE.Results The prevalence of CHE is 13.6% among hypertensive patients. The prevalence of CHE with one complication is 25.3% ( Ρ =0.000, OR=2.29 ) and 47.3% ( P=0.000, OR=3.60 ) in patients with two or more complications, which are both statistically higher than that in patients without complication (6.1%). Across all types of patients, income levels are inversely related to the prevalence of CHE. Patients who use outpatient or inpatient service are more likely to experience CHE ( Ρ =0.000 ). Factors including living arrangements, family size, educational attainment are found to be significantly associated with CHE in some subgroups ( Ρ <0.05 ).Conclusions CHE prevalence among hypertensive patients is high in rural China. Patients with hypertensive complication are at higher catastrophic risk than those without complication.
Analysis of health education utilization of migrants in Beijing using Anderson health service utilization model
Authors: Shao Shuang , Zhang Huirong , Xuxiao Jingyuan , Chen Xiaolei , Zhao Yali , Du Juan 
Published: September 2019

Abstract
Background: Domestic migration is considered as a challenge for China. Migrants are vulnerable to certain risks and diseases due to encounter several obstacles to accessing preventive care services. This research sought to unveil and explore the determinant factors associated with health education utilization as one important aspect of basic public health services for migrants in Beijing of China. Methods: A sample of 863 inter-provincial migrants who were 18 years old and above was chosen by three-stage stratified cluster sampling method in 2016 urban-rural connection districts of Beijing. A structured questionnaire survey was conducted via face-to-face interviews. Anderson health service utilization model was used to demonstrate the effects of the explanatory variables on health education seeking behavior from predisposing, enabling, health behavior and need variables. Results: The study revealed that 60.4% migrants desired to receive health education, while only 34.5% of them received in the past year. Many migrants desired to access various types of health education information from the internet. Chi-square independence test shows that age, "Hukou" registration system, marital status, education level, plan to reside for a long time in Beijing, have at least one child in Beijing, employment status, housing source, average working time daily, do exercises, acquire health knowledge, smoking, self-evaluation general health status are the major determinants affecting migrants to receive whole health education. The binary logistic regression indicates that the migrants with younger, high education level, have at least one child in Beijing, do exercises and self-evaluated good health status were more likely to receive whole health education. The results also show that average working time daily of enabling variables and do exercise of health behavior variables were the strong and consistent determinants of three types of health education utilization, including communicable, non-communicable and occupational diseases. Conclusion: There were certain gaps between the needs and utilization in health education. More attention should be given to the migrants with heavy workload and low education level. Relevant policies and feasible measures, including health providing health information by multiple channels, should be vigorously implemented to ensure easy and equitable access to health education for migrants.
How to improve the satisfaction levels of new rural cooperative medical system in underdeveloped areas of China ?
Authors: University Pin YaoShengjing Hospital of China Medical , Nursing China Medical University Yifan WuSchool of , Chen Xiaodong , OuYang Jing , Liu Chunping , Sun Shu 
Published: September 2019

Abstract
Abstract Background: Over the years, China has designed a new rural cooperative medical system for large rural population, which enables them to obtain adequate medical services and prevents poverty caused by medical treatments. However, the rapid economic growth makes the allocation of health resources and the efficient utilization of health services face severe challenges. The study aims to reveal the medical inequality of eight underdeveloped provinces from the perspectives of medical institutions, insurance policies, the government and farmers, in order to puts forward relevant recommendations. Methods: The relevant statistics about assessing the characteristics and equity of demographics, socio-economic and geographical dimensions were from the China Statistical Yearbook and the China Health Statistics Yearbook. A face-to-face sampling survey of farmers in 24 counties of eight less developed provinces (Guizhou, Yunnan, Sichuan, Shanxi, Gansu, Qinghai, Ningxia and Xinjiang) was carried out by multi-stage stratified random sampling. The protection effect of New Rural Cooperative Medical System（NRCMS）, satisfaction of medical service and willingness to participate in NRCMS were analyzed. Results: Since the implementation of the new rural cooperative medical system, there has been an inequality in medical service and insurance policy among poor residents in western China. The uneven distribution of medical resources, the inadequacy of local government investment, the complexity of the reimbursement process, and the low amount of compensation resulted in only 26.6% of the population believing that the economic burden of the disease had been reduced, and 57.3% that the relief effect was not obvious. The remaining 16.1% thought the system was ineffective and farmers' satisfaction was not enough. Conclusion: Compared with the eastern and central regions, there was a certain degree of unfairness in government investment in the resources of medical institutions of the western region with new rural cooperative medical care. This study suggested that policy makers can attract high-quality medical staff to the western region by providing economic security and improving policies. In addition, the increase of the government regional health expenditure and supervision propaganda was one of the important ways to improve the farmers' satisfaction with the policy.
A novel nomogram to predict the reliability of estimated glomerular filtration rate formula in oncology patients
Authors: Cheng Yichun , Huang Liu , Han Yunfeng , Vanisha Chummun , Ge Shuwang , Xu Gang 
Published: September 2019

