bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative genomic analysis of 142 bacteriophages infecting Salmonella enterica subsp. enterica
Authors: Gao Ruimin , Naushad Sohail , Moineau Sylvain , Levesque Roger , Goodridge Lawrence , Ogunremi Dele 
Published: May 2020

Abstract
Background
Bacteriophages are bacterial parasites and are considered the most abundant and diverse biological entities on the planet. Previously we identified 154 prophages from 151 serovars of Salmonella enterica subsp. enterica. A detailed analysis of Salmonella prophage genomics is required given the influence of phages on their bacterial hosts and should provide a broader understanding of Salmonella biology and virulence and contribute to the practical applications of phages as vectors and antibacterial agents.

Results
Here we provide a comparative analysis of the full genome sequences of 142 prophages of Salmonella enterica subsp. enterica which is the full complement of the prophages that could be retrieved from public databases. We discovered extensive variation in genome sizes (ranging from 6.4 to 358.7 kb) and guanine plus cytosine (GC) content (ranging from 35.5 to 65.4%) and observed a linear correlation between the genome size and the number of open reading frames (ORFs). We used three approaches to compare the phage genomes. The NUCmer/MUMmer genome alignment tool was used to evaluate linkages and correlations based on nucleotide identity between genomes. Multiple sequence alignment was performed to calculate genome average nucleotide identity using the Kalgin program. Finally, genome synteny was explored using dot plot analysis. We found that 90 phage genome sequences grouped into 17 distinct clusters while the remaining 52 genomes showed no close relationships with the other phage genomes and are identified as singletons. We generated genome maps using nucleotide and amino acid sequences which allowed protein-coding genes to be sorted into phamilies (phams) using the Phamerator software. Out of 5796 total assigned phamilies, one phamily was observed to be dominant and was found in 49 prophages, or 34.5% of the 142 phages in our collection. A majority of the phamilies, 4330 out of 5796 (74.7%), occurred in just one prophage underscoring the high degree of diversity among Salmonella bacteriophages.

Conclusions
Based on nucleotide and amino acid sequences, a high diversity was found among Salmonella bacteriophages which validate the use of prophage sequence analysis as a highly discriminatory subtyping tool for Salmonella. Thorough understanding of the conservation and variation of prophage genomic characteristics will facilitate their rational design and use as tools for bacterial strain construction, vector development and as anti-bacterial agents.
The utility of red cell distribution width to predict mortality of septic patients in a tertiary hospital of Nepal
Authors: Ghimire Rajan , Shakya Yogendra Man , Shrestha Tirtha Man , Neupane Ram Prasad 
Published: May 2020

Abstract
Background
Sepsis is a common problem encountered in the emergency room which needs to be intervened early. Predicting prognosis is always a difficult task in busy emergency rooms using present scores, which has several variables to calculate. Red cell distribution width (RDW) is an easy, cheap, and efficacious score to predict the severity and mortality of patients with sepsis.

Methods
This prospective analytical study was conducted in the emergency room of Tribhuvan University Teaching Hospital among the patients age ≥ 16 years and with a clinical diagnosis of sepsis using qSOFA score. 148 patients were analyzed in the study by using a non-probability purposive sampling method.

Results
RDW has fair efficacy to predict the mortality in sepsis (Area under the Curve of 0.734; 95% C. I = 0.649–0.818; p-value = 0.000) as APACHE II (AUC of 0.728; 95% C. I = 0.637 to 0.819; p-value = 0.000) or SOFA (AUC of 0.680, 95% C. I = 0.591–0.770; p-value = 0.001). Youden Index was maximum (37%) at RDW value 14.75, which has a sensitivity of 83% (positive likelihood ratio = 1.81) and specificity of 54% (negative likelihood ratio = 0.32). Out of 44 patients with septic shock 16 died (36.4%) and among 104 patients without septic shock, 24 died (22.9%) which had the odds ratio of 0.713 (p = 0.555, 95% C. I = 0.231–2.194). Overall mortality was 27.02% (n = 40). RDW group analysis showed no mortality in RDW < 13.1 group, 3.6% mortality in 13.1 to 14 RDW group, 22.0% mortality in 14 to > 15.6 RDW group and 45.9% mortality in > 15.6 RDW group. Significant mortality difference was seen in 14 to > 15.6 and > 15.6 RDW subgroups with a p-value of 0.003 and 0.008 respectively.

