bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical audit in the Pediatric primary care office setting: a tool for improvement of overweight prevention in preschool age.
Authors: Limauro Raffaele , Gallo Patrizia , Cioffi Luigi , Antignani Angelo , Cioffi Valentina , Calella Patrizia , Valerio Giuliana 
Published: December 2019

Abstract
Background: Clinical audit is a process by which physicians or other health care professionals perform a regular and systematic review of their clinical practice and amend it, when necessary. An internal audit allows to review the activities carried out by professionals, in order to assess the appropriateness, effectiveness, efficiency and safety of the services provided. Aim of this study was to apply the process of clinical audit to the obesity/overweight care in young children. After the correction of the nutritional errors that were considered potentially responsible for the excess weight gain, the effect of the changes of dietary advices on the frequency of overweight/obesity was assessed in a cohort of children aged 24-36 months. Methods: Three Italian primary care pediatricians have applied the audit strategy by recognizing the high prevalence of overweight and obesity in the entire cohort of children born in 2005, 2006 and 2007 (Pre-Audit group, age 24-36 months old) under their care. By reviewing their clinical practice, they changed the protocol of weaning and feeding up to 36 months, mainly reducing the protein intake. The change involved the cohorts of children born in the years 2010, 2011 and 2012 (Post-Audit group). Results: Changes in children’s diet yielded a reduction of the frequency of overweight and obesity between 24 and 36 months of life in the Post-Audit group. Conclusion: Clinical audit can be an effective tool in identifying inaccuracies in medical procedures and helpful in revising them.
Risky Sexual Behavior and Associated Factors Among Sexually-Active Unmarried Young Female Internal Migrants Working in Burayu Town, Ethiopia
Authors: Baru Ararso , Adeoye Ikeola A. , Adekunle Adeyemi O. 
Published: December 2019

Abstract
Background Young female internal migrants are highly vulnerable to risky sexual behaviors (RSB) which may result in serious health problems such as unintended pregnancy, abortion and sexually transmitted infections including HIV. RSB include early sexual debut (before 18 years), having multiple sexual partners, sex without condom or inconsistent use of condom and sex under influence of substance use. This study aimed to assess the magnitude and the factors associated with RSB among sexually-active unmarried young female internal migrants in Burayu Town, Ethiopia.Methods A cross sectional study design was used for the study. A total of 267 respondents were recruited in to the study using simple random sampling technique. A semi-structured interviewer administered questionnaire was used to obtain information from the study participants. The collected data were cleaned, coded and entered into Epi data version 3.1 and then exported to SPSS Ver.21 for analysis. Multiple logistic regression models were used to indicate the association between dependent and independent variables.Results About 35% of the young female internal migrants had sexual debut before age of 18 years; 64.4% had sex without condom or inconsistently used condom; nearly one quarter of the participants had multiple sexual partners and 29.6% had sex under influence of substance uses. The magnitude of RSB among the study participants was (79.1%). Sexting [AOR 3.47(95%; CI;1.10-11.94)], frequent indulgence of social media [AOR 10.9(95%;CI;2.31-51.89)], feeling of embarrassment to buy condom [AOR 8.28(95%; CI; 2.10-32.62)], unfavorable attitude toward using condom for steady and loving relationship [AOR 5.72(95%; CI; 1.47-22.24)] were related with RSB while self-efficacy [AOR 0.15(95%: CI; 0.04-0.57)] to use condom and perceived risks of getting pregnant [AOR 0.05(95%; CI; 0.01-0.23)] were found to be protective factors.Conclusion The study found high levels of RSB among sexually-active unmarried young female internal migrants. This finding suggests an urgent need of intervention to promote safe sex among this group. Special attention and prompt interventions are needed to promote the use of condom. Moreover, intense efforts should be made to improve awareness on the seriousness of exposure to sexting and judicious use of social media among unmarried female internal migrants.
Factors influencing malaria infection in Rwanda 2010: a cross-sectional survey study using generalized structural equation modeling
Authors: Bakar Muhammad Abu , Fiaz Rahma , Musenge Eustasius 
Published: December 2019

