bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of socioeconomic status on patient experience on quality of care for ambulatory healthcare services in tertiary hospitals in Southeast Nigeria
Authors: Aloh Henry E. , Onwujekwe Obinna E. , Aloh Obianuju G. , Okoronkwo Ijeoma L. , Nweke Chijioke Joel 
Published: May 2020

Abstract
Background
To determine how socioeconomic factors, such as level of education and employment status, affect patient experiences on quality of care for ambulatory healthcare services in teaching hospitals in southeast Nigeria.

Methods
The study is of a cross-sectional design and exit poll was used to collect its data. A pre-tested structured questionnaire was administered to clients accessing care in the outpatient departments of three tertiary hospitals in Nigeria. The assessment of patient experiences for quality of care was based on five (5) domains of care: waiting time; environment of the outpatient department; quality of doctor’s care; quality of care by nurses/other health workers; and responsiveness of care. In addition, the overall quality of care was assessed.

Results
The mean rating of patient experience for quality of care for ambulatory healthcare services (outpatients’ care) was 74.31 ± 0.32%. Moderate differences were observed between the hospitals assessed for various levels of patients’ care, especially for waiting time, quality of doctors’ care and overall quality of care. Employment status was a statistically significant (p ≤ 0.05) determinant of overall patient experience rating for quality of care, while the level of patient’s education was an influence on the perception of waiting by the patients and their rating of care from nurses/other healthcare providers (apart from medical doctors).

Conclusion
The study showed that educational and employment status (measures of socioeconomic status) of patients determined how patients receiving ambulatory (outpatient) healthcare services perceived the quality of care in the hospitals. Hence, in order to ensure equity, there is need to institutionalize patient-centered care, while full consideration is given to the patients’ socioeconomic status.
Children’s microvascular traits and ambient air pollution exposure during pregnancy and early childhood: prospective evidence to elucidate the developmental origin of particle-induced disease
Authors: Luyten Leen J. , Dockx Yinthe , Provost Eline B. , Madhloum Narjes , Sleurs Hanne , Neven Kristof Y. , Janssen Bram G. , Bové Hannelore , Debacq-Chainiaux Florence , Gerrits Nele , Lefebvre Wouter , Plusquin Michelle , Vanpoucke Charlotte , De Boever Patrick , Nawrot Tim S. 
Published: May 2020

Abstract
Background
Particulate matter exposure during in utero life may entail adverse health outcomes later in life. The microvasculature undergoes extensive, organ-specific prenatal maturation. A growing body of evidence shows that cardiovascular disease in adulthood is rooted in a dysfunctional fetal and perinatal development, in particular that of the microcirculation. We investigate whether prenatal or postnatal exposure to PM2.5 (particulate matter with a diameter ≤ 2.5 μm) or NO2 is related to microvascular traits in children between the age of four and six.

Methods
We measured the retinal microvascular diameters, the central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE), and the vessel curvature by means of the tortuosity index (TI) in young children (mean [SD] age 4.6 [0.4] years), followed longitudinally within the ENVIRONAGE birth cohort. We modeled daily prenatal and postnatal PM2.5 and NO2 exposure levels for each participant’s home address using a high-resolution spatiotemporal model.

Results
An interquartile range (IQR) increase in PM2.5 exposure during the entire pregnancy was associated with a 3.85-μm (95% CI, 0.10 to 7.60; p = 0.04) widening of the CRVE and a 2.87-μm (95% CI, 0.12 to 5.62; p = 0.04) widening of the CRAE. For prenatal NO2 exposure, an IQR increase was found to widen the CRVE with 4.03 μm (95% CI, 0.44 to 7.63; p = 0.03) and the CRAE with 2.92 μm (95% CI, 0.29 to 5.56; p = 0.03). Furthermore, a higher TI score was associated with higher prenatal NO2 exposure. We observed a postnatal effect of short-term PM2.5 exposure on the CRAE and a childhood NO2 exposure effect on both the CRVE and CRAE.