Conclusion
Area under the curve value for RDW is fair enough to predict the mortality of patients with sepsis in the emergency room. It can be integrated with other severity scores (APACHE II or SOFA score) for better prediction of prognosis of septic patients.
Craniofacial morphology of wind and string instrument players: a cephalometric study
Authors: Clemente Miguel Pais , Mendes Joaquim , Moreira André , Ferreira Afonso Pinhão , Amarante José Manuel 
Published: May 2020

Abstract
Background
Playing an instrument may promote a parafunctional behavior within the cranio-cervical-mandibular-complex with unknown repercussions. The aim of this study was to find any association between the dental inter-arch relationship and the practice of a wind or string instrument.

Methods
A sample of 77 musicians, divided in two groups of wind (n = 50) and string instrumentalists (n = 27), had a lateral cephalogram taken to compare six cephalometric parameters following the Rickett’s analysis (maxilla position, mandible position, facial type, skeletal class, upper incisor and lower incisor inclination). The Fisher test was performed to compare, with a 95% statistical confidence, if both groups have similar frequency distributions for each cephalometric parameter.

Results
No statistical differences were found for the maxilla position, mandible position, facial type, skeletal class and upper incisor inclination. Statistical differences were found for the lower incisor inclination (p = 0.011).

Conclusions
Playing a wind instrument showed to have little orthopaedic influence at the craniofacial morphology, on contrary it may influence the lower incisor inclination with its osseous base.
DL-3-n-butylphthalide improves cerebral hypoperfusion in patients with large cerebral atherosclerotic stenosis: a single-center, randomized, double-blind, placebo-controlled study
Authors: Chen Dawei , Yin Yanwei , Shi Jin , Yang Fen , Wang Kehua , Zhao Faguo , Li Wenping , Li Bin 
Published: May 2020

Abstract
Background
DL-3-n-butylphthalide (NBP) was demonstrated to increase the cerebral blood flow (CBF) in the animal models, but there are no clinic studies to verify this. We aimed to explore the effect of NBP on improving cerebral hypoperfusion caused by cerebral large-vessel stenosis.

Methods
In this single-center, randomized, double-blind, placebo-controlled study, 120 patients with severe carotid atherosclerotic stenosis and cerebral hypoperfusion in the ipsilateral middle cerebral artery (MCA) were included and randomly assigned into NBP or placebo group as 1:1 radio. Patients in NBP or placebo group received 200 mg or 20 mg of NBP capsules three times daily for four weeks respectively. Single photon emission computed tomography (SPECT) was used to assess regional CBF (rCBF) in four regions of interest (ROIs) corresponding to MCA before and 12 weeks after the treatment. After therapy, the rCBF change for every ROI and the whole CBF change in MCA territory for every patient were classified into amelioration, stabilization and deterioration respectively.

Results
48 NBP patients (6 with bilateral stenosis) and 46 placebo patients (8 with bilateral stenosis) completed the trial. Overall, both groups had 54 stenotic carotid arteries and 216 ROIs for rCBF change analysis. After therapy, the rCBF in ROIs increased in NBP group (83.5% ± 11.4% vs. 85.8% ± 12.5%, p = 0.000), whereas no change was found in placebo group (86.9% ± 11.6% vs. 87.8% ± 11.7%, p = 0.331). Besides, there was higher percentages of ROIs with rCBF amelioration and stabilization in NBP group than in placebo group (93.1% vs. 79.2%, p = 0.000). Furthermore, ordinal regression analysis showed that compared with placebo, NBP independently made more patients to have whole CBF amelioration in ipsilateral MCA (Wald-χ2 = 5.247, OR = 3.31, p = 0.022).