Abstract
BackgroundMalaria is one of the primary public health concerns in the world and an important cause of morbidity and mortality in sub-Saharan Africa. Malaria morbidity is associated with poverty and vulnerability as it is not easy for the poor people to access preventive treatment and protective measures. In Rwanda, malaria prevention has become a major problem against the double-barreled burden of an overstretched health system and strained financial resources.MethodsThis work was a cross-sectional survey study design based on data from Rwanda collected in 2010 through the Malaria Indicator Survey as part of the Demographic and Health Survey. The primary outcome variable was an ordinal variable with three categories; no malaria, probable malaria, and confirmed malaria cases. The outcome variable was formulated by combining rapid malaria test and confirmatory blood smear laboratory test. Statistical analysis was done using survey ordinal logistic regression modelling adjusting for random effects for direct effects and generalised structural equation modelling (G-SEM) to obtain total (direct and indirect) effects of malaria morbidity. ResultsThe 11,865 participants had a mean age of 22 years, and two-thirds of the participants were females (67%). Household related variables (socio-economic status, health insurance, age in years) showed a significant total effect on malaria infection. Socioeconomic status had the greatest total effect which was a sum of the direct and indirect effects influenced indirectly by education, health insurance and the number of rooms for sleeping. Conclusion Poverty is still the core issue to the morbidity patterns driving the malaria epidemic in Rwanda. Access to health insurance has a high positive impact on decreasing disease as such a special focus on some regions can be an effective intervention strategy. A better understanding of the drivers of morbidity directly and/or indirectly can better target interventions to be more efficient in those affected areas.
Development and outcomes of a comprehensive multidisciplinary incidental lung nodule and lung cancer screening program
Authors: LeMense Gregory , Waller Ernest A. , Campbell Cheryl , Bowen Tyler 
Published: December 2019

Abstract
BackgroundAppropriate management of lung nodules detected incidentally or through lung cancer screening can increase the rate of early-stage diagnoses and potentially improve treatment outcomes. However, the implementation and management of comprehensive lung nodule programs is challenging. MethodsA single-center, retrospective study was conducted to describe the development and outcomes of a lung nodule program at a community practice in Tennessee.ResultsThe number of patients with lung nodules referred to the program increased over 2 years, with 665 patients in Year 1 and 745 patients in Year 2. Most nodules were incidental (60% Year 1, 65% Year 2). In Year 1, 17% of nodules were symptomatic and 12% were identified through screening. Of the 665 nodules in Year 1, 182 underwent a diagnostic intervention and 121 (18%) received a cancer diagnosis. Most diagnostic interventions were image-guided bronchoscopy (88%) or percutaneous biopsy (9%). The proportion of Stage I-II cancer diagnoses increased from 23% prior to program implementation to 36% in Year 1 and 38% in Year 2. Among screening cases, follow-up scans were conducted within 18 months in 71%. Only 2% of patients under watchful waiting required a diagnostic intervention, of which 1% received a cancer diagnosis.ConclusionsThe current study reports outcomes over the first two years of a lung cancer screening and incidental nodule program. The program was successful and manageable, given the appropriate level of data management and oversight. Comprehensive lung nodule programs have the potential to benefit the patient, physician, and hospital system.
Prognosis of patients with acute exacerbation of combined pulmonary fibrosis and emphysema: A retrospective single-center study
Authors: Ikuyama Yuichi , Ushiki Atsuhito , Kosaka Makoto , Akahane Jumpei , Mukai Yuichi , Araki Taisuke , Kitaguchi Yoshiaki , Tateishi Kazunari , Urushihata Kazuhisa , Yasuo Masanori , Yamamoto Hiroshi , Hanaoka Masayuki 
Published: December 2019

Abstract
BackgroundPrevious analyses of combined pulmonary fibrosis and emphysema (CPFE) cohorts have provided conflicting data on the survival of patients with CPFE. Therefore, the aim of this study was to investigate the clinical prognosis of acute exacerbation (AE) of CPFE.MethodsWe retrospectively reviewed the medical records of patients who had been treated at Shinshu University Hospital (Matsumoto, Japan) between 2003 and 2017. We identified 21 patients with AE of CPFE and 41 patients with AE of idiopathic pulmonary fibrosis (IPF) and estimated their prognoses using the Kaplan–Meier method.ResultsTreatment content and respiratory management were not significantly different between the two groups before and after exacerbation. At the time of AE, the median serum Krebs von den Lungen-6 level was significantly lower in the CPFE group (Krebs von den Lungen-6: 966 U/µL; white blood cell count: 8810 /µL) than that in the IPF group (Krebs von den Lungen-6: 2130 U/µL, p < 0.001; white blood cells: 10809/µL, p = 0.0096). The baseline Gender-Age-Physiology score was not significantly different between the two groups (CPFE, 4.5 points; IPF, 4.7 points; p = 0.58). Kaplan–Meier curves revealed that the survival time after AE for patients with CPFE was longer than that for patients with IPF (p < 0.001, log-rank test).ConclusionsSurvival prognoses after AE were significantly better for patients with CPFE than that for patients with IPF. Our findings may improve the medical treatment and respiratory management of patients with AE-CPFE.
Lipase immobilized on functionalized superparamagnetic few-layer graphene oxide as an efficient nanobiocatalyst for biodiesel production from chlorella vulgarise bio-oil
Authors: Nematian Tahereh , Shakeri Alireza , Salehi Zeinab , Saboury Ali Aakbar 
Published: December 2019

