bluuebunny/crossref_metadata_2025_split huggingface dataset:
The burden of unrecognised chronic kidney disease in patients with type 2 diabetes at a county hospital clinic in Kenya: implications to care and need for screening
Authors: Otieno Frederick C. F. , Ogola Elijah N. , Kimando M. W. , Mutai Kenn 
Published: February 2020

Abstract
Background
Chronic Kidney Disease (CKD) in patients with type 2 diabetes enhances the cardiovascular risk profiles and disease, and is a strong predictor of progression to end-stage kidney disease. Early diagnosis is encouraged for referral to specialist kidney care to initiate active management that would optimize outcomes including forestalling progression to end-stage kidney disease.
This study was conducted in a regional referral public health facility in Central Kenya with a high prevalence of type 2 diabetes. It was aimed at finding out the burden of undiagnosed chronic kidney disease in their clinic of ambulatory patients with type 2 diabetes who dwell mainly in the rural area.

Methods
A cross-sectional study was conducted at the out-patient of Nyeri County hospital. A total of 385 patients were enrolled over 5 months. Informed consent was obtained and clinical evaluation was done, a spot sample of urine obtained for albuminuria and venous blood drawn for HbA1c, Lipids and serum creatinine. Estimated GFR (eGFR) was calculated using the Cockroft-Gault equation. Chronic kidney disease (CKD) was classified on KDIGO scale. Albuminuria was reported as either positive or negative. Descriptive statistics for data summary and regression analysis were employed on SPSS v23.

Results
A total of 385 participants were included in the study, 252 (65.5%) were females. There were 39.0% (95%CI 34.3–44.2) patients in CKD/KDIGO stages 3, 4 and 5 and 32.7% (95%CI, 27.8–37.4) had Albuminuria. The risk factors that were significantly associated with chronic kidney disease/KDIGO stages 3, 4 and 5 were: age > 50 years, long duration with diabetes > 5 years and hypertension. Employment and paradoxically, obesity reduced the odds of having CKD, probably as markers of better socio-economic status.

Conclusion
Unrecognized CKD of KDIGO stages 3,4 and 5 occurred in over 30 % of the study patients. The risk factors of hypertension, age above 50, long duration of diabetes should help identify those at high risk of developing CKD, for screening and linkage to care. They are at high risk of progression to end-stage kidney disease and cardiovascular events. The imperative of screening for chronic kidney disease is availing care in publicly-funded hospitals.
Multiple m6A RNA methylation modulators promote the malignant progression of hepatocellular carcinoma and affect its clinical prognosis
Authors: Qu Nanfang , Qin Sanyu , Zhang Xuemei , Bo Xiaotong , Liu Zhengchun , Tan Chao , Wen Guiqiong , Jiang Haixing 
Published: February 2020

Abstract
Background
Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related death in the world. N6-methyladenosine (m6A) RNA methylation is dynamically regulated by m6A RNA methylation modulators (“writer,” “eraser,” and “reader” proteins), which are associated with cancer occurrence and development. The purpose of this study was to explore the relationships between m6A RNA methylation modulators and HCC.

Methods
First, using data from The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) databases, we compared the expression levels of 13 major m6A RNA methylation modulators between HCC and normal tissues. Second, we applied consensus clustering to the expression data on the m6A RNA methylation modulators to divide the HCC tissues into two subgroups (clusters 1 and 2), and we compared the clusters in terms of overall survival (OS), World Health Organization (WHO) stage, and pathological grade. Third, using least absolute shrinkage and selection operator (LASSO) regression, we constructed a risk signature involving the m6A RNA methylation modulators that affected OS in TCGA and ICGC analyses.

Results
We found that the expression levels of 12 major m6A RNA methylation modulators were significantly different between HCC and normal tissues. After dividing the HCC tissues into clusters 1 and 2, we found that cluster 2 had poorer OS, higher WHO stage, and higher pathological grade. Four m6A RNA methylation modulators (YTHDF1, YTHDF2, METTL3, and KIAA1429) affecting OS in the TCGA and ICGC analyses were selected to construct a risk signature, which was significantly associated with WHO stage and was also an independent prognostic marker of OS.