Conclusions
Our results link prenatal and postnatal air pollution exposure with changes in a child’s microvascular traits as a fundamental novel mechanism to explain the developmental origin of cardiovascular disease.
Transcriptome profiling of porcine testis tissue reveals genes related to sperm hyperactive motility
Authors: van Son Maren , Tremoen Nina Hårdnes , Gaustad Ann Helen , Våge Dag Inge , Zeremichael Teklu Tewoldebrhan , Myromslien Frøydis Deinboll , Grindflek Eli 
Published: May 2020

AbstractBackgroundSperm hyperactive motility has previously been shown to influence litter size in pigs, but little is known about the underlying biological mechanisms. The aim of this study was to use RNA sequencing to investigate gene expression differences in testis tissue from Landrace and Duroc boars with high and low levels of sperm hyperactive motility. Boars with divergent phenotypes were selected based on their sperm hyperactivity values at the day of ejaculation (day 0) (contrasts (i) and (ii) for Landrace and Duroc, respectively) and on their change in hyperactivity between day 0 and after 96 h liquid storage at 18 °C (contrast (iii)).ResultsRNA sequencing was used to measure gene expression in testis. In Landrace boars, 3219 genes were differentially expressed for contrast (i), whereas 102 genes were differentially expressed for contrast (iii). Forty-one differentially expressed genes were identified in both contrasts, suggesting a functional role of these genes in hyperactivity regardless of storage. Zinc fingerDNLZwas the most up-regulated gene in contrasts (i) and (iii), whereas the most significant differentially expressed gene for the two contrasts were ADP ribosylation factorARFGAP1and solute carrierSLC40A1, respectively. For Duroc (contrast (ii)), the clustering of boars based on their gene expression data did not reflect their difference in sperm hyperactivity phenotypes. No results were therefore obtained for this breed. A case-control analysis of variants identified in the Landrace RNA sequencing data showed that SNPs inNEU3,CHRDL2andHMCN1might be important for sperm hyperactivity.ConclusionsDifferentially expressed genes were identified in Landrace boars with high and low levels of sperm hyperactivity at the day of ejaculate collection and high and low change in hyperactivity after 96 h of sperm storage. The results point towards important candidate genes, biochemical pathways and sequence variants underlying sperm hyperactivity in pigs.
Enhanced production of recombinant proteins in Corynebacterium glutamicum by constructing a bicistronic gene expression system
Authors: Sun Manman , Gao Xiong , Zhao Zihao , Li An , Wang Yali , Yang Yankun , Liu Xiuxia , Bai Zhonghu 
Published: May 2020

Abstract
Background
Corynebacterium glutamicum is a traditional food-grade industrial microorganism, in which an efficient endotoxin-free recombinant protein expression factory is under developing in recent years. However, the intrinsic disadvantage of low recombinant protein expression level is still difficult to be solved. Here, according to the bacteria-specific polycistronic feature that multiple proteins can be translated in one mRNA, efforts have been made to insert a leading peptide gene upstream of target genes as an expression enhancer, and it is found that this can remarkably improve the expression level of proteins under the control of inducible tac promoter in C. glutamicum.

Results
In this research, the Escherichia coli (E. coli) tac promoter combined with 24 different fore-cistron sequences were constructed in a bicistronic manner in C. glutamicum. Three strong bicistronic expression vectors were isolated and exhibited high efficiency under different culture conditions. The compatibility of these bicistronic vectors was further validated using six model proteins- aldehyde dehydrogenase (ALDH), alcohol dehydrogenase (ADH), RamA (regulator of acetate metabolism), Bovine interferon-α (BoIFN-α), glycoprotein D protein (gD) of infectious bovine rhinotracheitis virus (IBRV) and procollagen type Ι N-terminal peptide (PΙNP). All examined proteins were highly expressed compared with the original vector with tac promoter. Large-scale production of PΙNP was also performed in fed-batch cultivation, and the highest PΙNP production level was 1.2 g/L.

