bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of the skills of caregivers of people with dementia: observational study
Authors: Leocadie Marie-Conception , Morvillers Jean-Manuel , Pautex Sophie , Rothan-Tondeur Monique 
Published: July 2020

Abstract
Background
Due to demographic change within an aging population as announced by the WHO, the involvement of caregivers is essential. Caregivers are required to change their roles within the family unit. Such life transitions experienced by caregivers to people confronted with dementia-type pathologies are sometimes difficult, necessitating the acquisition and development of certain skills. Few studies have shown that caregivers develop specific and essential skills to promote quality care and safety. To characterize their skills, there is a need to identify the abilities, knowledge, resources, obstacles and constraints that contribute to caregivers’ transitions. The research question for this study was: What skills do caregivers use to care for their loved one with dementia?

Methods
Qualitative observational research based on the epistemological paradigm of socioconstructivist knowledge was conducted. The study was carried out in the canton of Geneva and recruitment was carried out through the participation of the Alzheimer’s association and the association for the support and assistance of elderly people in medical and social institutions and their families (APAF). Observations and semi-structured interviews were conducted in the homes of 14 family carers caring for their loved one with dementia. The observations were transcribed on observation grids and the interviews were recorded. Subsequently, according to the classic distinction of Denzin (Interpretive interractionism, 2001), we analysed the observation notes and verbatims, then as recommended by Miles et al. (Qualitative data analysis: a methods sourcebook, 2014), two researchers triangulated the results.

Results
The results identified five types of situations regularly experienced by caregivers. The study characterized 11 skills that caregivers use to cope with their daily lives. The learning process and maladaptive behaviours in caring for their loved ones with dementia were also highlighted.

Conclusion
This study was able to point out that today’s caregivers have developed more competency than their predecessors. This evolution can be explained by new paradigms of care requiring caregivers to be more involved. Although some caregivers need training, others through their experiences can act upon and provide knowledge. To improve the quality and safety of care for people with dementia, this expertise can be the subject of partnerships between caregivers and health care staff.
A cross-sectional study of Swiss ambulatory care services use by multimorbid patients in primary care in the light of the Andersen model
Authors: Messi Mia , Mueller Yolanda , Haller Dagmar M. , Zeller Andreas , Neuner-Jehle Stefan , Streit Sven , Burnand Bernard , Herzig Lilli 
Published: July 2020

Abstract
Background
Multimorbidity is frequently encountered in primary care and is associated with increasing use of healthcare services. The Andersen Behavioral Model of Health Services Use is a multilevel framework classifying societal, contextual, and individual characteristics about the use of healthcare services into three categories: 1. predisposing factors, 2. enabling factors, and 3. need factors. The present study aimed to explore multimorbid patients’ use of ambulatory healthcare in terms of homecare and other allied health services, visits to GPs, and number of specialists involved. A secondary aim was to apply Andersen’s model to explore factors associated with this use.

Method
In a cross-sectional study, 100 Swiss GPs enrolled up to 10 multimorbid patients each. After descriptive analyses, we tested the associations of each determinant and outcome variable of healthcare use, according to the Andersen model: predisposing factors (patient’s demographics), enabling factors (health literacy (HLS-EU-Q6), deprivation (DipCare)), and need factors (patient’s quality of life (EQ-5D-3L), treatment burden (TBQ), severity index (CIRS), number of chronic conditions, and of medications). Logistic regressions (dichotomous variables) and negative binomial regressions (count variables) were calculated to identify predictors of multimorbid patients’ healthcare use.

Results
Analyses included 843 multimorbid patients; mean age 73.0 (SD 12.0), 28–98 years old; 48.3% men; 15.1% (127/843) used homecare. Social deprivation (OR 0.75, 95%CI 0.62–0.89) and absence of an informal caregiver (OR 0.50, 95%CI 0.28–0.88) were related to less homecare services use. The use of other allied health services (34.9% (294/843)) was associated with experiencing pain (OR 2.49, 95%CI 1.59–3.90). The number of contacts with a GP (median 11 (IQR 7–16)) was, among other factors, related to the absence of an informal caregiver (IRR 0.90, 95%CI 0.83–0.98). The number of specialists involved (mean 1.9 (SD 1.4)) was linked to the treatment burden (IRR 1.06, 95%CI 1.02–1.10).