Conclusions
In summary, m6A RNA methylation modulators are key participants in the malignant progression of HCC and have potential value in prognostication and treatment decisions.
Effect of intraocular anti-VEGF on cystoid macular edema associated with Henoch-Schonlein purpura-a case report
Authors: Pan Dongyan , Cui Xiao , Zhu Weiye , Qin Haifeng , Li Qing , Xu Bing , Wu Jin-hui 
Published: February 2020

Abstract
Background
To report a bilateral cystoid macular edema associated with Henoch-Schonleinpurpura.

Case presentation
A 21-year-old man presented a bilateral, painless, and bilateral blurred vision for 5 weeks with visual acuity (VA) of 6/12 on the right eye and 6/48 on the left. FA and OCT showed bilateral cystoid macular edema, and the fundus photograph showed retinal hemorrhages. Using intravenous dexamethasone could reduce macular edema, but it reoccurred shortly after switching to oral prednisone. Repeated intraocular injection of anti-VEGF in both eyes was performed and VA improved to 6/6 on the right eye and 6/7.5 on the left with the regression of edema after 6 months follow-up.

Conclusions
Intraocular anti-VEGF might be an alternative choice to glucocorticoid in cases of bilateral cystoid macular edema associated with Henoch-Schonlein purpura.
Sick-listed workers’ experiences with motivational interviewing in the return to work process: a qualitative interview study
Authors: Foldal Vegard Stolsmo , Standal Martin Inge , Aasdahl Lene , Hagen Roger , Bagøien Gunnhild , Fors Egil Andreas , Johnsen Roar , Solbjør Marit 
Published: February 2020

Abstract
Background
When returning to work after being on long-term sick leave, individuals may experience varying levels of motivation and self-efficacy. Motivational interviewing (MI) is a counseling style that aims to increase motivation towards change, and it may be useful in the return to work (RTW) process. The aim of this study was to explore sick-listed workers’ experiences with MI in the RTW process.

Methods
This qualitative study was part of a randomized controlled trial evaluating the effects of MI on the RTW process, and it was administered by caseworkers at the Norwegian Labor and Welfare Administration. Sixteen sick-listed individuals, aged 33–60, participated in semi-structured interviews. All had a sick leave status of 50–100% for at least 8 weeks when interviewed and all had completed 2 MI sessions. The data was analyzed with systematic text condensation.

Results
Participants’ experiences of the MI sessions were categorized into three themes: (1) relationship with the MI caseworker, (2) normalizing sick leave, and (3) adjusting RTW strategies. The MI sessions were experienced as a positive encounter due to the supportive relationship that was built between the MI caseworker and the sick-listed worker. Being sick listed led to feelings of guilt and stigmatization, but acceptance and support from the MI caseworkers helped normalize the situation for the sick-listed workers. Furthermore, MI sessions allowed for personalized feedback and discussions on adjustments to their RTW strategies.

Conclusion
Sick-listed workers experienced MI as positive due to the good relationship that developed with the MI caseworker, how this normalized sick leave, and the help they received with adjusting their RTW strategies. Professionals working with individuals attempting to RTW may benefit from using MI as a method for helping sick-listed workers to RTW.

Trial registration
ClinicalTrials.gov: NCT03212118 (registered July 11, 2017).
Cassava/peanut intercropping improves soil quality via rhizospheric microbes increased available nitrogen contents
Authors: Tang Xiumei , Zhong Ruichun , Jiang Jing , He Liangqiong , Huang Zhipeng , Shi Guoying , Wu Haining , Liu Jing , Xiong Faqian , Han Zhuqiang , Tang Ronghua , He Longfei 
Published: February 2020

