bluuebunny/crossref_metadata_2025_split huggingface dataset:
Natural presence of the V179D and K103R/V179D mutations associated with resistance to nonnucleoside reverse transcriptase inhibitors in HIV-1 CRF65_cpx strains
Authors: Liu Yongjian , Zhang Yu , Li Hanping , Wang Xiaolin , Jia Lei , Han Jingwan , Li Tianyi , Li Jingyun , Li Lin 
Published: April 2020

Abstract
Background: There is increasing evidence that HIV-1 genetic diversity can have an impact on drug resistance. The aim of this study is to investigate the epidemiological situation of CRF65_cpx and the impact of natural polymorphisms of this variant on genotypic resistance. Methods: We used the BLAST search program followed by phylogenetic analysis to identify additional CRF65_cpx pol sequences from the Los Alamos HIV Sequence Database. Maximum likelihood phylogeny was estimated to clarify the epidemiological relationship of CRF65_cpx strains. Genotypic resistance was determined by submitting sequences to the Stanford HIV Drug Resistance Database. Results: A total of 32 CRF65_cpx pol sequences were obtained. The CRF65_cpx strains were detected in seven provinces with large geographic distance. Yunnan CRF65_cpx sequences were mainly derived from a heterosexual risk group, whereas the CRF65_cpx sequences in other provinces were almost exclusively derived from an MSM population. With one exception of V179E, the other 31 strains harbored V179D mutation. The combination of V179D and K103R, conferring intermediate resistance to EFV and NVP, was detected in seven treatment-naive MSM patients. Conclusions: This study confirmed the expansion CRF65_cpx in China. Furthermore, we found the natural presence of the V179D and K103R/V179D mutations associated with resistance to NNRTIs in HIV-1 CRF65_cpx. Our findings highlight the contribution of polymorphic mutations to drug resistance and underscore the challenges in treating patients harboring CRF65_cpx strains.
Analysis of ileostomy stool samples reveals dysbiosis in patients with high-output intestinal fluid
Authors: Matsuzawa Hirokazu , Munakata Shinya , Kawai Masaya , Sugimoto Kiichi , Kamiyama Hirohiko , Takahashi Makoto , Kojima Yutaka , Sakamoto Kazuhiro 
Published: April 2020

Abstract
Background Diverting stoma construction can significantly reduce the onset of severe anastomotic leakage in patients with rectal cancer. High-output stoma is one of the most important potential surgical complications after anal function-preserving surgery with ileostomy. Culture-independent techniques have revealed the interaction of complex intestinal bacterial ecology with various diseases. Our objective was to evaluate the differences in patient characteristics and gut microbiota distribution features in stoma high output patients. Patients and Methods The cases of 24 consecutive patients who underwent curative resection for rectal cancer at our hospital between November 2016 and June 2018 were reviewed and patients categorized into high-output and low-output groups. The microbiota was analyzed using next-generation sequencing of ileostomy stool samples collected on postoperative day 7. Results There was a significant difference in the percentage of Bacteroidetes between the high-output and low-output groups (14.8% vs 0.5%; p = 0.01). The percentage of Clostridium butyricum was increased in the low-output group ( p = 0.01). The analyses after the exclusion of those treated with the Miya-BM probiotic, whose principal component is C. butyricum , revealed no significant differences between the high-output and low-output groups. Conclusion This pilot study provides first evidence correlating gut microbiota in the pathogenesis of high output stoma compared with low output stoma.
Domestic Violence in Mozambique From policy to practice
Authors: Jethá Eunice , Keygnaert Ines , Martins Emilia , Sidat Mohsin , Roelens Kristien 
Published: April 2020

