bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantitative real-time PCR detection of Zika virus and evaluation with field-caught Mosquitoes
Authors: Faye Oumar , Faye Ousmane , Diallo Diawo , Diallo Mawlouth , Weidmann Manfred , Sall Amadou Alpha 
Published: October 2013

A bstract

Background
Zika virus (ZIKV), a mosquito borne flavivirus is a pathogen affecting humans in Asia and Africa. ZIKV infection diagnosis relies on serology–which is challenging due to cross-reactions with other flaviviruses and/or absence or low titer of IgM and IgG antibodies at early phase of infection- virus isolation, which is labor intensive, time consuming and requires appropriate containment. Therefore, real-time RT-PCR (rRT-PCR) is an appealing option as a rapid, sensitive and specific method for detection of ZIKV in the early stage of infection. So far, only one rRT-PCR assay has been described in the context of the outbreak in Micronesia in 2007. In this study, we described a one step rRT-PCR for ZIKV which can detect a wider genetic diversity of ZIKV isolates from Asia and Africa.

Results
The NS5 protein coding regions of African ZIKV isolates were sequenced and aligned with representative flaviviruses sequences from GenBank to design primers and probe from conserved regions. The analytical sensitivity of the assay was evaluated to be 32 genome-equivalents and 0.05 plaque forming unit (pfu). The assay was shown to detect 37 ZIKV isolates covering a wide geographic in Africa and Asia over 36 years but none of the 31 other flaviviruses tested showing high analytical specificity. The rRT-PCR could be performed in less than 3 hours. This method was used successfully to detect ZIKV strains from field-caught mosquitoes.

Conclusion
We have developed a rapid, sensitive and specific rRT – PCR for detection of ZIKV. This assay is a useful tool for detection of ZIKV infection in regions where a number of other clinically indistinguishable arboviruses like dengue or chikungunya co-circulate. Further studies are needed to validate this assay in clinical positive samples collected during acute ZIKV infection.
Poor knowledge of methotrexate associated with older age and limited English-language proficiency in a diverse rheumatoid arthritis cohort
Authors: Barton Jennifer L , Schmajuk Gabriela , Trupin Laura , Graf Jonathan , Imboden John , Yelin Edward H , Schillinger Dean 
Published: October 2013

Abstract
Introduction
Our objective was to determine rheumatoid arthritis (RA) patients’ understanding of methotrexate and assess whether knowledge varies by age, education, English language proficiency, or other disease-related factors.

Methods
Adults with RA (n = 135) who were enrollees of an observational cohort completed a structured telephone interview in their preferred language between August 2007 and July 2009. All subjects who reported taking methotrexate were asked 11 questions about the medication in addition to demographics, education level, and language proficiency. Primary outcome was a total score below the 50th percentile (considered inadequate methotrexate knowledge). Bivariable and multivariable logistic regressions were performed. Covariates included demographics, language proficiency, education, and disease characteristics.

Results
Of 135 subjects, 83% were female, with a mean age of 55 ± 14 years. The majority spoke English (64%), followed by 22% Spanish and 14% Cantonese or Mandarin. Limited English language proficiency (LEP) was reported in 42%. Mean methotrexate knowledge score was 5.4 ± 2.6 (range, 0 to 10); 73 (54%) had a score lower than 5 (of 10). Age older than 55, less than high school education, LEP, better function, and biologic use were independently associated with poor knowledge.

Conclusions
In a diverse RA cohort, overall methotrexate knowledge was poor. Older age and limited proficiency in English were significant correlates of poor knowledge. Identification of language barriers and improved clinician-patient communication around methotrexate dosing and side effects may lead to improved safety and enhanced benefits of this commonly used RA medication.
Safety, Efficacy, and Biomarkers of Nivolumab With Vaccine in Ipilimumab-Refractory or -Naive Melanoma
Authors: Weber Jeffrey S. , Kudchadkar Ragini Reiney , Yu Bin , Gallenstein Donna , Horak Christine E. , Inzunza H. David , Zhao Xiuhua , Martinez Alberto J. , Wang Wenshi , Gibney Geoffrey , Kroeger Jodi , Eysmans Cabell , Sarnaik Amod A. , Chen Y. Ann 
Published: October 2013

