bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylaxis with trimethoprim-sulfamethoxazole (TMP-SMX) decreases the incidence of interstitial pneumonia (IP) in B cell non-Hodgkin lymphoma (NHL) patients receiving chemotherapy with rituximab
Authors: Li Cong , Lu Fangxiao , Tao Lei , Yu Haifeng , Chen Xi , Peng Shuailing , Han Shuiyun , Yang Haiyan 
Published: February 2020

Abstract
Background
Several studies have reported on the incidence of interstitial pneumonia (IP) among patients with non-Hodgkin lymphoma (NHL) that have been treated with chemotherapy plus rituximab, however, the best means of prophylactically preventing IP remains unclear. This retrospective study was designed to explore the prophylactic effect of trimethoprim-sulfamethoxazole (TMP-SMX) on IP and to identify IP-associated risk factors in NHL patients.
Methods
Between March 2013 and April 2018, 498 patients (264 male, 53%) with B cell NHL undergoing first-line rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP)-like chemotherapy treatment were enrolled in this study.
Results
These patients had a median age of 56 years, and 311 of these patients (62.4%) were administered prophylactic TMP-SMX. IP occurred in 65 patients (13.1%), with once daily prophylactic TMP-SMX treatment leading to a significant reduced IP rate (21.4% vs. 8.0%; p<0.001). Among patients treated with TMP-SMX, 2 (1.2%) exhibited rashes, 38 (12.2%) suffered from nausea and vomiting, 52 (16.7%) showed signs of neutropenia, and 18 (5.8%) suffered kidney dysfunction. Being male, having a history of diabetes, and not having undergone prophylactic TMP-SMX treatment were all found to be significantly associated with IP risk in both univariate and multivariate analysis. Disease progression was observed in 55/311 (17.7%) patients that underwent prophylactic TMP-SMX treatment and in 63/187 (33.7%) patients that did not (p<0.001).
Conclusions
Overall, these results reveal that IP is common in B cell NHL patients undergoing chemotherapy plus rituximab treatment, with the prophylactic administration of once daily oral TMP-SMX significantly reduces the IP incidence.
The prognostic value of routine preoperative blood parameters in muscle-invasive bladder cancer
Authors: zhang jingqi , Zhou Xiaozhou , Ding Hua , Wang Liwei , Liu Sha , Liu Yuting , Chen Zhiwen 
Published: February 2020

Abstract
Background A routine blood examination is one of the most rapid, convenient and inexpensive clinical examinations that can reflect a patient’s inflammatory status and other blood conditions, and the prognostic value of routine preoperative blood parameters in MIBC patients is still unclear, so we evaluated the prognostic value of routine preoperative blood parameters in muscle-invasive bladder cancer (MIBC) following radical cystectomy (RC). Methods Data on 202 patients with MIBC who underwent RC at our institution were retrospectively collected between October 2007 and August 2018. The median preoperative neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and hemoglobin (HGB) values were used as cutoffs to form the low and high NLR, low and high PLR, and low and high HGB groups, respectively. The clinicopathologic characteristics of each group were compared by chi-square and t tests. Kaplan-Meier survival and multivariate Cox regression analyses were used to analyze prognosis. Results The median NLR, PLR and HGB values were 2.42, 112 and 125g/L, respectively. Kaplan-Meier results showed that the low HGB group had poor progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS). A high NLR and high PLR groups correlated only with poor OS. Multivariate Cox analyses showed that pathological T3/4 stage, positive lymph node status and low HGB were independent risk factors for PFS, CSS and OS, and age was the only independent risk factor for OS. Conclusion Preoperative peripheral blood HGB is an independent risk factor for the prognosis of MIBC patients. These data suggest that HGB may be a useful prognostic marker for MIBC patients undergoing RC.
Epidemiology of human exposure to rabies in Nunavik: incidence, the role of dog bites and their context, and victim profiles
Authors: Mediouni Sarah , Brisson Mario , Ravel André 
Published: February 2020