Abstract
Background

Formulae of estimated glomerular filtration rate (eGFR) based on serum creatinine (Scr) are routinely used in oncology patients, however, they are inaccurate in some populations. Our aim was to identify population characteristics where eGFR formulae performed poorly and thereby build a nomogram to predict the reliability of estimates.

Methods

Measured GFR (mGFR) using isotope from 444 oncology patients were compared with eGFR from four formulae (Cockcroft-Gault, Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology (CKD-EPI) Collaboration and Wright). Multivariate logistic regression was applied to identify characteristics associated with inaccurate eGFR and construct a predictive nomogram.

Results

The Cockcroft–Gault formula exhibited estimates with lowest bias and highest precision. Nonetheless, it was still unreliable in a relevant proportion of patients. The percentage of patients within 30%, 20%, and 10% of the accurate percentage error (APE) was seen in only 62.8%, 47.7% and 24.8% of patients respectively. Inaccuracy was found in overweight patients or in patients with BUN/Scr ratio greater than 20 or with eGFR greater than 120 ml/min. A novel nomogram was constructed to help oncologists to predict the risk of inaccuracy of eGFR. The calibration curve showed good agreement.

Conclusions

Our results suggest that all eGFR formulae tend to overestimate the eGFR in oncology patients. Our nomogram may assist oncologists in decision-making when mGFR is needed.
Escherichia Coli O157:H7: Distribution, molecular characterization, antimicrobial resistance patterns and source of contamination of sheep and goat carcasses at an export Abattoir, Mojdo, Ethiopia
Authors: Abreham Solomon , Teklu Akafete , Cox Eric , Tessema Tesfaye Sisay 
Published: September 2019

Abstract
Background : Cattle have been identified as a major reservoir of E. coli O157:H7 for human infection; the ecology of the organism in sheep and goats is less understood. This study was carried out to determine prevalence, source of infection, antibiotic resistance and molecular characterization of Escherichia coli O157: H7 isolated from sheep and goat.
Methods : Systematic random sampling was carried out at Modjo export abattoir, Ethiopia, from November 2012 to April 2013 to collect 408 samples from 72 sheep and 32 goats. Samples collected were skin swabs, fecal samples, intestinal mucosal swabs and the inside and outside part of carcasses as well as carcass in contacts such as workers hands, knife, hook and carcass washing water. Then, samples were processed following standard bacteriological procedures. Non-Sorbitol fermenting colonies were tested on latex agglutination test and the positives are subjected to PCR for detection of attaching and effacing genes ( eaeA) and shiga toxin producing genes ( stx1 and stx2 ). All E. coli O157:H7 isolates were checked for their susceptibility pattern towards 15 selected antibiotics.
Results : E. coli O157:H7 were detected in only 20/408 samples (4.9%). Among these 20 positive samples, 70% (14/20), 25% (5/20) and 5% (1/20) were from sheep, goats and knife samples, respectively. No significant associations were found between carcasses and the assumed sources of contaminations. Of all the 20 isolates virulence genes were found in 10 (50%) of them; 3 (15%) with only the eaeA gene and 7(35%) expressing eaeA and stx2 genes. All the isolates were susceptible to Norfloxacin (NOR) (100%).
Conclusions : The presence of virulence genes shows E. coli O157:H7 is a potential source of human infection in Ethiopia.
Key words : Abattoir, antibiotic sensitivity, CT-SMAC, E. coli O157:H7, IMS, Latex agglutination, multiplex PCR.
Factors influencing the relationship between fluoride in drinking water and dental fluorosis: a ten-year systematic review and meta-analysis
Authors: Akuno M. H. , Nocella G. , Milia E. P. , Gutierrez L. 
Published: September 2019