Conclusion
Multimorbid patients in primary care reported high use of ambulatory healthcare services variably associated with the Andersen model’s factors: healthcare use was associated with objective medical needs but also with contextual or individual predisposing or enabling factors. These findings emphasize the importance of adapting care coordination to individual patient profiles.
Mental health and well-being in older women in China: implications from the Andersen model
Authors: Yang Hui , Hagedorn Aaron , Zhu He , Chen Honglin 
Published: July 2020

Abstract
Background
Mental health and well-being among older women is an important topic due to the feminization of later life as women tend to have longer life expectancy resulting in elderly women being more advanced in age and outnumbering men. Older women generally play a key role in their families lifelong and mostly depend on social support from their family and close friends in older age to cope with any limitations they face as a result of age-related changes in their health and functional ability.

Methods
We examine which factors predict mental health and well-being in older women using the Third Wave of the 2010 Female Social Status Survey conducted by the All-China Women’s Federation (n = 3527). Applying the Andersen Model, regression analysis exploring predisposing, enabling and health need variables were tested using SPSS version 22 predicting a mental health scale.

Results
Results showed that living with a spouse was not a significant predictor of mental health for women, while it was for men (b = − 1.2, p < .01), ownership of property is significant only for men (b = −.96, p < .05), whereas women’s mental health is more strongly predicted by current exercise (b = −.89, p < .01) and participation in leisure activities (b = −.69, p < .001). Close relationships with neighbors, qualifying for old-age benefit programs and being in better overall health supports positive mental health for both men and women. Reporting delayed medical treatment is associated with a negative impact on mental health for men, but oddly women who report the same actually report better mental health, perhaps suggesting older women take pride in their self-sacrifice.

Conclusion
The findings of this study suggest that gender differences in wealth, living alone, and social participation are interpreted differently by women, who have longer lives with generally fewer material resources. Enabling factors tend to be more associated with financial factors for men, while women rely on a social convoy to thrive longer than their male counterparts.
Impact of GeneXpert MTB/RIF® on treatment initiation and outcomes of RIF-resistant and RIF-susceptible TB patients in Vladimir TB dispensary, Russia
Authors: Ershova Julia V. , Volchenkov Grigory V. , Somova Tatiana R. , Kuznetsova Tatiana A. , Kaunetis Natalia V. , Kaminski Dorothy , Demikhova Olga V. , Chernousova Larisa N. , Vasilyeva Irina A. , Kerr Eleanor M. , Cegielski J. Peter , Kurbatova Ekaterina V. 
Published: July 2020

Abstract
Background
The main advantage of GeneXpert MTB/RIF® (Xpert) molecular diagnostic technology is the rapid detection of M.tuberculosis DNA and mutations associated with rifampicin (RIF) resistance for timely initiation of appropriate treatment and, consequently, preventing further transmission of the disease. We assessed time to treatment initiation and treatment outcomes of RIF-resistant and RIF-susceptible TB patients diagnosed and treated in Vladimir TB Dispensary, Russia in 2012, before and after implementation of GeneXpert MTB/RIF® diagnostic technology.

Methods
All adult patients suspected of having TB during February–December 2012 underwent a clinical examination, chest x-ray, microscopy, culture, and phenotypic drug susceptibility testing (DST). Starting August 2012 Xpert diagnostic technology became available in the facility. We used logistic regression to compare treatment outcomes in pre-Xpert and post-Xpert periods. Kaplan-Meier curves and log-rank test were used to compare the time to treatment initiation between the groups.

Results
Of 402 patients screened for TB during February–December 2012, 338 were diagnosed with TB (280 RIF-susceptible, 58 RIF-resistant). RIF-resistant patients in the post-Xpert group started treatment with second-line drugs (SLD) earlier than those in pre-Xpert group (median 11 vs. 37 days, Log-rank p = 0.02). The hazard ratio for time to SLD treatment initiation was significantly higher in post-Xpert group (HR:2.06; 95%CI:1.09,3.89) compared to pre-Xpert group. Among the 53/58 RIF-resistant TB patients with available treatment outcome, 28 (53%) had successful outcomes (cured/completed treatment) including 15/26 (58%) in post-Xpert group versus 13/27 (48%) in pre-Xpert group. The observed difference, however, was not statistically significant (OR:0.69; 95%CI:0.23,2.06).
Among RIF-susceptible TB cases time to treatment initiation was not significantly different between the groups (2 vs. 3 days, Log-rank p = 0.73). Of 252/280 RIF-susceptible TB cases with treatment outcome, 199 (79%) cases had successful outcome including 94/114 (82%) in post-Xpert group versus 105/138 (76%) in pre-Xpert group (OR:0.68; 95%CI:0.36,1.26).

