bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics and Costs of Prehospital Care for Chronic Kidney Disease Patients: A Longitudinal Cohort Study
Authors: Sarria-Guerrero José Antonio , Guix-Comellas Eva Maria , Jiménez-Fábrega Francesc Xavier , Benito-Aracil Llúcia , Sancho-Agredano Raül , Padrés Núria Fabrellas 
Published: December 2020

Abstract
Background The global cost associated with substitute treatment for patients with chronic kidney disease has been calculated, but there is a lack of information about the characteristics and costs deriving from pre-hospital care with transport and admission to hospital emergency services. Therefore, the aim of this study was to identify the characteristics of urgent telephone requests to Emergency Medical Services for patients with chronic kidney disease in Catalonia, Spain, and make a cost estimation of prehospital care and admission to the emergency department, grouped by comorbidities. Methods Retrospective longitudinal observational study. Patients who required urgent prehospital care based on telephone triage were enrolled. Sociodemographic, clinical, and financial variables were collected. The data were gathered by means of a review of the clinical records in the Emergency Medical Services database. To explore the possible relation among the qualitative variables the χ² test was used, for the relation between a quantitative variable and dichotomy qualitative variable the student t test was used with prior testing of the normal deviation of quantitative variables, and the Mann-Whitney U test was then employed if they did not fulfil normality criteria. For all calculations an alpha error of p <0.05 was assumed.Results A total of 252 phone calls were analyzed. Some 98.4% of patients (n=248) were prioritized through phone triage and classified as very severely ill: resuscitation or emergencies. The most prevalent initial diagnoses were intense dyspnoea, accidental fall, abdominal pain, and disease decompensation; there were 11 cases of cardio-respiratory arrest (4.36%), half of which were associated with hypertensive heart disease (HHDT). The average cost of prehospital care was €480.06/patient (SD=256.74), but in patients with comorbidities this rose to €550.77 for HHD and €508.73 for diabetes mellitus (DM). No statistically significant differences were found between total cost/patient and comorbidity (p=0.361), or between the costliest comorbidities, HHD and DM (p=0.330). Conclusions Patients telephoned for help when they were in serious condition, in line with the levels established by telephone triage. The cost of prehospital care was high, and this increased in the presence of comorbidities.
Service Acceptance of HIV Non-Occupational Post-Exposure Prophylaxis(nPEP) Among College Students: A Cross-Sectional Study in China
Authors: Liu Tongtong , Wang Xi , Li Aixin , Ye Jiangzhu , Shan Duo , Zhang Guang , Liu An 
Published: December 2020

Abstract
Background: College students are the key group we should pay more attention for acquired immune deficiency syndrome (AIDS) prevention and control in recent years in China, and few studies of HIV non-occupational post-exposure prophylaxis(nPEP) knowledge awareness and service acceptance have been conducted among them in China. This study conducted a cross-sectional survey to understand the service acceptance of nPEP and its influencing factors among college students in the three cities of China. Methods: A questionnaire survey was conducted to collect information on socio-demographic, behavioral characteristic, HIV/AIDS knowledge, nPEP knowledge, acceptance of nPEP services among the college students in Beijing, Shenzhen, and Kunming of China from March to April of 2019. Each participant completed a computer-assisted or mobile phone-assisted self-interview with informed consent and completed an anonymous questionnaire on line. Multivariable logistic regression analyses identified predictors for service acceptance of nPEP. Results A total of 4698 students were surveyed with the average age of 20 years old. 98.0% (4605/4698) of them were undergraduates, 21.8%(1022/4698) had sexual intercourse; 48.6% (2282/4698)had heard of nPEP, among which4.95%(113/2282) received nPEP services. The rate of AIDS knowledge awareness was 85.6% (5495/4698) with the differences statistically significant between the three cities. The nPEP knowledge awareness rate was 16.5% (774/4698). There were differences in receiving nPEP services among students of different ages, genders, sexual behaviors, and knowledge of AIDS by univariate analysis. Multivariable analyses indicated that age group of 18 and under (OR=2.551, 95% CI=1.153-5.646), male (OR=3.131, 95% CI=1.866-5.253), homosexual behavior (OR=4.661,95%CI=2.658-8.172), heterosexual behavior (OR=1.676, 95% CI=1.040-2.947), no awareness of AIDS (OR=3.882, 95% CI=2.371-6.356) and nPEP (OR=4.788, 95% CI=2.50-9.169) knowledge, were associated factors with the service acceptance of nPEP among the college students. Conclusion The low acceptance of nPEP services was mainly affected by nPEP knowledge awareness among the college students and further publicity and education of nPEP knowledge are necessary, as well as dissemination of knowledge of HIV/AIDS prevention and treatment. More attention should be paid to the factors associated with acceptance of nPEP services.
Neutrophil to lymphocyte ratio and Fibrinogen Values in predicting patients with type B aortic dissection
Authors: Li Shuangshuang , Yang Jin , Guo Renle , Dong Jian , Chang Sheng , Zhu Hongqiao , Li Zhaohui , Zhou Jian Jian , Jing Zaiping 
Published: December 2020