Conclusion
In this study, the strength of the inducible tac promoter for C. glutamicum was improved by screening and inserting fore-cistron sequences in front of the target genes. Those vectors with bicistronic expression patterns have strong compatibility for expressing various heterogeneous proteins in high yield. This new strategy could be used to further improve the performance of inducible promoters, achieving double competence of inducible control and high yield.
Lipid profile and left ventricular geometry pattern in obese children
Authors: Bjelakovic Bojko , Stefanutti Claudia , Vukovic Vladimir , Kavaric Nebojsa , Saranac Ljiljana , Klisic Aleksandra , Lukic Stevo , Stankovic Sanja , Jovic Maja , Prijic Sergej , Bjelakovic Marko , Banach Maciej 
Published: May 2020

AbstractBackgroundLeft ventricular hypertrophy (LVH) is an important risk factor for cardiovascular and all-cause mortality. Previous studies reported conflicting results concerning the relationship between serum lipid levels and left ventricular geometry pattern. We sought to explore the relationship between standard serum lipid profile measures with left ventricular geometry pattern in obese children.Patients and methodsIn this cross-sectional study, a total of 70 obese children were examined. Fasting blood samples were taken to measure total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides (TGs), glucose, and insulin. Based on these valuesTG/HDLratio, BMI and HOMA index were calculated. We also measured the average 24-h ambulatory systolic blood pressure (SBP) and two-dimensional (2/D) transthoracic echocardiography was performed to determine left ventricular mass index (LVMI) and relative wall thickness (RWT). Multiple regression analyses were conducted to explore relationships between study variables and the LVMI or RWT as outcome variables. The final model with LVMI included TG/HDL ratio, BMI, 24 h-average SBP, age and sex, while for the RWT we included BMI, insulin, age and sex.ResultsOur study included 70 children (65.71% boys and 34.29% girls) median age (14 years, IQR = 12–16)." We demonstrated independent and positive association of TG/HDL ratio, BMI and 24 h-average SBP with LVMI (effect = 3.65, SE = 1.32,p < 0.01; effect = 34.90, SE = 6.84, p < 0.01; effect = 0.32, SE = 0.12, p < 0.01, respectively). On the other hand, in model with RWT as outcome variable, only BMI and insulin were significantly linked (BMI: effect = 13.07, SE = 5.02,p = 0.01 Insulin: effect = 2.80, SE = 0.97).ConclusionIncreased TG/HDL ratio in obese children is associated with the development of eccentric left ventricular hypertrophy while increased BMI and insulin were associated with concentric left ventricular hypertophy.
CK20 versus AMACR and p53 immunostains in evaluation of Urothelial Carcinoma in Situ and Reactive Atypia
Authors: Neal Daniel J. , Amin Mahul B. , Smith Steven C. 
Published: May 2020

AbstractAncillary testing with immunohistochemistry has shown recent promise in the workup of equivocal bladder lesions. We read with interest the recent findings of Alston et al., who assessed the diagnostic utility of alpha-methylacyl-CoA racemase (AMACR) in comparison to cytokeratin 20 (CK20) in evaluation of atypia in challenging flat urothelial lesions in the differential between carcinoma in situ (CIS) and reactive atypia. AMACR was reported to be a somewhat more specific but less sensitive marker for CIS than CK20, though showing weaker intensity. Spurred by their report, with the knowledge that we had consistently and consecutively performed AMACR, CK20, and p53 on flat urothelial lesions challenging enough to reach intradepartmental consensus, we performed a retrospective review. Similarly, we found that AMACR was less sensitive (80%) and more specific (100%) than CK20, with the same caveat of less staining intensity. Additionally, our p53 review identified a significant rate (~ 27%) of equivocal/non-informative findings. Taken together, our experience in this consecutive cohort confirms the impression of Alston et al. regarding the utility and challenges of AMACR use, while highlighting challenges with p53, which we plan to use more sparingly prospectively.
The primary total knee arthroplasty: a global analysis
Authors: Gao Jiaxiang , Xing Dan , Dong Shengjie , Lin Jianhao 
Published: May 2020