Purpose Nivolumab, a human immunoglobulin G4–blocking antibody against the T-cell programmed death-1 checkpoint protein, has activity against metastatic melanoma. Its safety, clinical efficacy, and correlative biomarkers were assessed with or without a peptide vaccine in ipilimumab-refractory and -naive melanoma. Patients and Methods In this phase I study, 90 patients with unresectable stage III or IV melanoma who were ipilimumab naive and had experienced progression after at least one prior therapy (cohorts 1 to 3, 34 patients) or experienced progression after prior ipilimumab (cohorts 4 to 6, 56 patients) received nivolumab at 1, 3, or 10 mg/kg every 2 weeks for 24 weeks, then every 12 weeks for up to 2 years, with or without a multipeptide vaccine. Results Nivolumab with vaccine was well tolerated and safe at all doses. The RECIST 1.1 response rate for both ipilimumab-refractory and -naive patients was 25%. Median duration of response was not reached at a median of 8.1 months of follow-up. High pretreatment NY-ESO-1 and MART-1–specific CD8+ T cells were associated with progression of disease. At week 12, increased peripheral-blood T regulatory cells and decreased antigen-specific T cells were associated with progression. PD-L1 tumor staining was associated with responses to nivolumab, but negative staining did not rule out a response. Patients who experienced progression after nivolumab could respond to ipilimumab. Conclusion In patients with ipilimumab-refractory or -naive melanoma, nivolumab at 3 mg/kg with or without peptide vaccine was well tolerated and induced responses lasting up to 140 weeks. Responses to nivolumab in ipilimumab-refractory patients or to ipilimumab in nivolumab-refractory patients support combination or sequencing of nivolumab and ipilimumab.
Prediagnostic Body Mass Index and Pancreatic Cancer Survival
Authors: Yuan Chen , Bao Ying , Wu Chen , Kraft Peter , Ogino Shuji , Ng Kimmie , Qian Zhi Rong , Rubinson Douglas A. , Stampfer Meir J. , Giovannucci Edward L. , Wolpin Brian M. 
Published: October 2013

Purpose Although obesity is associated with increased incidence of pancreatic cancer, studies have not prospectively evaluated prediagnostic body mass index (BMI) and survival. Patients and Methods We analyzed survival by prediagnostic BMI assessed in 1986 among 902 patients from two large prospective cohorts diagnosed from 1988 to 2010. We estimated hazard ratios (HRs) for death using Cox proportional hazards models, with adjustment for age, sex, race/ethnicity, smoking, diagnosis year, and stage. We evaluated the temporal association of BMI with survival by grouping reported BMI by 2-year lag-time intervals before diagnosis. Results The multivariable-adjusted HR for death was 1.53 (95% CI, 1.11 to 2.09) comparing patients with BMI ≥ 35 kg/m2 with those with BMI < 25 kg/m2 (P trend = .001), which was similar after adjustment for stage. The association of BMI with survival was stronger with longer lag times between reported BMI and cancer diagnosis. Among patients with BMI collected 18 to 20 years before diagnosis, HR for death was 2.31 (95% CI, 1.48 to 3.61; P trend < .001), comparing obese with healthy-weight patients. No statistically significant differences were seen by cohort, smoking status, or stage, although the association was stronger among never-smokers (HR, 1.61; 95% CI, 1.01 to 2.57; P trend = .002) than ever-smokers (HR, 1.36; 95% CI, 0.86 to 2.15; P trend = .63), comparing BMI ≥ 35 kg/m2 with BMI < 25 kg/m2. Higher prediagnostic BMI was associated with more advanced stage at diagnosis, with 72.5% of obese patients presenting with metastatic disease versus 59.4% of healthy-weight patients (P = .02). Conclusion Higher prediagnostic BMI was associated with statistically significantly decreased survival among patients with pancreatic cancer from two large prospective cohorts.
Oral versus intravenous tranexamic acid in enhanced-recovery primary total hip and knee replacement
Authors: Irwin A. , Khan S. K. , Jameson S. S. , Tate R. C. , Copeland C. , Reed M. R. 
Published: October 2013