Abstract
The aim of this study is to detect the diagnosis value of neutrophil lymphocyte ratio (NLR) and fibrinogen (FIB) in type B aortic dissection (TBAD) patients. This retrospective observation study consisted patients with TBAD, aortic aneurysm and physical examination between January 1, 2016 and December 31, 2019. Demographic and clinical information after the first admission were collected. Multivariate logistic regression analysis was performed to explore the correlational relationship between NLR, FIB and TBAD. Receiver Operating Characteristic Curve (ROC) was performed to evaluate the diagnostic implication of NLR and FIB in TBAD patients. Six hundred and six patients who were first diagnosed with TBAD were included. Control groups were 202 aortic aneurysm and 140 physical examination subjects. The level of NLR and FIB in aortic dissection patients was significantly higher than aortic aneurysm patients and healthy group (P < 0.001). According to the results of multivariate logistic regression analysis, NLR and FIB were independent risk factors of aortic dissection, and the odds ratio (OR) and 95% confidence interval (CI) value of NLR and FIB were 1.499(1.126-1.738) and 1.914(1.475-2.485), respectively. The area under the curve (AUC) was 0.836 of NLR and 0.756 of FIB. NLR and FIB showed high specificity, 89% and 83% respectively. This is the first study provided information on the diagnosis performance of NLR and FIB in TBAD patients. NLR and FIB showed high specificity, which may be a valuable tool for the diagnosis of TBAD.
Secondary Prevention Post Stroke in Primary Care in an Asian Setting: A Retrospective Cohort Study
Authors: Bansal Vivek , Lee Eng Sing , Smith Helen 
Published: December 2020

Abstract
Background: Stroke is one of the top contributors to burden of disability-adjusted life-years worldwide. Family physicians have key role in optimal secondary prevention post-stroke helping patients make appropriate lifestyle changes and take medication in accordance with the recommended clinical practice guidelines.Methods: Our aim was to characterize the profile of patients who were being managed in primary care setting for secondary prevention of stroke. Our specific objectives were: (i) to examine the level of overall and individual risk factors control after an index-stroke event in patients visiting the primary care setting and (ii) to describe the factors associated with the achievement of overall risk factors control in post-stroke patients.Study Design: Retrospective cohort study.We conducted a study looking retrospectively at records from our electronic chronic disease database. Our study included post-stroke patients who visited public primary care setting in Singapore between 1st January 2012 to 31st December 2016. Based on AHA Stroke guidelines, we operationalized our outcome of secondary prevention post-stroke as overall control, which comprised of patients having blood pressure, lipids, and glucose reading (for those who had diabetes) all well-controlled. We conducted descriptive analysis and performed multivariable logistic analysis to determine factors associated with overall control.Results: There were 24,240 patients in our study. Overall control was better in post-stroke patients without diabetes (49.2%) as compared to those with diabetes (28.1%).Among post-stroke patients without diabetes, factors significantly associated with overall control were sex [OR: 1.23, 95% CI: 1.10, 1.39], ethnicity [OR: 0.72, 95% CI: 0.58, 0.90], BMI [OR: 0.72, 95% CI: 0.62, 0.84) and atrial fibrillation [OR: 1.47, 95% CI: 1.21, 1.78].Among post-stroke patients with diabetes, factors significantly associated with overall control were sex [OR: 1.28, 95% CI: 1.12, 1.46], ethnicity, BMI, atrial fibrillation[OR: 1.24; 95% CI: 1.02, 1.51], chronic kidney disease and smoking status.Conclusion: We reported a sub-optimal level of overall control. Among post-stroke patients, those with diabetes had a higher proportion of sub-optimal control as compared to those without diabetes. Irrespective of diabetic status, being female, having high BMI, and of Malay ethnicity were associated with poor overall control compared to Chinese.
Posterior subthalamic nucleus (PSTh) mediates innate fear-associated hypothermia
Authors: Liu Can , Lee Chia-Ying , Asher Greg , Cao Liqin , Terakoshi Yuka , Cao Peng , Kobayakawa Reiko , Kobayakawa Ko , Sakurai Katsuyasu , Liu Qinghua 
Published: December 2020