Conclusion
We observed that availability of Xpert for initial diagnosis significantly reduced the time to SLD treatment for RIF-resistant patients in the Vladimir TB Dispensary. Although implementation of rapid diagnostics did not improve treatment outcomes, early diagnosis of MDR-TB is important for selection of appropriate treatment regimen and prevention of transmission of drug-resistant strains of TB.
A novel MYH14 mutation in a Chinese family with autosomal dominant nonsyndromic hearing loss
Authors: Wang Mingming , Zhou Yicui , Zhang Fengguo , Fan Zhaomin , Bai Xiaohui , Wang Haibo 
Published: July 2020

Abstract
Background
MYH14 gene mutations have been suggested to be associated with nonsyndromic/syndromic sensorineural hearing loss. It has been reported that mutations in MYH14 can result in autosomal dominant nonsyndromic deafness-4A (DFNA4).

Methods
In this study, we examined a four-generation Han Chinese family with nonsyndromic hearing loss. Targeted next-generation sequencing of deafness genes was employed to identify the pathogenic variant. Sanger sequencing and PCR-RFLP analysis were performed in affected members of this family and 200 normal controls to further confirm the mutation.

Results
Four members of this family were diagnosed as nonsyndromic bilateral sensorineural hearing loss with postlingual onset and progressive impairment. A novel missense variant, c.5417C > A (p.A1806D), in MYH14 in the tail domain of NMH II C was successfully identified as the pathogenic cause in three affected individuals. The family member II-5 was suggested to have noise-induced deafness.

Conclusion
In this study, a novel missense mutation, c.5417C > A (p.A1806D), in MYH14 that led to postlingual nonsyndromic autosomal dominant SNHL were identified. The findings broadened the phenotype spectrum of MYH14 and highlighted the combined application of gene capture and Sanger sequencing is an efficient approach to screen pathogenic variants associated with genetic diseases.
The effects of dialysis modalities on the progression of coronary artery calcification in dialysis patients
Authors: Niu Qingyu , Zhao Huiping , Zuo Li , Wang Mei , Gan Liangying 
Published: July 2020

Abstract
Background
Hemodialysis (HD) tend to have more hemodynamic changes than peritoneal dialysis (PD), which aggravates inflammation and oxidative stress. Whether HD and PD have different effects on the progression of vascular calcification? Therefore, we produced a study to explore the relationship of dialysis modalities and coronary artery calcification (CAC) progression.

Methods
This was a prospective cohort study. CT scans were performed at enrollment and 2 years later for each patient. Demographic and clinical data were collected. Tobit regression was used to compare delta CAC score between HD and PD patients.

Results
(1) 155 patients were enrolled, including 69 HD and 86 PD patients. (2) The baseline CAC scores were 97 (1, 744) in HD and 95 (0, 324) in PD; the follow-up CAC scores were 343 (6, 1379) in HD and 293 (18, 997) in PD. There were no significant differences in baseline, follow-up and delta CAC scores between 2 groups (P > 0.05). (3) In Tobit regression, after adjusted for variables, there was no significant difference of CAC progression in HD and PD groups (P > 0.05). (4) Logistic regression showed that older age, diabetes and higher time-averaged serum phosphate (P) were associated with faster progression of CAC (P < 0.05), but there was no evidence that HD was associated with faster CAC progression compared with PD (P = 0.879).

Conclusions
There was no evidence that different dialysis modalities have different effect on CAC progression. Old age, DM and higher time-averaged P were associated with fast CAC progression.
Elevated serum iron level is a predictor of prognosis in ICU patients with acute kidney injury
Authors: Shu Jie , Hu Yufeng , Yu Xueshu , Chen Jiaxiu , Xu Wenwei , Pan Jingye 
Published: July 2020

Abstract
Background
Accumulation of iron is associated with oxidative stress, inflammation, and regulated cell death processes that contribute to the development of acute kidney injury (AKI). We aimed to investigate the association between serum iron levels and prognosis in intensive care unit (ICU) patients with AKI.