In our department we use an enhanced recovery protocol for joint replacement of the lower limb. This incorporates the use of intravenous tranexamic acid (IVTA; 15 mg/kg) at the induction of anaesthesia. Recently there was a national shortage of IVTA for 18 weeks; during this period all patients received an oral preparation of tranexamic acid (OTA; 25 mg/kg). This retrospective study compares the safety (surgical and medical complications) and efficacy (reduction of transfusion requirements) of OTA and IVTA. During the study period a total of 2698 patients received IVTA and 302 received OTA. After adjusting for a range of patient and surgical factors, the odds ratio (OR) of receiving a blood transfusion was significantly higher with IVTA than with OTA (OR 0.48 (95% confidence interval 0.26 to 0.89), p = 0.019), whereas the safety profile was similar, based on length of stay, rate of readmission, return to theatre, deep infection, stroke, gastrointestinal bleeding, myocardial infarction, pneumonia, deep-vein thrombosis and pulmonary embolism. The financial benefit of OTA is £2.04 for a 70 kg patient; this is amplified when the cost saving associated with significantly fewer blood transfusions is considered. Although the number of patients in the study is modest, this work supports the use of OTA, and we recommend that a randomised trial be undertaken to compare the different methods of administering tranexamic acid. Cite this article: Bone Joint J 2013;95-B:1556–61.
Modeling and Simulation of 5 and 11 DOF Ball Bearing System with Localized Defect
Authors: Marín J. M. , Rubio H. , García-Prada J. C. , Reinoso O. 
Published: October 2013

Abstract
This paper proposes a model of concentrated parameters for a rolling bearing operating in dynamic conditions with and without localized defect. The rolling bearing is modeled as a Z + 2 df degree of freedom (DOF) system, where Z is the number of rolling elements. The radial displacement of these rolling elements is considered in this model. In the analytical formulation, the contact force between the balls and races is considered as non-linear spring-dampers, whose stiffnesses are obtained applying Hertzian elastic contact deformation theory. The equations of motion are formulated using Lagrange's equation, considering the characteristics of the individual components of a rolling bearing, such as rotor, rolling elements, and inner and outer race. The Runge-Kutta method is used to solve the non-linear differential equations of motion. The simulation is accomplished by MATLAB and SIMULINK. To validate the simulated model, we have designed a testbed to carry out. The frequency components of the signal generated by the model in simulation and the experimentally obtained signal are compared. The results achieved experimentally demonstrate the validity of the mathematical model presented here. The model provides a powerful tool to predict the satisfactory behavior of this system.
Evaluating the Operational Efficiency of the Banking Sector in Taiwan: A Two-Stage Data Envelopment Analysis Approach
Authors: Wang Mu-Shun , Lu Shih-Tong 
Published: October 2013

Abstract
In this study we adopted two-stage data envelopment analysis (DEA) methods, including the Charnes–Cooper–Rhodes and Banker–Charnes–Cooper methods, to evaluate the performance of marketing-orientation and profit-orientation activities on the cost efficiency of Taiwan's banks. The conventional DEA model was modified to take into account the series relationship for dividing two sub-processes in order to identify the causes of inefficiency. Information was obtained from 37 Taiwanese banks for the period from 2008 to 2011. The Malmquist total factor productivity index was employed to measure the effect of productivity changes on the panel data. The empirical results from the two-stage approach indicate the following: (1) the mean efficiency score of profitability stage banks is higher than that of the marketability stage banks; (2) the technical efficiency is significantly different from ranking according to the operating scale and pure technical efficiency, and the scale efficiencies are significantly different from ranking according to fixed assets; and (3) economies of scale and scope exist at small and medium-sized banks.
Az adhaesioképződés mechanizmusa és modellezésének lehetőségei – Előkísérleti modellek
Authors: Szabó Györgyi , Gamal Eldin Mohamed , Sándor József , Ferencz Andrea , Lévay Bernadett , Csukás Domokos , Dankó Titanilla , Wéber György 
Published: October 2013