AbstractBackgroundIntercropping, an essential cultivation pattern in modern agricultural systems, increases crop yields and soil quality. Cassava and peanut intercropping systems exhibit advantages in solar utilization and cadmium absorption, etc. However, the inner mechanisms need to be elucidated. In this study, Illumina MiSeq platform was used to reveal the rhizospheric microbes and soil quality in cassava/peanut intercropping systems, and the results provided a reference for the application of this method in studying other intercropping systems.ResultsBoth intercropping cassava/peanut (IP) and intercropping peanut/cassava (IC) systems significantly increased available N, available K, pH value, and urease activity, comparing with that in monocropping cassava (MC) and monocropping peanut (MP) system. However, there were few effects on the total N, total P, total K, available P, organic matter, protease activity, catalase activity, sucrase activity, and acid phosphatase activity. Both IP and MP soils contained more bacteria and fungi than those in the IC and MC soils, which were mainly made of Proteobacteria and Actinobacteria. Intercropping remarkably increased the number of Nitrospirae in IP and IC soils comparing those in MC and MP soils. Redundancy analysis (RDA) revealed that the abundances ofDA101,Pilimelia, andRamlibacterwere positively correlated to the soil quality. These results suggest that intercropping enhances the available nitrogen content of soil through increasing the quantity of rhizospheric microbes, especially that ofDA101andPilimelia.ConclusionsThe cassava/peanut intercropping system improves soil quality through increasing the available nitrogen content and abundance ofDA101,Pilimelia, andRamlibacterin the soil.
Efficacy of Ageratum conyzoides extracts against Giardia duodenalis trophozoites: an experimental study
Authors: Pintong Ai-rada , Ruangsittichai Jiraporn , Ampawong Sumate , Thima Kanthinich , Sriwichai Patchara , Komalamisra Narumon , Popruk Supaluk 
Published: February 2020

Abstract
Background
Giardia duodenalis causes giardiasis in humans, particularly in developing countries. Despite the availability of treatments, resistance to some of the commercial anti-Giardia drugs has been reported in addition to their harmful side effects. Therefore, novel treatments for giardiasis are required. In this study, we aimed to assess the in vitro activity of crude extracts of Ageratum conyzoides against G. duodenalis trophozoites.

Methods
Plants were classified into three groups based on their flower colors: white (W), purple (P), and white–purple (W–P). Plants were separately cut into leaf (L) and flower (F) parts. Changes in internal organelle morphology of trophozoites following exposure to crude extracts were assessed using transmission electron microscopy (TEM). In subsequent experiments, efficacy of the most active essential oils from crude extracts [half maximal inhibitory concentrations (IC50) ≤ 100 μg/mL] against G. duodenalis trophozoites was tested. In vitro anti-Giardia assays using essential oils were performed in the same way as those performed using crude extracts.

Results
LW–P and FP extracts showed high activity (IC50 ≤ 100 μg/mL) against G. duodenalis trophozoites, with IC50 ± SD values of 45.67 ± 0.51 and 96.00 ± 0.46 μg/mL, respectively. In subsequent experiments, IC50 ± SD values of LW–P and FP essential oils were 35.00 ± 0.50 and 89.33 ± 0.41 μg/mL, respectively. TEM revealed the degeneration of flagella and ventral discs of G. duodenalis trophozoites following exposure to crude extracts.

Conclusion
Crude LW–P and FP extracts of A. conyzoides showed the highest activity against G. duodenalis. Exposure to crude extract induced changes in the flagella and ventral discs of G. duodenalis trophozoites, which play important roles in attachment to the surface of mucosal cells. Our results suggest that the tested extracts warrant further research in terms of their efficacy and safety as giardiasis treatment.
The IASP pain curriculum for undergraduate allied health professionals: educators defining competence level using Dublin descriptors
Authors: van Lankveld W. , Afram B. , Staal J. B. , van der Sande R. 
Published: February 2020

Abstract
Background
Improving pain education for undergraduate health professionals is hampered by lacking shared education outcomes. This study describes how educators and pain experts operationalize content and competency levels deemed necessary for a undergraduate pain education core curriculum for health professionals (physical and occupational therapists, nurses, psychologists).

Methods
Educators and experts on pain and pain education gave their opinion on content and competency level for each individual item of the International Association for the Study of Pain (IASP) inter professional curriculum. Participants decided whether or not to include each item in the undergraduate curriculum. Items were included when > 70% of the respondents agreed. The required competency for each item was rated using ordinal Dublin Descriptors.