AbstractBackgroundThe use of total knee arthroplasty (TKA) in treatment of chronic degenerative pathologies of the knee has boasted of an experience of 50 years. The aim of this bibliometric and visualized study is to comprehensively examine the current status and global trends of TKA research.MethodsPublications related to TKA research from 2010 to 2019 were retrieved from Web of Science (WoS) and Science Citation Index-Expanded (SCIE) database and then analyzed through bibliometric methodology. As for the visualized study, the software VOS viewer was utilized for bibliographic coupling, coauthorship, cocitation, and co-occurrence analysis, along with further simulation of publication trends in this field.ResultsA total of 8631 publications were eventually included. The number of publications tends to increase annually worldwide. The USA was the pioneer which has made tremendous contributions, with the most publications and citations, as well as the highest H-index.The Journal of Arthroplastyhas published the most papers, whileClinical Orthopaedics and Related Researchhas the highest citation frequency. The Hospital for Special Surgery has made the greatest contribution when total publication number and coauthorship were taken together. Studies could be divided into five clusters: “alignment study”, “revision TKA study”, “complication study”, “rehabilitation study”, and “perioperative management study”, which have a trend of balanced development in this field.ConclusionsThere will be an increasing number of publications on TKA research according to the current global trends, and the USA maintained the leadership in this area. Additionally, a trend of balanced development may exist in the field of TKA research, accompanied with inherent changes of hotspots in each cluster.
Consensus guideline for the diagnosis and treatment of tetrahydrobiopterin (BH4) deficiencies
Authors:   on behalf of the International Working Group on Neurotransmitter related Disorders (iNTD), Opladen Thomas , López-Laso Eduardo , Cortès-Saladelafont Elisenda , Pearson Toni S. , Sivri H. Serap , Yildiz Yilmaz , Assmann Birgit , Kurian Manju A. , Leuzzi Vincenzo , Heales Simon , Pope Simon , Porta Francesco , García-Cazorla Angeles , Honzík Tomáš , Pons Roser , Regal Luc , Goez Helly , Artuch Rafael , Hoffmann Georg F. , Horvath Gabriella , Thöny Beat , Scholl-Bürgi Sabine , Burlina Alberto , Verbeek Marcel M. , Mastrangelo Mario , Friedman Jennifer , Wassenberg Tessa , Jeltsch Kathrin , Kulhánek Jan , Kuseyri Hübschmann Oya 
Published: May 2020

AbstractBackgroundTetrahydrobiopterin (BH4) deficiencies comprise a group of six rare neurometabolic disorders characterized by insufficient synthesis of the monoamine neurotransmitters dopamine and serotonin due to a disturbance of BH4biosynthesis or recycling. Hyperphenylalaninemia (HPA) is the first diagnostic hallmark for most BH4deficiencies, apart from autosomal dominant guanosine triphosphate cyclohydrolase I deficiency and sepiapterin reductase deficiency. Early supplementation of neurotransmitter precursors and where appropriate, treatment of HPA results in significant improvement of motor and cognitive function. Management approaches differ across the world and therefore these guidelines have been developed aiming to harmonize and optimize patient care. Representatives of the International Working Group on Neurotransmitter related Disorders (iNTD) developed the guidelines according to the SIGN (Scottish Intercollegiate Guidelines Network) methodology by evaluating all available evidence for the diagnosis and treatment of BH4deficiencies.ConclusionAlthough the total body of evidence in the literature was mainly rated as low or very low, these consensus guidelines will help to harmonize clinical practice and to standardize and improve care for BH4deficient patients.
Change in Norwegian consumer attitudes towards piglet castration: increased emphasis on animal welfare
Authors: Sødring Marianne , Nafstad Ola , Håseth Torunn Thauland 
Published: May 2020