Abstract
Background: To reduce the impact of domestic violence (DV), Mozambican governmental and non-governmental entities are making efforts to strengthen the legislative framework and improve the accessibility of care services for survivors of violence. Despite this remarkable commitment, the translation of policies and legislation into actions remains a huge challenge. Therefore, this paper aims to identify gaps in the implementation of existing national policies and laws for DV in the services providing care for survivors of DV. Methods: This study, using a qualitative approach had two components. The first was content analysis of guidelines and protocols for DV care provision. The second consisted of in-depth interviews with institutional gender focal points. The analysis of the document content was based on a framework developed according to key elements recommended by international agencies (PAHO and UN) for DV policies and strategies design. Data from the in-depth interviews, where analysed in accordance with study objectives. Results: Eleven (11) guidelines/protocols of care provision and innumerable brochures and pamphlets were identified and analysed. There is a standardised form which highlights the integrated approach incorporating fields for police and the health sector but excludes Civil Society Organizations. However, there is no national DV database. Although the focal points recognised the relevance of the reviewed documents, many identified gaps in implementation. This is related to the weaknesses of the offender’s penalisation and to the scarcity of care providers. And, many providers who do exist often lack appropriate training. They also recognised their performance is negatively influenced by socio-cultural factors. Conclusion : Within services providing care to survivors of DV, a scarcity of guidelines and protocols exist, compromising the quality and standardisation of care . Recognition of the relevance of care guidelines and protocols is a strength, there are challenges governmental and non-governmental entities must address in order to ensure DV prevention and control strategies have the desired results.
Analysis of the Practice of Dengue Prevention and Sustainable Control with Multi-attribute Decision-making
Authors: Wang Shen-Tsu , Li Meng-Hua , Lien Chun-Chi , Cho Wan-Ching 
Published: April 2020

Abstract
Dengue fever is one of the most common insect-borne diseases in the world, and epidemics mostly occur in tropical and subtropical regions. In the past, the grey multi-attribute decision-making method has been combined with the Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) method to predict which areas in southern Tainan may easily trigger dengue epidemics. As many studies have shown that the extent of human communication and active government is crucial in dengue prevention, this study aims to propose dengue prevention and control methods before and after the occurrence of dengue cases. This study found that, when dengue fever cases begin to appear, the relevant county and city government departments must hire vector control companies to carry out regional indoor and outdoor spraying. Before the emergence of dengue cases, the green and sustainable-oriented remediation strategies, as promoted by the Environmental Protection Administration (EPA), can be adopted. Remediation of soil and groundwater pollution sites can reduce the source of vector mosquitoes, in order that the green environment can achieve sustainable development.
Measuring capital in active addiction and recovery: The development of the Strengths And Barriers Recovery Scale (SABRS)
Authors: Best David , Vanderplasschen Wouter , Nisic Mulka 
Published: April 2020

Abstract
The international Life In Recovery (LiR) surveys have provided an important message to the public and policy makers about the reality of change from addiction to recovery, consistently demonstrating both that there are marked gains across a range of life domains and that the longer the person is in recovery the better their recovery strengths and achievements. However, to date, no attempt has been made to quantify the LiR scales and to assess what levels of change in removing barriers and building strengths is achieved at which point in the recovery journey. The current study undertakes a preliminary analysis of strengths and barriers from the LiR, using data from a European LiR survey conducted, and suggests that the LiR instrument can be edited into a Strengths And Barriers Recovery Scale (SABRS). The resulting data analysis shows that there are stepwise incremental changes in recovery strengths at different recovery stages, but these occur with only very limited reductions in barriers to recovery, with even those in stable recovery typically having at least two barriers to their quality of life and wellbeing. Greater strengths in active addiction (which we will refer to as ‘natural recovery capital’) are associated with greater strengths and resources in recovery.
A Qualitative Study on the Unmet Needs of Cancer Carers in Vietnam
Authors: Jenkins Chris , Ho Hien Thi , Nghiem Hoa Le Phuong , Prue Gillian , Lohfeld Lynne , Donnelly Michael , Hoang Minh Van , Santin Olinda 
Published: April 2020