Conclusions
NBP might improve the cerebral hypoperfusion in the patients with carotid artery atherosclerotic stenosis.

Trial registration
Chinese Clinical Trial Registry, ChiCTR1900028005, registered December 8th 2019- Retrospectively registered (http://www.chictr.org.cn/index.aspx).
Damage-associated molecular patterns (DAMPs) related to immunogenic cell death are differentially triggered by clinically relevant chemotherapeutics in lung adenocarcinoma cells
Authors: Solari José Ignácio Gonzalez , Filippi-Chiela Eduardo , Pilar Emily Salles , Nunes Vitória , Gonzalez Esteban Alberto , Figueiró Fabrício , Andrade Cristiano Feijó , Klamt Fábio 
Published: May 2020

Abstract
Background
Chemotherapeutics can stimulate immune antitumor response by inducing immunogenic cell death (ICD), which is activated by Damage-Associated Molecular Patterns (DAMPs) like the exposure of calreticulin (CRT) on the cell surface, the release of ATP and the secretion of High Mobility Group Box 1 (HMGB1).

Methods
Here, we investigated the levels of ICD-associated DAMPs induced by chemotherapeutics commonly used in the clinical practice of non-small cell lung cancer (NSCLC) and the association of these DAMPs with apoptosis and autophagy. A549 human lung adenocarcinoma cells were treated with clinically relevant doses of cisplatin, carboplatin, etoposide, paclitaxel and gemcitabine. We assessed ICD-associated DAMPs, cell viability, apoptosis and autophagy in an integrated way.

Results
Cisplatin and its combination with etoposide induced the highest levels of apoptosis, while etoposide was the less pro-apoptotic treatment. Cisplatin also induced the highest levels of ICD-associated DAMPs, which was not incremented by co-treatments. Etoposide induced the lower levels of ICD and the highest levels of autophagy, suggesting that the cytoprotective role of autophagy is dominant in relation to its pro-ICD role. High levels of CRT were associated with better prognosis in TCGA databank. In an integrative analysis we found a strong positive correlation between DAMPs and apoptosis, and a negative correlation between cell number and ICD-associated DAMPs as well as between autophagy and apoptosis markers. We also purpose a mathematical integration of ICD-associated DAMPs in an index (IndImunnog) that may represent with greater biological relevance this process. Cisplatin-treated cells showed the highest IndImmunog, while etoposide was the less immunogenic and the more pro-autophagic treatment.

Conclusions
Cisplatin alone induced the highest levels of ICD-associated DAMPs, so that its combination with immunotherapy may be a promising therapeutic strategy in NSCLC.
Dropout at Danish vocational schools: does the school’s health promotion capacity play a role? A survey- and register-based prospective study
Authors: Thøgersen Maja , Aadahl Mette , Elsborg Peter , Klinker Charlotte Demant 
Published: May 2020

Abstract
Background
School dropout rates and risky health behavior is common among students in vocational education and training (VET) schools. Students with poor physical and mental health are more likely to drop out, and as such VET schools may be an important setting for health promotion initiatives, not only to support a healthy lifestyle, but also to assure completion of education. A common feature of successful health promotion at VET schools is a high health promotion capacity at the school level. This study aimed to investigate the association between VET school’s health promotion capacity and later student dropout rates. Secondary, we explored other school characteristics associated with student dropout rates.

Methods
This prospective study comprised 58 Danish VET schools offering basic programs. Health promotion capacity was assessed using questionnaire data from 2017 from school managers and teachers, and this was combined with register-based data on student dropouts the following year. Health promotion capacity was assessed using six scales, representing six underlying domains, and managers and teachers’ ratings of these were compared using t-test. Associations between health promotion capacity and student dropout rates as well as associations between school characteristics and student dropout rates were analyzed using multiple linear regression.