AbstractBackgroundMale piglets are surgically castrated at a young age primarily to prevent pork meat from being tainted with boar taint, an offensive taste and odor that can be present in uncastrated male pigs. The practice of surgical castration is considered to be both stressful and painful for the piglets, and is therefore under scrutiny due to animal welfare concerns. Rearing of intact males or vaccination against boar taint (immunocastration) are two potential alternatives to surgical castration, but in order to successfully implement either of these alternatives, consumer acceptance of the different methods must be taken into consideration as it will be central for future sales of pork products. A consumer survey mapping Norwegian consumers’ attitudes toward piglet castration was conducted to explore whether the consumers’ position regarding castration has changed since an almost identical study was completed in 2008.ResultsThe internet-based survey found that Norwegian consumers are comfortable with the current practice of surgical castration with anesthesia, but also that they are open to the alternative method of vaccination against boar taint. When provided additional information stating that vaccination against boar taint may not be able to reduce boar taint to the levels that castration with anesthesia does, consumer skepticism towards vaccination increased. When evaluating castration methods, animal welfare was the most important influencing factor. Since the original survey from 2008, animal welfare was also the single factor that has increased the most among a set of assessment criteria when purchasing pork products.ConclusionNorwegian consumers regard animal welfare as an important factor both when purchasing pork products and when evaluating different methods of castration, and animal welfare as a factor has increased in importance since the initial survey in 2008. Although the current practice of castration using local anesthesia is still widely accepted among consumers, the acceptance of today’s method has declined since the original survey in 2008.
The use of tear ferning test in cats for evaluation of ocular surface
Authors: Veloso Jéssica Fontes , Oriá Arianne Pontes , Raposo Ana Cláudia Santos , Lacerda Ariane Jesus , Silva Cláudia Vital Borges , Lima Larissa Ferreira , Carlos Renata Santiago Alberto 
Published: May 2020

Abstract
Background
The tear film is a trilaminar fluid composed mainly of lipids, electrolytes, proteins and water. It is responsible for lubrication, nutrition and protection against microbial and toxic agents. Disruption of any these components may weaken the ocular surface, making it more susceptible to disease. Increasing evidence suggests that qualitative tear film deficiencies are an important predisposing factor or cause of some of the most common and challenging ocular diseases in cats, including conjunctivitis, corneal ulcer, spontaneous chronic corneal epithelial defects (SCCED), pigmentary keratitis, corneal sequestrum and dry eye syndrome. The aim of this study was to describe the tear ferning test in healthy cats and to compare the results by using two grading scales for humans. Tear samples were collected using Schirmer tear test (STT) strips from 60 healthy cats, and, after centrifuging the strips to obtain the samples, the aliquot was placed on clean microscope glass until it dried and the tear ferning patterns were observed under a polarized light microscope and classified according to the Rolando and Masmali grading scales.

Results
Ferning patterns in the lower grades showed full crystallization with high density, without gaps between the ferns and branches, forming several nuclei that were easily distinguished. According to the Rolando scale, 50% (60/120), 46.6% (56/120) and 3.4% (4/120) of eyes showed type I, II and III patterns, respectively. According to the Masmali scale, 15% (18/120), 56.6% (68/120 eyes) and 28.4% (34/120) of eyes showed grade 0, 1 and 2 patterns, respectively. No difference was observed between the right and left eyes for both Rolando (P = 0.225) and Masmali (P = 0.683) scales.

Conclusions
The tear ferning test is a qualitative test that can be used in cats as a complementary evaluation of the ocular surface. While the Rolando scale showed an increased prevalence of types I and II, the Masmali scale showed an increased prevalence of grades 1 and 2. This can be attributed to the species-specific differences between human and feline tear film. So Masmali grade 2 can be considered a normal tear pattern for the species, because all the cats used in study were clinically healthy. For this reason, future complementary studies are necessary for comparing healthy eyes and eyes with different ocular surface disease in cats. Both scales can be feasible options for grading tear crystallization in cats, but as Rolando scale included 96.6% of the samples in the 2 types that are considered normal for humans, we think that this scale seemed to be more precise to classify crystallization pattern in cats. The crystallization patterns observed in this study can form the basis for standardizing ocular surface parameters in cats.