Abstract
Background: In Nunavik, Arctic rabies is still endemic due to a spillover from wildlife to dogs. The prevention of human exposure and the management of potential exposure is a significant public health concern in this region.
Methods: This study retrospectively describes cases of potential exposure to rabies in humans as reported to the Nunavik Public Health Board through their registry of reported cases. We used multi-correspondence analysis as well as univariable and multivariable regression models to test for differences between children and adults in reported cases, and to examine to contexts of exposure to dogs and dog attacks.
Results: From 2008 to 2017, 320 cases of potential exposure to rabies were reported, 92% of which were linked to dogs. The annual incidence rate was 2.5 per 1,000 people. The incidence increased significantly during the study period, although the reasons for this are unclear. Fifteen cases of exposure were with rabid animals, mostly dogs (9 of 15). No human cases of rabies occurred thanks to adequate medical case management. Two specific profiles for potential exposure to rabies were identified based on age and gender. The first was children (<15 y/o), male or female, who were more likely to be exposed through playing with dogs and were more often injured in the head and/or neck. The second was young male adults (aged 15 to 34 y/o), who were more involved with wildlife than other age groups and mostly injured in the upper limbs and as a result of a reaction by the animal.
Conclusion: Rabies is a real public health threat in Nunavik. Potential human exposure needs to be prevented, and prevention measures should be tailored to the two risk profiles identified based on age, gender and animal species involved.
Differential protective effects of bisphosphonates and denosumab on primary breast cancer risk, potentially to be modified by statins: a retrospective study using electronic health records
Authors: Stanoyevitch Alexander , Zhang Lei , Sanz Javier , Follett Robert , Bell Douglas 
Published: February 2020

Abstract
Background: The risks of osteoporosis and breast cancer are increasing in elderly women, as well as hyperlipidemia. Bisphosphonates and denosumab are recommended for treatment of osteoporosis, and statins are used for hyperlipidemia. There are different and overlapping pharmacodynamics among bisphosphonates, denosumab and statins. We aim to assess effects of bisphosphonates and denosumab on breast cancer, possibly affected by statins use.Methods: This retrospective cohort is consisted of 97,671 women elder than 50 years with no previous history of malignancy and no cancer other than breast during follow-up, including 778, 2326, 15287 and 7631denosumab, bisphosphonates, statins and hormone for postmenopausal symptoms ever users. Univariate and bivariate analysis, and the Cox Proportional Hazards multi-variate model are performed.Results: Over an average of 3.6 years follow up, the breast cancer risks counted after 365 days of latency are 1.54% (12/778) for denosumab, 0.52% (12/2326) for bisphosphonates, compared to 0.65% (99/15287) in statins ever use group, 0.26% (20/7631) in hormone users for menopausal symptoms and 1.38% (1032/74867) in control group. The significant difference of breast cancer risk between denosumab and bisphosphonates group (p=0.0047) is supported by the Log-rank test (p=0.0004). The multivariate model is in partial agreement with the uni- and bivariate analysis. Further subgroup analysis revealed that concurrent use of statins in denosumab prescribers lowered the breast cancer risk to 0.89% (2/224), but with no significantly change of breast cancer risk in bisphosphonates group (7/919, 0.762%).Conclusion : Our data suggest superior protective effects of bisphosphonates over denosumab on breast cancer risk in elderly women. Statins could potentially exert breast cancer protective effect in denosumab users with no synergistic effect in patients taking bisphosphonates. A large scale study with long term follow up is needed.
Factors associated with 36-month loss to follow-up and mortality outcomes among HIV-infected adults on antiretroviral therapy in Central Kenya
Authors: Wekesa Paul , McLigeyo Angela , Owuor Kevin , Mwangi Jonathan , Nganga Evelyn , Masamaro Kenneth 
Published: February 2020

Abstract
Background : The scale-up of HIV treatment programs has resulted in a reduction in HIV-related morbidity and mortality. However, retention of patients in these programs remains a challenge in sub-Saharan Africa. Understanding factors associated with loss to follow-up (LTFU) and mortality outcomes is therefore important to inform targeted program interventions.