Results
No associations between VET schools’ health promotion capacity and student dropout rates were observed, neither for the schools’ overall health promotion capacity or for any of the six underlying domains (p = 0.17–0.84). School managers assessed health promotion capacity significantly higher than teachers overall and within all domains (p < 0.05). Moreover, student dropout rates were significantly lower at schools with a higher proportion of ethnic Danish students, VET-students at higher educational level and schools located in the Western part of Denmark (p < 0.05).

Conclusion
No associations between VET schools’ health promotion capacity and student dropout rates were observed. This may be due to a relatively short follow-up time in our study and future research may reveal if VET school health promotion capacity may affect dropout rates over a longer time period. Moreover, more work is needed to further develop instruments for measuring health promotion capacity in a VET school context as well as other contexts.
Complications after surgical management of proximal humeral fractures: a systematic review of event terms and definitions
Authors: Alispahic N. , Brorson S. , Bahrs C. , Joeris A. , Steinitz A. , Audigé L. 
Published: May 2020

Abstract
Background
The most frequently used surgical procedures for treating a proximal humeral fracture (PHF) are plate osteosynthesis, nail osteosynthesis and arthroplasty. Evidence-based recommendations for an appropriate surgical procedure after PHF requires transparent and valid safety data. We performed a systematic review to examine reported terms and definitions of complications after surgically-treated PHFs.

Methods
A literature search was conducted on PubMed, Cochrane Library, EMBASE, Scopus and WorldCat to identify clinical articles and book chapters on complications of PHF published from 2010 to 2017. Complication terms and definitions were extracted from each selected article independently by two reviewers and grouped according to a predefined scheme.

Results
From 1376 initial references, we selected 470 articles, of which 103 were reviewed in reverse chronological order until no further information was gained. Twelve book chapters were reviewed. We found 667 local event terms associated with complications after surgical treatment of PHFs. The most frequently used event terms were infection (52 references), nonunion (n = 42), malunion (n = 35), avascular necrosis (n = 27) and pain (n = 25). Overall, 345, 177, 257 and 102 local event terms were related to plating, nailing, arthroplasty and other surgical techniques, respectively. Radiological assessment was the basis for the majority of event terms and complication definitions. Thirty-six event definitions were extracted, mostly defining the terms “secondary fracture displacement”, “screw perforation/cutout”, “malunion”, “delayed healing” and “notching”.

Conclusion
Scientific literature on surgically-managed PHF uses different terms to describe complications and without approved definitions, which highlights a lack of agreement on adverse event terminology for PHFs. Defined event terms are mostly based on radiological observations. Consensus among shoulder surgeons on a core event set is indispensable to support the standardization of safety reporting for surgically-treated PHFs.
Use of web-based game in neonatal resuscitation - is it effective?
Authors: Yeo Cheo Lian , Ho Selina Kah Ying , Tagamolila Vina Canlas , Arunachalam Sridhar , Bharadwaj Srabani Samanta , Poon Woei Bing , Tan Mary Grace , Edison Priyantha Ebenezer , Yip Wai Yan , Haium Abdul Alim Abdul , Jayagobi Pooja Agarwal , Vora Shrenik Jitendrakumar , Khurana Simrita Kaur , Allen John Carson , Lustestica Ereno Imelda 
Published: May 2020