Absztrakt
A hasüregi sebészeti beavatkozásokat követő adhaesio kialakulását számos műtéti körülmény segíti elő – pl. vérzés, idegen anyag bejutása, szövetsérülés, -roncsolódás, ischaemia, hypoxia. Képződése műtéti típustól függően akár 95%-os is lehet. Az adhaesio sok esetben elősegíti további posztoperatív szövődmények kialakulását. Ez lehet krónikus hasi fájdalom, a szervek megfelelő motilitásának akadályozása, de nőknél akár infertilitást is okozhat. Éppen ezért fontos a képződés mechanizmusának pontos ismerete, illetve a megfelelő állatmodell kidolgozása, amely lehetővé teszi a különböző prevenciós módszerek vizsgálatait. Az adhaesioképződésben kulcsszerepet játszó molekulákat, működésük és egymásra hatásuk mechanizmusát szakirodalmi adatok összefoglalásával állítottuk össze. Az adhaesiós állatmodell kidolgozásához hím Wistar-patkányokat használtunk. Az adhaesio kialakításához a következő módszereket alkalmaztuk: pontszerű vérzés előidézése, különböző idegen anyagok beültetése, ischaemizált terület létrehozása, kisebb és jelentősebb szöveti roncsolás. Modelljeinkben a pontszerű vérzések és ischaemizált hasfali területek esetén nem látható adhaesio. Idegen anyagok használatánál a behelyezett anyag felületétől függő méretű adhaesio képződött. Kisebb sérülés esetén szintén jól működött az adhaesio képződését gátló mechanizmus. Az adhaesiós kísérleteink közül a durva szövetsérülést okozó típus a legmegbízhatóbb, az adhaesioképződés minden állatban megfigyelhető, ezért további vizsgálatainkhoz jól használható modell. A bonyolult mechanizmusban a kulcsszereplők megismerése és a megfelelő modell kialakítása elengedhetetlen feltétele a megfelelő prevenciós módszerek kidolgozásának.
Health Care Utilization Patterns of Homeless Individuals in Boston: Preparing for Medicaid Expansion Under the Affordable Care Act
Authors: Bharel Monica , Lin Wen-Chieh , Zhang Jianying , O’Connell Elizabeth , Taube Robert , Clark Robin E. 
Published: October 2013

Objectives. We studied 6494 Boston Health Care for the Homeless Program (BHCHP) patients to understand the disease burden and health care utilization patterns for a group of insured homeless individuals. Methods. We studied merged BHCHP data and MassHealth eligibility, claims, and encounter data from 2010. MassHealth claims and encounter data provided a comprehensive history of health care utilization and expenditures, as well as associated diagnoses, in both general medical and behavioral health services sectors and across a broad range of health care settings. Results. The burden of disease was high, with the majority of patients experiencing mental illness, substance use disorders, and a number of medical diseases. Hospitalization and emergency room use were frequent and total expenditures were 3.8 times the rate of an average Medicaid recipient. Conclusions. The Affordable Care Act provides a framework for reforming the health care system to improve the coordination of care and outcomes for vulnerable populations. However, improved health care coverage alone may not be enough. Health care must be integrated with other resources to address the complex challenges presented by inadequate housing, hunger, and unsafe environments.
Risk Factors for Becoming Homeless Among a Cohort of Veterans Who Served in the Era of the Iraq and Afghanistan Conflicts
Authors: Metraux Stephen , Clegg Limin X. , Daigh John D. , Culhane Dennis P. , Kane Vincent 
Published: October 2013

Objectives. In this population-based cohort study, we assessed baseline risk factors for homelessness, including the role of service in the Iraq or Afghanistan conflicts, among a large cohort of recent veterans.Methods. Data for this study came from administrative records for 310 685 veterans who separated from active military duty from July 1, 2005, to September 30, 2006. We used survival analysis methods to determine incidence rates and risk factors for homelessness, based on baseline data for military factors, demographic characteristics, and diagnoses of behavioral health disorders and traumatic brain injury.Results. Service in Iraq or Afghanistan and, more specifically, posttraumatic stress disorder among veterans deployed there, were significant risk factors of modest magnitude for homelessness, and socioeconomic and behavioral health factors provided stronger indicators of risk. Gender was not a significant indicator of differential risk.Conclusions. Although service in Iraq and Afghanistan was significant, socioeconomic and behavioral health indicators show more promise in efforts to use administrative data to inform prevention efforts by identifying veterans who are at elevated risk for becoming homeless upon their return to civilian life.
Efficient Targeting of Homelessness Prevention Services for Families
Authors: Shinn Marybeth , Greer Andrew L. , Bainbridge Jay , Kwon Jonathan , Zuiderveen Sara 
Published: October 2013