Methods : A retrospective multi-cohort analysis of 23,890 adult patients on ART over 36 months of follow-up in Kenya was done. Multivariate logistic regression analysis was done to assess for factors associated with LTFU and mortality at 6, 12, 24, and 36 months of follow-up.
Results : Majority, 67.7%, were female. At 36 months , 27.2% were LTFU and 13.5% had died. Factors associated with mortality at 36 months included older age (51 years and above) using 20-35 years as reference [(adjusted odds ratio [aOR], 1.51, 95% confidence interval (CI) 1.23–1.86, p<0.001], being male (aOR, 1.59, 95% CI 1.39–1.83, p<0.001), divorced using married as reference (aOR, 1.86, 95% CI 1.56–2.22, p<0.001), having a body mass index (BMI) score of less than 18.5 kg/m² using 18.5-24.9 kg/m² as reference (aOR = 1.79, 95% CI 1.52–2.11, p<0.001), and, World Health Organization stage III and IV using stage I as the reference (aOR, 1.94, 95% CI 1.43–2.63 and aOR, 4.24, 95% CI 3.06–5.87, p<0.001 respectively). Factors associated with LTFU at 36 months included being young between 20-35 years (aOR, 1.49, 95% CI 1.40-1.59, p<0.001) using 36-50 years as reference, being male (aOR, 1.19, 95% CI 1.12–1.27, p<0.001), and being single or divorced using married as reference (aOR, 1.34, 95% CI 1.23–1.45 and aOR, 1.25, 95% CI 1.15–1.36, p<0.001 respectively). Patients with baseline BMI of less than 18.5 kg/m² using normal BMI as reference (aOR, 1.68, 95% CI 1.39–2.02, p<0.001) were also likely to be LTFU.

Conclusions : Factors associated with LTFU and mortality were generally similar over time. Implementation of programs in similar settings should be tailored to gender, age profiles, nutritional, and, marital status of patients to address LTFU. In addition, programs should focus on the care of older patients to reduce the risk of mortality.
Stigma and utilization of treatment for adolescent perinatal depression in Ibadan Nigeria
Authors: Kola Lola , Bennett Ian M , Bhat Amritha , Ayinde Olatunde O. , Oladeji Bibilola D. , Abiona Dolapo , Abdulmalik Jibril , Faregh Neda , Collins Pamela Y. , Gureje Oye 
Published: February 2020

Abstract
Background. Depression is a common and severe disorder among low-income adolescent mothers in low-and middle-income countries where resources for treatment are limited. We wished to identify factors influencing health service utilization for adolescent perinatal depression in Nigeria to inform new strategies of care delivery.Methods. Focus Group Discussions (FGDs) were conducted among purposively selected low-income young mothers (with medical histories of adolescent perinatal depression), and separately with primary care clinicians treating this condition in Ibadan, Nigeria. Participants from this community-based study were from the database of respondents who participated in a previous randomized control trial (RCT) conducted between 2014 and 2016 in 28 primary health care facilities in the 11 Local government areas in Ibadan. A semi-structured interview guide was designed according to the themes of the Behavioral Model for Vulnerable Populations to obtain views of participants on the factors that promote or hinder help-seeking and engagement. FGDs were conducted, and saturation of themes was achieved after discussions with six groups. Transcripts were analyzed using content analysis framework.Results. A total of 42 participants, 17 mothers (who were adolescents at the time of the RCT), and 25 care providers participated in 6 FGDs. The availability of care for PD at the primary care level was an important enabling factor in healthcare utilization for the adolescents. Perceived health benefits of treatment received for perinatal depression were strong motivation for service use. Significant stigma and negative stereotypes expressed by care providers towards adolescent pregnancy and perinatal depression were potential obstacles to care. However, individual patient resilience was a major enabling factor, facilitating service engagement. Providers trained in the management of perinatal depression were perceived to deliver more tolerant and supportive care that adolescent mothers valued. Conclusions. Participants identified an unsupportive and stigmatizing clinic environment as a significant potential barrier to accessing available care. Interventions to reduce stigma among healthcare providers may improve services for this vulnerable population.
Elderly patients´ perspectives on treatment, care and rehabilitation after hip fracture: A qualitative systematic review
Authors: Abrahamsen Charlotte , Nørgaard Birgitte 
Published: February 2020