AbstractBackgroundKnowledge and skills decline within months post simulation-based training in neonatal resuscitation. To empower ‘Millennial’ learners to take control of their own learning, a single-player, unguided web-based Neonatal Resuscitation Game was designed. The present study investigates the effectiveness of the game on retention of resuscitation knowledge and skills.MethodsThe study evaluated 162 healthcare professionals who attended simulation-based training in neonatal resuscitation. Following standard simulation-based training, participants were assigned to either a gaming group (Gamers) with access to the web-based Neonatal Resuscitation Game or a control group (Controls) with no access to the game. Although Gamers were given access, game utilization was completely voluntary and at will. Some Gamers chose to utilize the web-based game (Players) and others did not (Non-players). Knowledge and skills in neonatal resuscitation were assessed upon completion of training and 6 months post-training using a multiple-choice question test and a manikin-based skills test. Changes in scores were compared statistically between Gamers vs Controls, Players vs Controls, and Players vs Controls + Non-players using two-sample t-tests.ResultsAt the final assessment, declines in knowledge scores were seen in all groups. Mean change from baseline in knowledge and skill performance scores at 6 months, adjusted for baseline skill performance and MCQ test scores, did not differ significantly between Players vs Controls and Players vs Controls + Non-players.ConclusionThe web-based game in its current format may not be effective in facilitating retention of knowledge and technical skills in neonatal resuscitation.
Workplace interventions that support older employees’ health and work ability - a scoping review
Authors: Söderbacka Tina , Nyholm Linda , Fagerström Lisbeth 
Published: May 2020

Abstract
Background
The aim of this study was to examine workplace interventions that support older employees’ health and work ability and the effect of these interventions.

Methods
We used a scoping review, a type of a systematic literature review in which selected published academic articles and grey literature reports are included, to answer the following questions: 1) What kind of interventions have been made to support older employees’ health? and 2) What effects do these interventions have on older employees’ work ability? The scoping review framework proposed by Arksey and O’Malley and summarized by the Joanna Briggs Institute was used. Four key concepts comprised the basis for the research: health, intervention, older employee and work ability. A total of 8 articles were found to meet the inclusion and exclusion criteria. The study was limited to published academic articles between 2007 and 2019. Participant age varied between 37 and 74 years (overall average age 50–55) and workplaces comprised the intervention settings.

Results
Three main intervention categories were discerned: health checks and counselling for employees on the individual level, interventions based on screenings, and improvements in work environment or organization. Positive behavioral change and lowered health risks can be achieved through health counselling, which increases work ability. Measurements and screenings comprise good ways to chart and follow-up on employees’ work ability and health status. Supervisor training and support from supervisors were seen to have a positive effect on health outcomes and increased work ability.

Conclusions
To guarantee good results, employers should focus on employees’ health and interventions should occur when employees are younger than the studied group. The small number of articles related to intervention studies for the age group studied here indicate that a knowledge gap exists. We maintain that workplaces that promote employees’ health by strengthening older employees’ vitality can encourage employees to have longer careers.
The translation and psychometric assessment of the perception of empowerment in midwifery scale: the Persian version
Authors: Hajiesmaello Maryam , Kariman Nourossadat , Sharif Nia Hamid , Ozgoli Gity , Hajian Sepideh , Bazzazian Shahin , Mokhtarian-Gilani Tahereh 
Published: May 2020

AbstractBackgroundA major part of midwifery care involves the empowerment of women and their families for the control of factors affecting their health. To this end, midwives should experience their own empowerment first. The present study was conducted to translate and determine the psychometric properties of the Perception of Empowerment in Midwifery Scale among Iranian midwives.MethodsA total of 380 people participated in this cross-sectional study. A demographic questionnaire and the 22-item Perception of Empowerment in Midwifery Scale were sent to the participants online. The validity of the scale and the analysis of its main components were carried out through exploratory factor analysis with Varimax rotation and confirmatory factor analysis. The reliability of the scale was assessed using the internal consistency method with Cronbach’s alpha coefficient, average inter-item correlation (AIC) and McDonald’s omega.ResultsSeventeen scale items were retained after the exploratory factor analysis, and five factors were extracted, including “effective management”, “professional practice”, “authority”, “advocacy”, and “professional informant”, with factor loadings ranging from 0.489 to 0.899. The five latent factors explained 53.07% of the overall variance of the scale. The confirmatory factor analysis showed an acceptable goodness of fit. The internal consistency of the scale was confirmed with a Cronbach’s alpha above 0.7.ConclusionThe Persian version of the Perception of Empowerment in Midwifery Scale with 17 items has adequate reliability for midwives working in Iran. Given its appropriate psychometric properties, this scale is fit to be used among midwives in future studies.