Abstract
Mammals normally maintain a constant body temperature irrespective of their environmental temperature. However, emotions such as fear can trigger acute changes in body temperature accompanying defensive behaviors to enhance survival in life-threatening conditions. The neural mechanisms of fear-associated thermoregulation remain unclear. Here, we find that innate fear odor 2-methyl-2-thiazoline (2MT) evokes rapid hypothermia and elevated tail temperature, indicative of vasodilation-induced heat dissipation, in wild-type mice, but not in mice lacking Trpa1, the chemosensor for 2MT. Following 2MT exposure, wild-type but not Trpa1-/- mice exhibit high c-fos expression in the posterior subthalamic nucleus (PSTh), external lateral parabrachial subnucleus (PBel), and nucleus of the solitary tract (NTS). Tetanus toxin light chain (TeLC)-mediated inactivation of NTS-projecting PSTh neurons blunts 2MT-evoked hypothermia and abrogated tail temperature increase. Optogenetic activation of the PSTh-rostral NTS (RNTS) pathway specifically induces hypothermia and elevated tail temperature. Moreover, selective opto-stimulation of 2MT-activated PSTh-projecting PBel neurons, by capturing activated neuronal ensembles (CANE), induces hypothermia and elevated tail temperature. Conversely, chemogenetic suppression of vGlut2+ neurons in PBel and PSTh or PSTh-projecting PBel neurons attenuates 2MT-evoked hypothermia and tail temperature increment. Taken together, these results uncover a novel PBel-PSTh-NTS neural pathway that underlies 2MT-evoked innate fear-associated hypothermia and tail vasodilation.
Bacterial Diversity and Predicted Enzymatic Function in a Multipurpose Surface Water System – From Wastewater Effluent Discharges to Drinking Water Production
Authors: Tiwari Ananda , Hokajärvi Anna-Maria , Domingo Jorge Santo , Elk Michael , Jayaprakash Balamuralikrishna , Ryu Hodon , Siponen Sallamaari , Vepsäläinen Asko , Kauppinen Ari , Puurunen Osmo , Artimo Aki , Perkola Noora , Huttula Timo , Miettinen Ilkka T. , Pitkänen Tarja 
Published: December 2020

Abstract
BackgroundRivers and lakes are used for multiple purposes such as for drinking water (DW) production, recreation, and as recipients of wastewaters from various sources. The understanding of the seasonal dynamics of bacterial communities on such waters may help for protecting human health and the environment. This study analyzed 16S rRNA-gene high-throughput sequence data for determining the spatial and seasonal dynamics of bacterial communities, their predicted functions, and potential health-related bacterial (PHRB) reads within the Kokemäenjoki River watershed in south-west Finland. Water samples were collected from various sampling points of the watershed, from its major pollution sources (sewage influent and effluent, industrial effluent, mine runoff) and different stages of the DW treatment process (pre-treatment, groundwater observation well, DW production well) by using the river water as raw water with artificial groundwater recharge (AGR). ResultsThe beta-diversity analysis revealed that bacterial communities were highly varied among sample groups (R = 0.92, p < 0.001, ANOSIM). The species richness and evenness indices were highest in surface water (Chao1; 920±10) among sample groups and gradually decreased along the DW treatment process (DW production well; Chao1: 320±20). Although the phylum Proteobacteria was omnipresent, its relative abundance was higher in sewage and industrial effluents (66-80%) than in surface water (55%). Phyla Firmicutes and Fusobacteria were only detected in sewage samples. Actinobacteria was more abundant in the surface water (≥13%) than in other groups (≤3%). Acidobacteria was more abundant in the DW treatment process (≥13%) than in others (≤2%). In total, the share of PHRB reads was higher in sewage and surface water than in the DW treatment samples. In surface water, the recorded richness indices and the share of PHRB reads were lowest during summer than other seasons. When all sample groups were considered together, the predicted enzymatic function was lowest during spring than other seasons. Conclusions The significantly different bacterial communities at the pollution sources as compared to surface water highlight the importance of effective wastewater treatment for protecting surface water quality. The low bacterial diversity and absence of PHRB reads in the DW samples indicate AGR is able to produce biologically stable and microbiologically safe drinking water.
L-Fuzzy Concept Analysis as a Decision-Making Tool in the Development of Bio-Based Materials
Authors: Leceta Itsaso , Alcalde Cristina , Urdanpilleta Marta , Guerrero Pedro , Caba Koro de la , Burusco Ana 
Published: December 2020