Methods
A total of 483 patients with AKI defined as per the Kidney Disease: Improving Global Guidelines were included in this retrospective study. The data was extracted from the single-centre Medical Information Mart for Intensive Care III database. AKI patients with serum iron parameters measured upon ICU admission were included and divided into two groups (low group and high group). The prognostic value of serum iron was analysed using univariate and multivariate Cox regression analysis.

Results
The optimal cut-off value for serum iron was calculated to be 60 μg/dl. Univariable Cox regression analysis showed that serum iron levels were significantly correlated with prognosis of AKI patients. After adjusting for possible confounding variables, serum iron levels higher than 60 μg/dl were associated with increases in 28-day (hazard [HR] 1.832; P <  0.001) and 90-day (HR 1.741; P <  0.001) mortality, as per multivariable Cox regression analysis.

Conclusions
High serum iron levels were associated with increased short- and long-term mortality in ICU patients with AKI. Serum iron levels measured upon admission may be used for predicting prognosis in AKI patients.
Quantification of the severity of outflow stenosis of hemodialysis fistulas with a pulse- and thrill-based scoring system
Authors: Chen Matt Chiung-Yu , Weng Mei-Jui , Chang Bai-Chun , Lai Hsiu-Ching , Wu Misoso Yi-Wen , Fu Chia-Yun , Liu Yi-Chun , Chi Wen-Che 
Published: July 2020

Abstract
Background
Hyper-pulsatility of hemodialysis arteriovenous fistula (AVF) is the basic physical examination finding when there is outflow stenosis. The arm elevation test can also be utilized to detect outflow stenosis. If there is no significant outflow stenosis, the AVF should collapse, at least partially, because of the effect of gravity when the AVF-bearing arm is elevated to a level above that of the heart. However, if there is significant outflow stenosis, the portion of the AVF downstream of the stenosis will collapse, while the portion upstream of the stenosis will remain distended (Clin J Am Soc Nephro 8:1220-7, 2013). In our daily practice, when performing the arm elevation test, we not only observe the collapsibility of the access outflow but also palpate the outflow to identify a background thrill that sometimes disappears with the arm at rest, only to reappear when the arm is elevated. If there is no thrill upon arm elevation, we assume that the outflow stenosis is severe and refer to this condition as “physical examination significant outflow stenosis” (PESOS). The aim of this study is to characterize PESOS using percentage stenosis and Doppler flow parameters.

Methods
We performed a case-control study using data collected prospectively between June 2019 and December 2019. A pulse- and thrill-based score system was developed to assess the severity of AVF outflow stenosis. We recorded the outflow scores and Doppler measurements performed in 84 patients with mature fistulas over a 6-month period. Angiograms were reviewed to determine the severity of outflow stenosis, which was assessed by calculation of percentage stenosis.

Results
Receiver operating characteristic analysis showed that a cutoff value of ≥74.44% stenosis discriminated PESOS from other AVF outflow scores, with an area under the curve of 0.9011. PESOS diagnosed cases with ≥75% outflow stenosis in an AVF, with a sensitivity of 80.39%, a specificity of 78.79%, a positive predictive value of 85.42%, and a negative predictive value of 72.22%.

Conclusions
PESOS can be used to diagnose ≥75% outflow stenosis in an AVF, with or without a significant collateral vein, and its diagnostic accuracy is high. The use of PESOS as an indicator for treatment implies that physical examination may represent a useful surveillance tool.
Pre-existing mental health disorders affect pregnancy and neonatal outcomes: a retrospective cohort study
Authors: Sūdžiūtė Kotryna , Murauskienė Greta , Jarienė Kristina , Jaras Algirdas , Minkauskienė Meilė , Adomaitienė Virginija , Nedzelskienė Irena 
Published: July 2020

Abstract
Background
This was a hospital registry-based retrospective age-matched cohort study that aimed to compare pregnancy and neonatal outcomes of women with pre-existing mental disorders with those of mentally healthy women.

Methods
A matched cohort retrospective study was carried out in the Department of Obstetrics and Gynecology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, a tertiary health care institution. Medical records of pregnant women who gave birth from 2006 to 2015 were used. The study group was comprised of 131 pregnant women with mental disorders matched to 228 mentally healthy controls. The primary outcomes assessed were antenatal care characteristics; secondary outcomes were neonatal complications.