Abstract
Background Microalgae, due to its well-recognized advantages have been gained renewed interest as potentially good feedstock for biodiesel. Production of fatty acid methyl esters (FAMEs) as a type of biodiesel was carried out from Chlorella vulgaris bio oil. Biodiesel was produced in the presence of nano-biocatalysts composed of immobilized lipase on functionalized superparamagnetic few-layer graphene oxide via a transesterification reaction. A hybrid of few-layer graphene oxide and Fe3O4 (MGO) was prepared and characterized. The MGO was functionalized with 3-aminopropyl triethoxysilane (MGO-AP) as well as with a couple of AP and glutaraldehyde (MGO-AP-GA). The Rhizopus oryzae lipase (ROL) was immobilized on MGO and MGO-AP using electrostatic interactions as well as on MGO-AP-GA using covalent bonding. The supports, MGO, MGO-AP, and MGO-AP-GA, as well as Nano-biocatalyst, ROL/MGO, ROL/MGO-AP, and ROL/MGO-AP-GA, were characterized using FESEM, VSM, FTIR, and XRD. The few-layer graphene oxide was characterized using AFM and the surface charge of supports was evaluated with the zeta potential technique. The nano-biocatalysts assay was performed with an evaluation of kinetic parameters, loading capacity, relative activity, time-course thermal stability, and storage stability. Biodiesel production was carried out in the presence of nano-biocatalysts and their reusability was evaluated in 5 cycles of transesterification reaction. Results: The AFM analysis confirmed the few-layer structure of graphene oxide and VSM also confirmed that all supports were superparamagnetic. The maximum loading of ROL (70.2%) was related to MGO-AP-GA. The highest biodiesel conversion of 71.19% achieved in the presence of ROL/MGO-AP-GA. Furthermore, this nano-biocatalyst could maintain 58.77% of its catalytic performance after 5 cycles of the transesterification reaction and was the best catalyst in the case of reusability. Conclusions: In this study, the synthesized nano-biocatalyst based on bare and functionalized magnetic graphene oxide was applied and optimized in the process of converting microalgae bio-oil to biodiesel for the first time and compared with bare lipase immobilized on magnetic nanoparticles. Results showed that the loading capacity, kinetic parameters, thermal stability, and storage stability improved by the functionalization of MGO. The biocatalysts, which were prepared via covalent bonding immobilization of enzyme generally, showed better characteristics. Keywords Few-layer graphene oxide; Biodiesel; Chlorella vulgaris; Bio-oil; Superparamagnetic; Nano-biocatalyst.
New insights from the biogas microbiome by comprehensive genome-resolved metagenomics of nearly 1600 species originating from multiple anaerobic digesters
Authors: Campanaro Stefano , Treu Laura , Rodriguez-Rojas Luis M , Kovalovszki Adam , Ziels Ryan M , Maus Irena , Zhu Xinyu , Kougias Panagiotis G. , Basile Arianna , Luo Gang , Schlüter Andreas , Konstantinidis Konstantinos T. , Angelidaki Irini 
Published: December 2019