Abstract
Background: Due to limited resources in hospitals and social and cultural norms regarding caregiving in Vietnam, carers provide a range of supportive functions for family members diagnosed with cancer. This paper provides empirical evidence on the self-identified unmet needs of carers of inpatients in national oncology hospitals in Vietnam.Methods: An international, multidisciplinary research team conducted focus group and in-depth interviews with informal carers (n=20) and health care providers (n=22) and collaboratively analysed the results using thematic content analysis.Results: Thematic content analysis highlighted four main areas of needs: (i) material requirements such as accessible and comfortable facilities, accommodation and finance; (ii) information needs about cancer, caring, and nutrition; (iii) emotional support; and (iv) training about how to provide care to their family members during (a) treatment and (b) recovery phases.Conclusions: Carers provide invaluable support in supporting people with a cancer diagnosis, particularly given wider systemic challenges in delivering cancer services in Vietnam. Increasing visibility and formal support is likely to have both a positive impact upon the health and wellbeing of carers, as well as for cancer patients under their care.
The use of the Hungarian Test Your Memory (TYM-HUN), MMSE and ADAS-Cog tests for patients with Mild Cognitive Impairment (MCI) in a Hungarian population: a cross-sectional study
Authors: Garbóczy Szabolcs , Magócs Éva , Szőllősi Gergő , Harsányi Szilvia , Anikó Égerházi , Kolozsvári László 
Published: April 2020

Abstract
BACKGROUND Alzheimer's Disease (AD) is a growing disease process with aging. If we could recognize the disease at an early stage and increase the number of years spent in a better condition through preventive and treatment measures, we could reduce the pressure both directly on families and indirectly on society. There is a need for testing methods that are easy to perform even in general practitioner’s office, inexpensive and non-invasive, which could help early recognition of mental decline. We have selected Test Your Memory (TYM), which has proven to be reliable for detecting AD and mild cognitive impairment (MCI) in several countries. Our study was designed to test the usability of the TYM-HUN comparing with the ADAS-Cog (Alzheimer's Disease Assessment Scale-Cognitive Subscale) in MCI recognition in the Hungarian population.METHODS TYM test was translated and validated into Hungarian (TYM-HUN). The TYM-HUN test was used in conjunction with and compared with the Mini-Mental State Examination (MMSE) and the ADAS-Cog. For our study, 50 subjects were selected, 25 MCI patients and 25 healthy controls. Spearman’s rank correlation was used to analyze the correlation between the scores of MMSE and ADAS-Cog with TYM-HUN.RESULTS MCI can be distinguished from AD and normal aging using ADAS-Cog and MMSE is a useful tool to detect dementia. We established a 'cut-off' point of TYM-HUN (44/45points) where optimal sensitivity and specificity values were obtained to screen MCI. The total TYM-HUN scores significantly correlated with the MMSE scores (ρ=0.626; p<0.001) and ADAS-Cog scores (ρ=-0.723; p<0.001).CONCLUSIONS Our results showed that the Hungarian version of TYM (TYM-HUN) is an easy, fast, self-administered questionnaire with the right low threshold regarding MCI and can be used for the early diagnosis of cognitive impairment.
Implementing the Risk Identification (RI) and Modified Early Obstetric Warning Signs (MEOWS) tool in district hospitals in Rwanda: A cross-sectional study
Authors: Tuyishime Eugene , Ingabire Honorine , Mvukiyehe Jean Paul , Durieux Marcel , Twagirumugabe Theogene 
Published: April 2020

Abstract
Background: Despite reaching Millennium Development Goal (MDG) 3, the maternal mortality rate (MMR) is still high in Rwanda. Most deaths occur after transfer of patients with obstetric complications from district hospitals (DHs) to referral hospitals; timely detection and management may improve these outcomes. The RI and MEOWS tool has been designed to predict morbidity and decrease delay of transfer. Our study aimed: 1) to determine if the use of the RI and MEOWS tool is feasible and acceptable in DHs in Rwanda and 2) to determine the role of the RI and MEOWS tool in predicting morbidity.Methods: A cross-sectional study enrolled parturient admitted to 4 district hospitals during the study period from April to July 2019. Data was collected on compliance rate to RI and MEOWS tool, acceptability, and prediction of morbidity (hemorrhage, infection, and pre-eclampsia).Results: Among 798 parturient enrolled in this study, the mean age was 20.3 years (Sd=6.8), most of them had insurance (95%), the mean of length of stay was 3.1 days (Sd=2.08), and the morbidity rate was 10.3%. The RI and MEOWS tool compliance rate was 76.3 and acceptability rate among 22 respondents was 90.9%. The RI and MEOWS tool had accuracy of 14.29%, P value <0.001, relative risk of 0.277 42 (0.1718-0.4487), sensitivity of 73.68%, specificity of 93.86%, positive predictive value of 11.57%, and negative predictive value of 41.67% .Conclusion: RI and MEOWS tool is a feasible and acceptable in the DHs of Rwanda. In addition, having moderate or high scores on the RI and MEOWS tool predict morbidity. After consideration of local context, this tool can be considered for scale up to other district hospitals in Rwanda or other low resources settings.
Status of and Factors Influencing the Anxiety and Depression of Front-line Medical Staff Supporting Wuhan in Containing COVID-19
Authors: sun ning , LI Laiyou , CHEN Shuangqin , YANG Shuang , LIU Xiufen 
Published: April 2020