Results
Pregnant women with pre-existing mental health disorders were significantly more likely to have low education, be unmarried and unemployed, have a disability that led to lower working capacity, smoke more frequently, have chronic concomitant diseases, attend fewer antenatal visits, gain less weight, be hospitalized during pregnancy, spend more time in hospital during the postpartum period, and were less likely to breastfeed their newborns. The newborns of women with pre-existing mental disorders were small for gestational age (SGA) more often than those of healthy controls (12.9% vs. 7.6%, p < 0.05). No difference was found comparing the methods of delivery.

Conclusions
Women with pre-existing mental health disorders had a worse course of pregnancy. Mental illness increased the risk to deliver a SGA newborn (RR 2.055, 95% CI 1.081–3.908).
Cancer cases and deaths attributable to lifestyle risk factors in Chile
Authors: Rezende Leandro F. M. , Murata Eliana , Giannichi Beatriz , Tomita Luciana Yuki , Wagner Gabriela Arantes , Sanchez Zila M. , Celis-Morales Carlos , Ferrari Gerson 
Published: July 2020

Abstract
Background
To identify modifiable risk factors that contribute to cancer holds important public health relevance for setting up prevention strategies. Therefore, the aim of this study was to estimate the proportion of cancer cases and deaths attributable to alcohol consumption, high body mass index (BMI), low fruits and vegetables consumption, lack of physical activity, tobacco smoking, and passive smoking in Chile in 2018.

Methods
We retrieved data from a national representative survey to describe the distribution of six lifestyle risk factors. Relative risks of each risk factor-cancer pair were obtained from published meta-analysis and pooled cohort studies. Cancer cases and deaths were obtained from the GLOBOCAN 2018.

Results
Nearly 30% of all cancer cases (15,097 out of 50,320 cases) and 36% of all cancer deaths (10,155 out of 28,010 deaths) in Chile in 2018 were attributable to lifestyle risk factors. Smoking and high BMI accounted for most of the cancer cases (9232 and 4394, respectively) and deaths (6868 and 2572). The cancer burden of other lifestyle risk factors varied by sex. In men, the proportion of all cancer cases attributed to alcohol were 3.7% compare to 2.0% for women. Cancers cases and deaths of the larynx, lung, oral/cavity, esophagus and bladder could be at least halved if lifestyle risk factors were eliminated.

Conclusion
Smoking and high BMI were the leading causes of preventable cancer cases and deaths within the six lifestyles factors considered. Cancer prevention strategies should consider evidence-based interventions and public policies to encourage the adoption of a healthier lifestyle.
A panel of DNA methylation signature from peripheral blood may predict colorectal cancer susceptibility
Authors: Onwuka Justina Ucheojor , Li Dapeng , Liu Yupeng , Huang Hao , Xu Jing , Liu Ying , Zhang Yuanyuan , Zhao Yashuang 
Published: July 2020

Abstract
Background
Differential DNA methylation panel derived from peripheral blood could serve as biomarkers of CRC susceptibility. However, most of the previous studies utilized post-diagnostic blood DNA which may be markers of disease rather than susceptibility. In addition, only a few studies have evaluated the predictive potential of differential DNA methylation in CRC in a prospective cohort and on a genome-wide basis. The aim of this study was to identify a potential panel of DNA methylation biomarkers in peripheral blood that is associated with CRC risk and therefore serve as epigenetic biomarkers of disease susceptibility.

Methods
DNA methylation profile of a nested case-control study with 166 CRC and 424 healthy normal subjects were obtained from the Gene Expression Omnibus (GEO) database. The differentially methylated markers were identified by moderated t-statistics. The DNA methylation panel was constructed by stepwise logistic regression and the least absolute shrinkage and selection operator in the training dataset. A methylation risk score (MRS) model was constructed and the association between MRS and CRC risk assessed.

Results
We identified 48 differentially methylated CpGs sites, of which 33 were hypomethylated. Of these, sixteen-CpG based MRS that was associated with CRC risk (OR = 2.68, 95% CI: 2.13, 3.38, P <  0.0001) was constructed. This association is confirmed in the testing dataset (OR = 2.02, 95% CI: 1.48, 2.74, P <  0.0001) and persisted in both males and females, younger and older subjects, short and long time-to-diagnosis. The MRS also predicted CRC with AUC 0.82 (95% CI: 0.76, 0.88), indicating high accuracy.

Conclusions
Our study has identified a novel DNA methylation panel that is associated with CRC and could, if validated be useful for the prediction of CRC risk in the future.