Abstract
Background
Microorganisms in biogas reactors are essential for degradation of organic matter and methane production. However, a comprehensive genome-centric comparison, including relevant metadata for each sample, is still needed to identify the globally distributed biogas community members and serve as a reliable repository.
Results
Here, 134 publicly available metagenomes derived from different biogas reactors were used to recover 1,635 metagenome-assembled genomes (MAGs) representing different biogas bacterial and archaeal species. All genomes were estimated to be >50% complete and nearly half ≥90% complete with ≤5% contamination. In most samples, specialized microbial communities were established, while only a few taxa were widespread among the different reactor systems. Metabolic reconstruction of the MAGs enabled the prediction of functional traits related to biomass degradation and methane production from waste biomass. An extensive evaluation of the replication index provided an estimation of the growth rate for microbes involved in different steps of the food chain. The recovery of many MAGs belonging to Candidate Phyla Radiation and other underexplored taxa suggests their specific involvement in the anaerobic degradation of organic matter.
Conclusions
The outcome of this study highlights a high flexibility of the biogas microbiome, allowing it to modify its composition and to adapt to the environmental conditions, including temperatures and a wide range of substrates. Our findings enhance our mechanistic understanding of the AD microbiome and substantially extend the existing repository of genomes. The established database represents a relevant resource for future studies related to this engineered ecosystem.
Keywords
Anaerobic digestion, Metagenome-Assembled Genomes, Biogas, Microbial community structure, Functional reconstruction
Transcriptome analysis of the regulation of natamycin biosynthesis in Streptomyces natalensis HW-2 by fungal elicitor
Authors: Wang Dahong , Shen Wenhao , Yuan Jiangfeng , Wei Lanlan , Zhang Ying 
Published: December 2019

Abstract
Background

Natamycin is a polyene macrolide polyketide antibiotics and used in 150 countries as a natural food preservative. Streptomyces natalensis is an important producer. Elicitation had been approved to be an effective method to improve the biosynthesis of secondary metabolites. Fungal elicitor from Penicillium chrysogenum AS 3.5163 showed inductive effect on the biosynthesis of natamycin in S. natalensis HW-2 fermentation. However, regarding the global gene expression of natamycin in response to fungal elicitor is not still reported.

Results

RNA-Seq analysis showed that there were 1265 differential expression genes (DEGs) at 40 h and 2196 DEGs at 80 h. The fungal elicitor had stronger effects on the transcription level of S. natalensis HW-2 at 80 h than that at 40 h. Gene Ontology (GO) enrichment analysis of DEGs showed significant enrichment in biological processes. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that the fungal elicitor mainly affected the expression levels of some genes about cellular process, metabolism and genetic information, especially in pentose phosphate pathway (PPP), glycolytic pathway (EMP) and tricarboxylic acid cycle (TCA). KEGG pathway showed that fungal elicitor had a greater influence on the metabolism of branched-chain amino acids (BCAAs). Among them, 23 DEGs associated with BCAAs metabolism were up-regulated or down-regulated. The supplementation experiment with BCAAs confirmed that 0.2 g/L of L-Ile and 0.5 g/L of L-Val increased natamycin yield by 17.6% and 37.8%, respectively. Fungal elicitor also up-regulated the transcriptional levels of most of the enzymes associated with the biosynthesis of natamycin and two important transcription regulators ( pimR and pimM ). To confirm the accuracy of RNA-Seq, the results of qPCR showed that these gene expression levels were in agreement with the transcription changes by RNA-Seq.

Conclusion

In this study, the change of transcriptional levels in S. natalensis HW-2 under treated with the fungal elicitor was firstly reported. The major finding of our comparative transcriptome analysis is that the fungal elicitor improves the supply of precursor, and alters the expression of natamycin related genes and regulator of secondary metabolism. From our results, we conclude that regulatory alterations are important factors for the enhancement of natamycin.
TB-diabetes comorbidity and associated factors in Maekel Zone, Eritrea: A cross sectional study.
Authors: Araia Zenawi Zeramariam , Mebrahtu Amanuel Hadgu , Tewelde Adiam Ghebreyohanns , Mesfun Araia Berhane , Saleh Randa Osma , Tuumzghi Hagos Andom 
Published: December 2019