Abstract
Background: The novel coronavirus pneumonia (NCP) has the novel coronavirus as its pathogen. At present, more than 30,000 medics from nationwide medical teams have supported Wuhan. However, some medical workers have been seriously infected in Wuhan and other parts of Hubei Province, with over 3,000 medical staff having been confirmed of infection. Therefore, it is necessary to analysis the emotional status of front-line medical staff and their influencing factors in dealing with the NCP so as to provide an objective basis for prevention and intervention measures. Methods: This research aimed to shed light on the relation between the personality characteristics of front-line medical workers and their anxiety and depression, to provide the basis and reference for targeted mental health education and for relevant departments to formulate relevant policies. This study adopted a convenient sampling method and examined the psychological status of 150 front-line medical workers from Zhejiang Province with questionnaire surveys using the Hamilton Anxiety and Depression Scale. Results: The participants had severe anxiety and depression; the top three items under the category of anxiety were genitourinary symptoms, behavior at interview, and respiratory symptoms, whereas the top three items under depression were feelings of guilt, weight loss, and retardation. Among all personal data, the following factors influenced anxiety, in decreasing order: degree of suspicion of being infected when showing associated symptoms, degree of fear of yourself and your family being infected, and the affiliated hospital (P <0.05). The first two factors similarly influenced depression (P <0.05). Conclusion: The front-line medical staff were found to have serious anxiety and depression when dealing with the outbreak of the novel coronavirus pneumonia, and have enormous psychological stress in the face of the growing number of confirmed cases and current absence of special treatment. Targeted mental health promotion work must be carried out to alleviate the psychological pressure of front-line medical staff and enhance their physical and mental health so that they can better contribute to the efforts against the current epidemic.
HPV16-E6 but not E7 inhibits the antitumor activity of LKB1 in lung cancer cells by down regulating the expression of KIF7
Authors: Hu Yue , Wu Ming-Zhe , Gu Na-Jin , Qiu Xue-Shan , Wang En-Hua , Wu Guang-Ping 
Published: April 2020

Abstract
Background: The E6 and E7 proteins in HPV16 are the main oncogenes in the occurrence of lung cancer. In recent studies, we had found that E6 and E7 downregulated the expression of LKB1 in lung cancer cells. However, it is not clear how E6 and E7 regulate LKB1 in lung cancer cells.

Methods: The double directional genetic manipulation and Nuclear plasma separation technology were performed to explore the molecular mechanism of E6 and E7 inhibiting the antitumor activity of LKB1 in well-established lung cancer cell lines.

Results: E6 but not E7 significantly downregulated the expression of tumor suppressor KIF7 at protein level, and the inhibition of KIF7 further reduced the expression of LKB1 both in the nuclei and in the cytoplasm, whereas reduced the expression of p-LKB1 in the cytoplasm only. Therefore, we suggested that HPV16 E6 but not E7 downregulates the antitumor activity of LKB1 by down regulating the expression of p-LKB1 in the cytoplasm only.