Results
Overall, 22 experts rated the curriculum, with > 70% agreement on inclusion on 62% of the IASP items. Within the IASP domain ‘Multidimensional nature of pain’ there was full agreement on the inclusion of 12 items. ‘Ethics’ was considered less important with only 1 item deemed necessary. There is a high number of items selected within the domains ‘Pain Assessment and measurement’ (78%) and ‘Management of Pain’ (74%). Considerably less items were chosen in the domain ‘Clinical Conditions’ (41%). For most items the median required skills and competency level was either Knowledge and Understanding, or Applying Knowledge and Understanding.

Conclusion
Overall, educators and experts in pain agreed on content and competency levels for an undergraduate pain curriculum based on the IASP. Defining a shared competency level will help improve definition of education outcome.
A study on users’ preference towards diabetes-related video clips on YouTube
Authors: Zhang Jin , Zheng Zhong , Wang Yanyan , Zhu Yifan 
Published: February 2020

Abstract
Background
Social media has arisen to be a new and important channel for information users for seeking and creating user-generated content. For health consumers, social media has long been regarded and employed as an important source to find health-related information and emotional support. This study investigated the characteristics of diabetes-related videos posted on YouTube, one of the most popular video-based social media platforms, and explored the factors influencing users’ preference towards the investigated videos.

Methods
A mixed research method including coding and negative binomial regression test was applied. Coding was utilized to identify the status of the diabetes-related video clips and the factors related to users’ attitude to them. Negative binomial regression approach was employed to detect significant relationships among the factors and users’ attitude.

Results
The researchers selected eight factors (e.g. number of views, post period, presenters’ gender, and subject) to represent the characteristics of the diabetes-related video clips. Eleven subjects were identified by examining the diabetes-related videos and three subjects, Treatment, Sign & Symptom, and Social & Culture, appeared the most frequently. Media type, presentation setting, post period, presenter role, and presenters’ gender affect the users’ positive attitude significantly. Post period, presenter role, and the Sign & Symptom subject and the Nutrient subject have significant influence on the users’ negative attitude.

Conclusions
Treatment, Sign & Symptom, and Social & Culture are the most popular subjects of the investigated video clips. The users are less likely to show their attitude to old videos. They prefer journalists and patients on videos but dislike male presenters compared with other presenters, and show more negative attitude towards the videos about nutrients. The findings of this study can be used to enhance the content creation of diabetes-related video clips for video contributors, the design and organization of the diabetes-related content for multimedia-based social media Website designers, and the information seeking and communication among health information users.
Cost of inappropriate antimicrobial use for upper respiratory infection in Japan
Authors: Tsuzuki Shinya , Kimura Yuki , Ishikane Masahiro , Kusama Yoshiki , Ohmagari Norio 
Published: February 2020

Abstract
Background
Antibiotics are often prescribed inappropriately to patients with upper respiratory infection (URI) in ambulatory care settings; however, the economic burden of such prescription has not been quantitatively assessed. Here, we aimed to evaluate the additional cost of antimicrobial prescription for URI at the population level in Japan.

Methods
We conducted a retrospective observational survey using longitudinal claims data between 2013 and 2016 obtained from JMDC Claims Database, which contains data from 5·1 million corporate employees and family members under the age of 65 years. Appropriateness of antibiotic prescription was assessed by a panel of six infectious disease physicians according to ICD-10 code in JMDC Claims Database. Total additional cost of antibiotic prescription for URI at the national level was estimated by weighting of age-structured population data.

Results
The annual additional cost of inappropriate antibiotic prescription for URI was estimated at 423·6 (95% CI: 416·8–430·5) million USD in 2013, 340·9 (95% CI: 335·7–346·2) million USD in 2014, 349·9 (95% CI: 344·5–355·3) million USD in 2015, and 297·1 (95% CI: 292·4–301·9) million USD in 2016. Three classes of broad-spectrum oral antibiotics (third-generation cephalosporins, macrolides, and fluoroquinolones) accounted for > 90% of the total additional cost.