Objectives. We developed and evaluated a model to target homelessness prevention services to families more efficiently. Methods. We followed 11 105 families who applied for community-based services to prevent homelessness in New York City from October 1, 2004, to June 30, 2008, through administrative records, using Cox regression to predict shelter entry. Results. Over 3 years, 12.8% of applicants entered shelter. Both the complete Cox regression and a short screening model based on 15 risk factors derived from it were superior to worker judgments, with substantially higher hit rates at the same level of false alarms. We found no evidence that some families were too risky to be helped or that specific risk factors were particularly amenable to amelioration. Conclusions. Despite some limitations, an empirical risk model can increase the efficiency of homelessness prevention services. Serving the same proportion of applicants but selecting those at highest risk according to the model would have increased correct targeting of families entering shelter by 26% and reduced misses by almost two thirds. Parallel models could be developed elsewhere.
Comparing Homeless Persons’ Care Experiences in Tailored Versus Nontailored Primary Care Programs
Authors: Kertesz Stefan G. , Holt Cheryl L. , Steward Jocelyn L. , Jones Richard N. , Roth David L. , Stringfellow Erin , Gordon Adam J. , Kim Theresa W. , Austin Erika L. , Henry Stephen Randal , Kay Johnson N. , Shanette Granstaff U. , O’Connell James J. , Golden Joya F. , Young Alexander S. , Davis Lori L. , Pollio David E. 
Published: October 2013

Objectives. We compared homeless patients’ experiences of care in health care organizations that differed in their degree of primary care design service tailoring.Methods. We surveyed homeless-experienced patients (either recently or currently homeless) at 3 Veterans Affairs (VA) mainstream primary care settings in Pennsylvania and Alabama, a homeless-tailored VA clinic in California, and a highly tailored non-VA Health Care for the Homeless Program in Massachusetts (January 2011-March 2012). We developed a survey, the “Primary Care Quality-Homeless Survey," to reflect the concerns and aspirations of homeless patients.Results. Mean scores at the tailored non-VA site were superior to those from the 3 mainstream VA sites (P < .001). Adjusting for patient characteristics, these differences remained significant for subscales assessing the patient–clinician relationship (P < .001) and perceptions of cooperation among providers (P = .004). There were 1.5- to 3-fold increased odds of an unfavorable experience in the domains of the patient–clinician relationship, cooperation, and access or coordination for the mainstream VA sites compared with the tailored non-VA site; the tailored VA site attained intermediate results.Conclusions. Tailored primary care service design was associated with a superior service experience for patients who experienced homelessness.
Achieving Public Health Goals Through Medicaid Expansion: Opportunities in Criminal Justice, Homelessness, and Behavioral Health With the Patient Protection and Affordable Care Act
Authors: DiPietro Barbara , Klingenmaier Lisa 
Published: October 2013

States are currently discussing how (or whether) to implement the Medicaid expansion to nondisabled adults earning less than 133% of the federal poverty level, a key aspect of the Patient Protection and Affordable Care Act. Those experiencing homelessness and those involved with the criminal justice system—particularly when they struggle with behavioral health diagnoses—are subpopulations that are currently uninsured at high rates and have significant health care needs but will become Medicaid eligible starting in 2014. We outline the connection between these groups, assert outcomes possible from greater collaboration between multiple systems, provide a summary of Medicaid eligibility and its ramifications for individuals in the criminal justice system, and explore opportunities to improve overall public health through Medicaid outreach, enrollment, and engagement in needed health care.
Opportunities for Engaging Low-Income, Vulnerable Populations in Health Care: A Systematic Review of Homeless Persons’ Access to and Use of Information Technologies
Authors: McInnes D. Keith , Li Alice E. , Hogan Timothy P. 
Published: October 2013

We systematically reviewed the health and social science literature on access to and use of information technologies by homeless persons by searching 5 bibliographic databases. Articles were included if they were in English, represented original research, appeared in peer-reviewed publications, and addressed our research questions. Sixteen articles met our inclusion criteria. We found that mobile phone ownership ranged from 44% to 62%; computer ownership, from 24% to 40%; computer access and use, from 47% to 55%; and Internet use, from 19% to 84%. Homeless persons used technologies for a range of purposes, some of which were health related. Many homeless persons had access to information technologies, suggesting possible health benefits to developing programs that link homeless persons to health care through mobile phones and the Internet.