Abstract
The use of L-fuzzy concept analysis for the determination of the formulations of gelatin-based films that fulfillspecifc functional properties is reported. The requirements of water contact angle (CA), water vapourtransmission rate (WVTR), L* and b* colour values, tensile strength (TS), elongation at break (EB) and glossvalues were specified for both fatty food packaging and wound healing applications. Once the requiredformulations were estimated by L-fuzzy concepts, the experimental results showed a high accordance with thepredicted values of the nal properties, as well as with the requirements. The errors were lower than 20% in allcases, except in colour (for food packaging) and gloss and elongation at break (for wound healing), in whichthe nal properties were even better that the estimations. This analysis allowed nding the requiredformulations in a highly cost-effective way.
Identification of Prognosis-related RBPs to Reveal the Role of RNA&nbsp;Binding Proteins in the Progression and Prognosis of Wilms’ Tumor
Authors: Qi Xuejiao , Dong Yihui , Lin Xiaojie , Chen Jingqiu 
Published: December 2020

Abstract
BackgroundRNA-binding proteins (RBPs), the ubiquitous regulators that can bind to RNA, mediate the function of RNA in the process of its maturation, translation, transport and localization [1, 2]. Despite the various key functions of RBPs in posttranscriptional events, the mechanism of their influence on Wilms’ tumor has not been well elucidated. So we construct the research to identify several RBPs related to Wilmes’ tumor progression and prognosis, for the better understanding of RBPs’ role in the occurrence and development of Wilmes’ tumor, and to provide effective reference targets for new drug development.MethodsA total of 127 samples of different clinical characteristics including gender, race and stage were selected from TCGA to carry out our study. After the gene functional enrichment pathways, univariate Cox regression analysis and lasso regression analysis were performed to test the prognostic effect of the differentially-expressed genes and establish the prognostic index . Further Cox regression analyses were utilized to identify the independence of our model and to analyze the relationship between our model and clinical parameters. What’s more, gene set enrichment analysis (GSEA) was also performed to elucidate the biological characteristics of genes involved in Wilms’ tumor. P< 0.05 was considered to be statistically significant.Results26 RBPs were statistically correlated with Wilms’ tumor. After the construction of a prognostic index , patients were divided into high-and low-risk scores group. Kaplan-Meier (K-M) analyses showed that patients with high risk scores possessed poorer survival probability than patients with low risk scores in both training group and test group. Furthermore, multivariate Cox regression analysis explored the relationship between our prognostic model and clinical parameters and confirmed that our model was an independent predicted factor for Wilms’ tumor. ConclusionOur study clarifies the application of RBPs in the prognosis of Wilms’ tumor. We are confident that our risk scoring model can provide ideas for the development of new targets for broad-spectrum anticancer drugs and has great potential in clinical practice.Trial registrationretrospectively registered
Genetic Polymorphisms of Plasmodium Falciparum Isolates From Melka-werer, North East Ethiopia Based on the Merozoite Surface Protein-2 (msp-2) Gene as a Molecular Marker
Authors: Ali Hussein Mohammed , Assefa Ashenafi , Chernet Melkie , Wulataw Yonas , Commons Robert J 
Published: December 2020