Abstract
BackgroundHip fracture surgery is a distressing and life-changing event for patients. The treatment, care and rehabilitation of hip fracture patients governed by evidence-based recommendations, the patients’ preferences are often not represented. The aim of this systematic review is to identify what elderly hip fracture patients consider important in relation to their fracture.MethodsA qualitative approach was applied to present findings on patient perspectives. Data were extracted from the findings in the Results section of each study, categorized by similarity in meaning by both authors as either health-related factors or healthcare-related experiences. The quality of the presented evidence was evaluated, and all studies were assessed using the Critical Appraisal Skills Programme (CASP) checklist.ResultsSixteen qualitative studies met the inclusion criteria. The health-related factors category included: 1) symptoms and complications, 2) physical health, 3) mental health and 4) social relationships and 5) personal goals. Healthcare-related experiences revolved around: 1) waiting time, 2) information, , 3) participation and respect and 4) discharge.ConclusionsThis systematic review provides an overview of hip fracture patients’ perspectives on important aspects of care, treatment and training during their trajectory, thereby contributing to plan and deliver care based on what matters to patients. .
Resistance against macrocyclic lactones in Psoroptes ovis in cattle
Authors: Mol Wouter van , De Wilde Nathalie , Casaert Stijn , Chen Zhenzhen , Vanhecke Marieke , Duchateau Luc , Claerebout Edwin 
Published: February 2020

Abstract
Background Psoroptic mange is an important disease in beef cattle, and Belgian Blue cattle are particularly susceptible. Treatment failure of macrocyclic lactones against Psoroptes ovis has been reported, but clear evidence of in vivo resistance is still lacking. This study was conducted to investigate the efficacy of macrocyclic lactone products in 16 beef farms in Belgium and The Netherlands in vivo and in vitro . Methods On each farm a group of animals (n= 7-14) with psoroptic mange was treated with two subcutaneous injections of a macrocyclic lactone product with 7-10 days interval (15 farms) or a single injection with a long-acting macrocyclic lactone (1 farm). In vivo efficacy was assessed by the reduction in mite counts and clinical index (estimated proportion of the body surface affected by lesions), the proportion of the animals with negative mite counts after the first treatment round and the number of treatment rounds needed to obtain zero mites counts in all animals. A mite population from a given farm was categorized as sensitive when the mite count reduction after the first treatment round >95% and the lower limit of the uncertainty interval >90%. Resistance was detected when both parameters were below the threshold. Resistance was suspected when only one was below its threshold. In vitro knock-down and mortality was evaluated in a contact test. Results The proportion of the animals with negative mite counts after the first treatment round varied from 0-80%. All farms needed two or more rounds of treatments to obtain zero mite counts on all animals. Clinical index had a high variation and only started to reduce after the second treatment round. Mite populations from three farms were categorized as sensitive, one as suspected resistant and the other 12 as resistant. No correlation was found between in vitro lethal dose 50 and knock-down dose 50 values and any parameter of in vivo efficacy. Conclusions Unambiguous treatment failure was detected on 12/16 beef farms, confirming the presence of macrocyclic lactone resistance on Belgian Blue beef farms. In vitro parameters could not discriminate the farms based on their in vivo sensitivity. The mean reduction in mite counts and the lower limit of the confidence interval are proposed as most useful parameters to identify acaricide resistance.
Escherichia coli σ70 promoters allow expression rate control at the cellular level in genome-integrated expression systems
Authors: Schuller Artur , Cserjan-Puschmann Monika , Tauer Christopher , Jarmer Johanna , Wagenknecht Martin , Reinisch Daniela , Grabherr Reingard , Striedner Gerald 
Published: February 2020