Conclusion: We demonstrated for the first time that E6 but not E7 inhibits the antitumor activity of LKB1 in lung cancer cells by down regulating the expression of KIF7. Our findings provided new evidence to support the important role of KIF7 in the pathogenesis of lung cancer and suggested new therapeutic targets.
Microglia exosomes miR-7239-3p promoting Glioma progression by regulating the Circadian genes
Authors: Li Xuepei , Guan Junwen , Jiang Zhou , Cheng Shuting , Hou Wang , Yao Junjie , Wang Zhengrong 
Published: April 2020

Abstract
Background Glioma associated microglial cells (GAMs), as an important component of the tumor microenvironment (TME) play an important role in glioma progression. Materials & Methods Mouse glioma cells line GL261 and mouse microglia cell line BV2 were chosen in this studys. Firstly, Circadian genes expressions in glioma cells among M1 and M2 microglia, were detected, and unpolarized and M2 microglia exosomes were extracted. Subsequently, we labeled exosomes with PKH-67 and treated them with GL261 cells to observe the exosomes distribution. The GL261 cells phenotype and related protein expression were detected to explore the promotion effect of M2 microglial exosomes on gliomas. Then the miR-7239-3p specific inhibitors was added to vertify miR-7239-3p functions. Finally, we used a mouse subcutaneous tumorigenic model to verify the tumorigenic effect of M2 microglial exosomes in vivo. Results In the glioma co-cultured with M2 microglia, the expression of BMAL1 protein was decreased ( p <0.01) and the expression of CLOCK protein was increased ( p <0.05), which is in contrast to the gliomas co-cultured with M1 microglial. After treated by M2 microglia exosomes, the apoptosis of GL261 cells decreased ( p <0.001), and cell viability, proliferation and migration of GL261 cell increased. The expression of N-cadherin and Vimentin increased, and E-cadherin decreased after treated by M2 microglia exosomes. When added miR-7239-3p inhibitors to M2 microglia exosomes the aforementioned results were reversed. Conclusions We found that miR-7239-3p in the glioma microenvironment is recruited to glioma cells by exosomes and inhibited Bmal1 expression. M2 microglial exosomes promote the proliferation and migration of gliomas by regulating tumor-related protein expression and reducing apoptosis.
Pediatric Outpatient Utilization by Differing Medicaid Payment Models in the United States
Authors: Canares Therese , Friedman Ari , Rodean Jonathan , Burns Rebecca R. , Berkowitz Deena , Hall Matt , Alpern Elizabeth , Montalbano Amanda 
Published: April 2020

Abstract
Background In the United States (US), medicaid capitated managed care costs are controlled by optimizing patients’ healthcare utilization. Adults in capitated plans utilize primary care providers (PCP) more than emergency departments (ED), compared to fee-for-service (FFS). Pediatric data are lacking. We aim to determine the association between US capitated and FFS Medicaid payment models and children’s outpatient utilization. Methods This retrospective cohort compared outpatient utilization between two payment models of Medicaid enrollees aged 1-18 years using Truven’s 2014 Marketscan Medicaid database. Children enrolled >11 months were included, and were excluded for eligibility due to disability/complex chronic condition, lack of outpatient utilization, or provider capitation penetration rate <5% or >95%. Negative binomial and logistic regression assessed relationships between payment model and number of visits or odds of utilization, respectively. Results Of 711,008 children, 66,980(9.4%) had FFS and 644,028(90.6%) had capitated plans. Children in capitated plans had greater odds of visits to urgent care, PCP-acute, and PCP-well-child care (aOR 1.21[95%CI 1.15-1.26]; aOR 2.07[95%CI 2.03-2.13]; aOR 1.86 [95%CI 1.82-1.91], respectively), and had lower odds of visits to EDs and specialty care (aOR 0.82 [95%CI 0.8-0.83]; aOR 0.61 [95%CI 0.59-0.62], respectively), compared to FFS. Conclusions The majority of children in this US Medicaid population had capitated plans associated with higher utilization of acute care, but increased proportion of lower-cost sites, such as PCP-acute visits and UC. Policies that improve healthcare coverage of children and programs that encourage capitated payment models with care coordination may improve access to timely acute care in lower-cost settings for non-chronically ill children.