Abstract
The relationship between naturally fluoridated groundwater and dental fluorosis has received large attention from researchers around the world. Despite recognition that several factors influence this relationship, there is a lack of systematic studies analyzing the heterogeneity of these results. To fill such a gap, this study performs a systematic review and meta-analysis to understand which factors influence this relationship and how. Selected studies were sampled between 2007 and 2017 from Web of Science, PubMed, Google Scholar and Scopus using keywords and Boolean operators. Results of the systematic review show that dental fluorosis affects individuals of all ages, with the highest prevalence below 11, while the impact of other factors (gender, environmental conditions, diet and dental caries) was inconclusive. Meta-regression analysis, based on information collected through systematic review, indicates that both fluoride in drinking water and temperature influence dental fluorosis significantly and that these studies might be affected by publication bias. Findings show that fluoride negatively affects people's health in less developed countries. The conclusions discuss policy tools and technological innovations that could reduce fluoride levels below that of the World Health Organization (WHO) (&lt;1.5 mg/L).
The In Silico Drug Discovery Toolbox: Applications in Lead Discovery and Optimization
Authors: Bruno Agostino , Costantino Gabriele , Sartori Luca , Radi Marco 
Published: September 2019

Background:Discovery and development of a new drug is a long lasting and expensive journey that takes around 20 years from starting idea to approval and marketing of new medication. Despite R&D expenditures have been constantly increasing in the last few years, the number of new drugs introduced into market has been steadily declining. This is mainly due to preclinical and clinical safety issues, which still represent about 40% of drug discontinuation. To cope with this issue, a number of in silico techniques are currently being used for an early stage evaluation/prediction of potential safety issues, allowing to increase the drug-discovery success rate and reduce costs associated with the development of a new drug.Methods:In the present review, we will analyse the early steps of the drug-discovery pipeline, describing the sequence of steps from disease selection to lead optimization and focusing on the most common in silico tools used to assess attrition risks and build a mitigation plan.Results:A comprehensive list of widely used in silico tools, databases, and public initiatives that can be effectively implemented and used in the drug discovery pipeline has been provided. A few examples of how these tools can be problem-solving and how they may increase the success rate of a drug discovery and development program have been also provided. Finally, selected examples where the application of in silico tools had effectively contributed to the development of marketed drugs or clinical candidates will be given.Conclusion:The in silico toolbox finds great application in every step of early drug discovery: (i) target identification and validation; (ii) hit identification; (iii) hit-to-lead; and (iv) lead optimization. Each of these steps has been described in details, providing a useful overview on the role played by in silico tools in the decision-making process to speed-up the discovery of new drugs.
Current Computational Approaches for the Development of Anti-HIV Inhibitors: An Overview
Authors: Panwar Umesh , Chandra Ishwar , Selvaraj Chandrabose , Singh Sanjeev K. 
Published: September 2019

Background:Today, HIV-1 infection has become an extensive problem to public health and a greater challenge to all working researchers throughout the world. Since the beginning of HIV-1 virus, several antiviral therapeutic agents have been developed at various stages to combat HIV-1 infection. But, many of antiviral drugs are on the platform of drug resistance and toxicology issues, needs an urgent constructive investigation for the development of productive and protective therapeutics to make an improvement of individual life suffering with viral infection. As developing a novel agent is very costly, challenging and time taking route in the recent times.Methods:The review summarized about the modern approaches of computational aided drug discovery to developing a novel inhibitor within a short period of time and less cost.Results:The outcome suggests on the premise of reported information that the computational drug discovery is a powerful technology to design a defensive and fruitful therapeutic agents to combat HIV-1 infection and recover the lifespan of suffering one.Conclusion:Based on survey of the reported information, we concluded that the current computational approaches is highly supportive in the progress of drug discovery and controlling the viral infection.