Abstract
Background : In Eritrea, no study document the true burden of TB-diabetes comorbidity. However, diabetes has been constantly increasing with a prevalence of 3.4 %. Similarly, even though TB notification is showing a declining trend the prevalence is 123/100,000 population. With an increasing diabetes trend, the country is at higher risk of rising TB-diabetes comorbidity which can further complicate TB care, control and prevention activities. Thus, this study was conducted to assess the prevalence of diabetes among pulmonary positive TB patients and its influencing factors in Maekel zone, Eritrea. Methods: This study was a cross sectional study conducted in all (11) TB diagnostic and treatment sites of Maekel zone. All consecutive pulmonary positive TB cases who were registered during the period of 2015-2018 in the national TB treatment register and were eligible included in the analysis. Pretested data extraction tool was used to collect the required information. Data analysis was done by SPSS version 23. Simple frequencies, percentages and means were used to describe the data. Chi-square test and logistic regression analysis was also performed. Results: A total of 490 pulmonary positive TB cases were eligible for the study and the overall prevalence of diabetes among pulmonary positive TB cases was 4.3%. Univariate logistic regression showed that participants with an older age (45-90) were more likely to have TB-diabetes comorbidity (COR: 4.397[CI: 1.675-11.545], p<0.01) than those aged 10-44 years old. In addition, subjects whose weight was 65kg and above were more likely (COR: 7.647[CI: 1.965-29.758], p<0.01) to have TB- diabetes comorbidity than those with lower body weight. Conclusion: TB-diabetes comorbidity observed in this study is low but given the growing diabetes trend in the country, an integrated TB-DM services should be given regularly on full scale at all health facilities.
High sustained viral response among HCV genotype 3 patients with advanced liver fibrosis – real-world data of HCV elimination program in Georgia
Authors: Butsashvili Maia , Gvinjilia Lia , Kamkamidze George , Metreveli David , Dvali Shorena , Rukhadze Tamar , Gamkrelidze Amiran , Nasrullah Muazzam , Shadaker Shaun , Morgan Juliette , Averhoff Francisco 
Published: December 2019

Abstract
Background: In 2015, Georgia launched world’s first HCV elimination program. Initially, patients with advanced liver disease were prioritized to receive sofosbuvir-based treatment regimen, as it was the only DAA available for all genotypes. Purpose of the study was to assess real-world data of treatment outcome among patients with HCV GEN3 and advanced liver fibrosis with sofosbuvir-based regimens. Methods: GEN3 patients enrolled in the program, received sofosbuvir-based regimens, and had outcome data from April 28 through September 30, 2016 were eligible for the study. Demographic and clinical data were analyzed. Results: A total of 1525 genotype 3 patients were eligible for analysis; most (72.6%) were aged >45 years, majority were males (95.1%), and all (100%) had advanced liver disease (F3 or F4 by METAVIR score based on elastography). Of those who received sofosbuvir/ribavirin (SOF/RBV) for 24 weeks, 449/566 (79.3%) achieved SVR, while 925/959 (96.5%) who received sofosbuvir/pegylated interferon/ribavirin (SOF/PEG/RBV) for 12 weeks achieved SVR (p<.01). Among patients with liver cirrhosis (defined as F4) overall cure rate was 85.7% as opposed to 96.4% for those with F3. Females were more likely to be cured (98.7% vs 89.7%; OR=8.54, 95%CI:1.18-61.87). Patients aged 31-45 years had higher likelihood of achieving SVR compared to patients aged 46-60 years (95.7% vs 87.4%; OR=0.32, 95%CI:0.19-0.53). Independent predictors of SVR were treatment with SOF/PEG/RBV (aOR=6.72, 95%CI:4.49-10.06) and lower fibrosis stage (F3) (aOR=4.18, 95%CI:2.64-6.61). Conclusions: Real-world experience among HCV GEN3 patients with advanced liver fibrosis and treated by sofosbuvir regimen w/o PEGIFN, demonstrated overall high SVR rate.
Mycoplasma genitalium in Singapore is Associated with Chlamydia trachomatis Infection and Displays High Macrolide and Fluoroquinolone Resistance Rates
Authors: Hart Tim , Tang Wen Ying , Mansoor Siti Aminah , Chio Martin Tze-Wei , Barkham Timothy Sebastian 
Published: December 2019

Abstract
Mycoplasma gentialium is considered to be an emerging sexually transmitted infection, with increasing rates of resistance to fluroquinolones and macrolides, the most recommended treatment. Despite this, M. genitalium is not part of routine screening for Sexually Transmitted Infections (STIs) in many countries. We report the results of a study into M. genitalium prevalence at the national sexual health clinic in Singapore. M. genitalium was heavily associated with C. trachomatis (CT) infection (8.1% of cases), but not independently with N. gonorrhoea (NG) infection and present in only of 2.4% in CT negative cases. Furthermore, we found high rates of resistance mutations to both macrolides (25%) and fluoroquinolones (37.5%) with the majority of resistant isolates dual-resistant. Resistance mutations were only found in isolates from patients with CT co-infection. Screening CT positive patients for M. genitalium infection, followed by appropriate extended treatment, could be a cost-effective strategy to reduce the incidence of M. genitalium and reduce levels of antibiotic resistance.