Abstract
Background

The genome-integrated T7 expression system offers significant advantages, in terms of productivity and product quality, even when expressing the gene of interest (GOI) from a single copy of. Compared to plasmid-based expression systems, this system does not incur a plasmid-mediated metabolic load, and it does not vary the dosage of the GOI during the production process. However, long-term production with T7 expression system leads to a rapidly growing non-producing population, because the T7 RNA polymerase (RNAP) is prone to mutations. The present study aimed to investigate whether two σ 70 promoters, which were recognized by the Escherichia coli host RNAP, might be suitable in genome-integrated expression systems. We applied a promoter engineering strategy that allowed control of expressing the model protein, GFP, by introducing lac operators ( lacO ) into the constitutive T5 and A1 promoter sequences.

Results

We showed that, in genome-integrated E. coli expression systems that used σ 70 promoters, the number of lacO sites must be well balanced. Promoters containing three and two lacO sites exhibited low basal expression, but resulted in a complete stop in recombinant protein production in partially induced cultures. In contrast, expression systems regulated by a single lacO site and the lac repressor element, lacI Q , on the same chromosome caused very low basal expression, were highly efficient in recombinant protein production, and enables fine-tuning of gene expression levels on a cellular level.

Conclusions

Based on our results, we hypothesized that this phenomenon was associated with the autoregulation of the lac repressor protein, LacI. We reasoned that the affinity of LacI for the lacO sites of the GOI must be lower than the affinity of LacI to the lacO sites of the endogenous lac operon; otherwise, LacI autoregulation could not take place, and the lack of LacI autoregulation would lead to a disturbance in lac repressor-mediated regulation of transcription. By exploiting the mechanism of LacI autoregulation, we created a novel E. coli expression system for use in recombinant protein production, synthetic biology, and metabolic engineering applications.
Synthesis and biological evaluation of 4-substituted aryl-piperazine derivatives of 1,7,8,9-tetrachloro-10,10-dimethoxy-4-azatricyclo [5.2.1.02,6] dec-8-ene-3,5-dione as anti-cancer and anti-angiogenesis agents
Authors: Guo Lifang , Xu Benshan , Wan Zirui , Ren Lulu , Zhang Jie , Zhang Wen , Liu He , Liu Lihong 
Published: February 2020

Abstract
The authors have requested that this preprint be removed from Research Square.
FHIR PIT: an open software application for spatiotemporal integration of clinical data and environmental exposures data
Authors: Xu Hao , Cox Steven , Stillwell Lisa , Pfaff Emily , Champion James , Ahalt Stanley C. , Fecho Karamarie 
Published: February 2020

Abstract
Background Informatics tools to support the integration and subsequent interrogation of spatiotemporal data such as clinical data and environmental exposures data are lacking. Such tools are needed to support research in environmental health and any biomedical field that is challenged by the need for integrated spatiotemporal data to examine individual-level determinants of health and disease. Results We have developed an open-source software application—FHIR PIT (Health Level 7 Fast Healthcare Interoperability Resources Patient data Integration Tool)—to enable studies on the impact of individual-level environmental exposures on health and disease. FHIR PIT was motivated by the need to integrate patient data derived from our institution’s clinical warehouse with a variety of public data sources on environmental exposures and then openly expose the data via ICEES (Integrated Clinical and Environmental Exposures Service). FHIR PIT consists of transformation steps or building blocks that can be chained together to form a transformation and integration workflow. Several transformation steps are generic and thus can be reused. As such, new types of data can be incorporated into the modular FHIR PIT pipeline by simply reusing generic steps or adding new ones. We have validated FHIR PIT in the context of a driving use case designed to investigate the impact of airborne pollutant exposures on asthma. Specifically, we replicated published findings demonstrating racial disparities in the impact of airborne pollutants on asthma exacerbations. Conclusions While FHIR PIT was developed to support our driving use case, the software can be used to integrate any type and number of spatiotemporal data sources at a level of granularity that enables individual-level study. We expect FHIR PIT to facilitate research in environmental health and numerous other biomedical disciplines.