Abstract
Background: The characterization of parasite populations circulating in malaria endemic areas is necessary to evaluate the success of ongoing interventions and malaria control strategies. This study was designed to investigate the genetic diversity of Plasmodium falciparum isolates from the semi-arid area in North East Ethiopia, using the highly polymorphic merozoite surface protein-2 (msp2) gene as a molecular marker. Methods: Dried blood spot isolates were collected from patients with Plasmodium falciparum infection between September 2014 and January 2015 from Melka-Werer, North East Ethiopia. Parasite DNA was extracted and genotyped using allele-specific nested polymerase chain reactions for msp2. Results: 52 isolates were collected with msp2 identified in 41 (78.8%) isolates. Allele typing of the msp2 gene detected the 3D7/IC allelic family in 54% and FC27 allelic family in 46%. A total of 14 different msp2 genotypes were detected including 6 belonging to the 3D7/IC family and 8 to the FC27 family. Forty percent of isolates had multiple genotypes and the overall mean multiplicity of infections (MOI) was 1.2 (95%CI 0.96-1.42). The heterozygosity index was 0.50 for the msp2 locus. There was no difference in MOI between age groups. A negative correlation between parasite density and multiplicity of infection was found (p = 0.02).Conclusion: P. falciparum isolates from the semi-arid area of North East Ethiopia are mainly monoclonal with low MOI and limited genetic diversity in the study population.
A Beckwith-Wiedemann Syndrome Case with de novo 24 Mb Duplication of Chromosome 11p15.5-14.3
Authors: Jiang Huling , Ping Zepeng , Wang Jianguo , Liu Xiaodan , Jin Yuxia , Li Suping , Zhou Chiyan , Huang Pinghua , Jin Yi , Ai Ling , Chen Jie 
Published: December 2020

Abstract
BackgroundMolecular genetic testing for the 11p15-associated imprinting disorder Beckwith-Wiedemann syndrome(BWS) is challenging because of the molecular heterogeneity and complexity of the affected imprinted regions. An accurate diagnosis of BWS requires a complete molecular method to analyze epigenetic changes.Case presentationWe reported a Chinese case with BWS detected by SNP array analysis and methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA). The genetic analysis showed a de nove duplication of 24 Mb at 11p15.5-14.3 is much longer than ever reported. MS-MLPA showed copy number changes with a peak height ratio value of 1.5(three copies) at 11p15. The duplication of paternal origin withincrease of methylation index of 0.68 at H19 and decreased methylation index of 0.37 at KCNQ1OT1.ConclusionCombined chromosome microarray analysis and methylation profiling provided reliable diagnosis for this paternally derived duplication of BWS. The phenotype associated with 11p15 duplications depends on the size, genetic content, parental inheritance and imprinting status. Identification of these rare duplications is crucial for genetic counselling.
Barriers and Facilitators to Implementing a Longitudinal Dementia Education Programme into Undergraduate Healthcare Curricula: A Qualitative Study.
Authors: Feeney Yvonne Anne , Daley Stephanie , Flaherty Breda , Banerjee Sube 
Published: December 2020

Abstract
BackgroundAs worldwide prevalence of dementia rises, there are international calls for improved knowledge and awareness about the condition across the healthcare workforce. There are concerns that traditional models of healthcare education, which focus on short-term episodes of care limits student understanding of long-term conditions. This has led to the introduction of the Time for Dementia programme at five Universities in the UK. Through longitudinal contact with families living with dementia, healthcare students gain increased understanding about the experiences of living with dementia. However, implementing new educational models brings challenges. To enable implementation of similar models by other educational institutions, this study aimed to identify the common barriers and facilitators of implementing a longitudinal programme at scale. MethodsTwelve in-depth semi-structured interviews were completed between October and December 2018 with participants that had experience implementing the Time for Dementia programme. Interviews were analysed using inductive thematic analysis.ResultsThe analysis identified five key themes important to implementation. These were: 1) leadership, 2) organisational buy-in, 3) perceived value, 4) team coalition, and 5) time and fit. Implementation of the programme was enhanced by resilient leaders managing the challenges of curricular change. Their belief in the value of the programme, stakeholder buy-in, and supportive team working enabled challenges to be overcome. Workload reduced and student buy-in increased as time progressed and as more resources became available. A flexible approach to implementation was recommended to ensure the programme fits within the established curriculum. Conclusion Curricular change is a challenging task, yet a necessary endeavour to meet high quality educational standards. This study highlights the common barriers and facilitators experienced when implementing a longitudinal educational programme at scale. The findings presented in this study can be used by other educational institutions to manage curricular change efforts.