Conclusions
Although a decreasing trend was observed, annual additional costs of inappropriate antibiotic prescriptions for URI could be a substantial economic burden in Japan. Appropriately prescribing broad-spectrum oral antibiotics might be an important issue to reduce unnecessary medical costs in Japanese ambulatory care.
Lung CD4+ Vα2.3+ T-cells in sarcoidosis cohorts with Löfgren’s syndrome
Authors: Darlington Pernilla , Kullberg Susanna , Eklund Anders , Grunewald Johan 
Published: February 2020

Abstract
Background
Sarcoidosis is diagnosed by a combination of typical clinical and radiological findings together with biopsy proof of non-caseating epithelioid cell granulomas in affected tissues and/or the cell distribution in bronchoalveolar lavage fluid (BALF). We aimed at investigating the usefulness of measuring the proportion of T-cell receptor (TCR) CD4+ Vα2.3+ T-cells in BALF as an additive marker to CD4/CD8-ratio to confirm the diagnosis.

Methods
From a register consisting of 749 sarcoidosis patients [Löfgren’s syndrome (LS) n = 274, non-LS n = 475] with information on Vα2.3+ T-cells, an expansion of CD4+ Vα2.3+ T-cells (CD4+ Vα2.3+ T cells > 10.5% in BALF) was seen in 268 (36%). Controls were healthy volunteers (n = 69) and patients with other pulmonary conditions (n = 39), investigated because of suspicion of sarcoidosis.

Results
A proportion of CD4+ Vα2.3+ T-cells in BALF > 10.5% was highly specific for sarcoidosis, with a specificity of 97% and with a sensitivity of 36% (p < 0.0001). Receiver operating characteristic (ROC) curves show that testing for CD4+ Vα2.3+ T-cells in BALF was a more useable test in individuals with LS [area under the curve (AUC) 0.82, p < 0.0001] compared to the whole patient group (AUC 0.64, p < 0.0001).

Conclusion
In this study, we show that an increased proportion of CD4+ Vα2.3+ T-cells in BALF is highly specific for sarcoidosis. This suggests that this T-cell subset could be used as an additional tool to the CD4/CD8-ratio to support the sarcoidosis diagnosis, particularly in patients with LS but also in patients with non-LS.
Labral calcification plays a key role in hip pain and symptoms in femoroacetabular impingement
Authors: Trisolino Giovanni , Favero Marta , Dallari Dante , Tassinari Enrico , Traina Francesco , Otero Miguel , Goldring Steven R. , Goldring Mary B. , Carubbi Chiara , Ramonda Roberta , Stilli Stefano , Grigolo Brunella , Olivotto Eleonora 
Published: February 2020

AbstractBackgroundHip osteoarthritis (HOA) is the most common hip disorder and a major cause of disability in the adult population, with an estimated prevalence of end-stage disease and total hip replacement. Thus, the diagnosis, prevention, and treatment of the early stages of the disease in young adults are crucial to reduce the incidence of end-stage HOA.The purpose of this study was to determine whether (1) a relationship among the inflammatory status of labrum and synovium collected from patients with femoroacetabular impingement (FAI) would exist; and (2) to investigate the associations among the histopathological features of joint tissues, the pre-operative symptoms and the post-operative outcomes after arthroscopic surgery.MethodsJoint tissues from 21 patients undergoing hip arthroscopy for FAI were collected and their histological and immunohistochemical features were correlated with clinical parameters.ResultsSynovial mononuclear cell infiltration was observed in 25% of FAI patients, inversely correlated with the hip disability and osteoarthritis outcome score (HOOS) pain and function subscales and with the absolute and relative change in total HOOS. All the labral samples showed some pattern of degeneration and 67% of the samples showed calcium deposits. The total labral score was associated with increased CD68 positive cells in the synovium. The presence of labral calcifications, along with the chondral damage worsened the HOOS post-op symptoms (adjustedR-square = 0.76p= 0.0001).ConclusionsOur study reveals a relationship between the histologic labral features, the synovial inflammation, and the cartilage condition at the time of FAI.The presence of labral calcifications, along with the cartilage damage and the synovitis negatively affects the post-operative outcomes in patients with FAI.