bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of an integrated multidisciplinary geriatric rehabilitation programme for older stroke patients: a process evaluation
Authors: Vluggen Tom , Haastregt Jolanda van , Verbunt Jeanine , Heugten Caroline van , Schols Jos 
Published: May 2020

Abstract
Background: Almost half of the stroke patients admitted to geriatric rehabilitation has persisting problems after discharge. Currently, there is no evidence based geriatric rehabilitation programme available for older stroke patients, combining inpatient rehabilitation with adequate aftercare aimed at reducing the impact of persisting problems after discharge from a geriatric rehabilitation unit. Therefore, we developed an integrated multidisciplinary rehabilitation programme consisting of inpatient neurorehabilitation treatment using goal attainment scaling, home based self-management training, and group based stroke education for patients and informal caregivers. We performed a process evaluation to assess to what extent this programme was performed according to protocol. Furthermore, we assessed the participation of the patients in the programme, and the opinion of patients, informal caregivers and care professionals on the programme.Methods: In this multimethod study, process data were collected by means of interviews, questionnaires, and registration forms among 97 older stroke patients, 89 informal caregivers, and 103 care professionals involved in the programme.Results: A part of patients and informal caregivers did not receive all key elements of the programme. Almost all patients formulated rehabilitation goals, but among two thirds of the patients the goal attainment scaling method was used. Furthermore, the self-management training was considered rather complex and difficult to apply for frail elderly persons with stroke, and the percentage of therapy sessions performed in the patients’ home environment was lower than planned. In addition, about a quarter of the patients and informal caregivers attended the education sessions. However, a majority of patients, informal caregivers and care professionals indicated the beneficial aspects of the programme.Conclusion: This study revealed that although the programme in general is perceived to be beneficial by patients, and informal and formal caregivers, the feasibility of the programme needs further attention. Because of persisting cognitive deficits and specific care needs in our frail and multimorbid target population, some widely used methods such as goal attainment scaling, and self-management training seemed not feasible in their current form. To optimize feasibility of the programme, it is recommended to tailor these elements more optimally to the population of frail older patients. Trial registration: International Standard Randomized Controlled Trial Register Number (ISRCTN62286281), and The Dutch Trial Register (NTR2412).
Identification of blast resistance QTLs based on two ad vanced backcross populations in rice
Authors: Jiang Haichao , Feng Yutao , Qiu Lei , Gao Guanjun , Zhang Qinglu , He Yuqing 
Published: May 2020

Abstract
Background: Rice blast is an economically important and mutable disease of rice. Using host resistance gene to breed resistant varieties has been proven to be the most effective and economical method to control rice blast and new resistance genes or quantitative trait loci (QTLs) are then needed.Results: In this study, we constructed two advanced backcross population to mapping blast resistance QTLs. CR071 and QingGuAi3 were as the donor parent to establish two BC3F1 and derived BC3F2 backcross population in the Jin23B background. By challenging the two populations with natural infection in 2011 and 2012, 16 and 13 blast resistance QTLs were identified in Jin23B/CR071 and Jin23B/QingGuAi3 population, respectively. Among Jin23B/CR071 population, 3 major and 13 minor QTLs have explained the phenotypic variation from 3.50% to 34.08% in two years. And, among Jin23B/QingGuAi3 population, 2 major and 11 minor QTLs have explained the phenotypic variation from 2.42% to 28.95% in two years.Conclusions: Sixteen and thirteen blast resistance QTLs were identified in Jin23B/CR071 and Jin23B/QingGuAi3 population, respectively. QTL effect analyses suggested that major and minor QTLs interaction is the genetic basis for durable blast resistance in rice variety CR071 and QingGuAi3.
Anopheles gambiae (s.l.) exhibit high intensity pyrethroid resistance throughout Southern and Central Mali (2016–2018): PBO or next generation LLINs may provide greater control
Authors: Sovi Arthur , Keita Chitan , Sinaba Youssouf , Dicko Abdourhamane , Traore Ibrahim , Cisse Moussa BM , Koita Ousmane , Dengela Dereje , Flatley Cecilia , Bankineza Elie , Mihigo Jules , Belemvire Allison , Carlson Jenny , Fornadel Christen , Oxborough Richard Martin 
Published: May 2020

Abstract
Background: Millions of pyrethroid LLINs have been distributed in Mali during the past 20 years which, along with agricultural use, has increased the selection pressure on malaria vector populations. This study investigated pyrethroid resistance intensity and susceptible status of malaria vectors to alternative insecticides to guide choice of insecticides for LLINs and IRS for effective control of malaria vectors. Methods: For 3 years between 2016 and 2018, susceptibility testing was conducted annually in 14–16 sites covering southern and central Mali. Anopheles gambiae (s.l.) were collected from larval sites and adult mosquitoes exposed in WHO tube tests to diagnostic doses of bendiocarb (0.1%) and pirimiphos-methyl (0.25%). Resistance intensity tests were conducted using CDC bottle bioassays (2016–2017) and WHO tube tests (2018) at 1×, 2×, 5×, and 10× the diagnostic concentration of permethrin, deltamethrin and alpha-cypermethrin. WHO tube tests were conducted with pre-exposure to the synergist PBO followed by permethrin or deltamethrin. Chlorfenapyr was tested in CDC bottle bioassays at 100 µg active ingredient per bottle and clothianidin at 2% in WHO tube tests. PCR was performed to identify species within the An. gambiae complex. Results: In all sites An. gambiae (s.l.) showed high intensity resistance to permethrin and deltamethrin in CDC bottle bioassay tests in 2016 and 2017. In 2018, the WHO intensity tests resulted in survivors at all sites for permethrin, deltamethrin and alpha-cypermethrin when tested at 10× the diagnostic dose. Across all sites mean mortality was 33.7% with permethrin (0.75%) compared with 71.8% when pre-exposed to PBO (4%), representing a 2.13-fold increase in mortality. A similar trend was recorded for deltamethrin. There was susceptibility to pirimiphos-methyl, chlorfenapyr and clothianidin in all surveyed sites, including current IRS sites in Mopti Region. An. coluzzii was the primary species in 4 of 6 regions. Conclusions: Widespread high intensity pyrethroid resistance was recorded during 2016–2018 and is likely to compromise the effectiveness of pyrethroid LLINs in Mali. PBO or chlrofenapyr LLINs should provide improved control of An. gambiae (s.l.). Clothianidin and pirimiphos-methyl insecticides are currently being used for IRS as part of a rotation strategy based on susceptibility being confirmed in this study.
Factors affecting perioperative serum albumin variation and short term complications in pediatric patients undergoing major gastroenterology surgery
Authors: Liu Qingshuang , Gao Kai , Sun Xiaomin , Guo Chunbao 
Published: May 2020

Abstract
Background: Albumin is considered a negative acute-phase protein because its concentration decreases during injury and sepsis. The decrease in serum albumin might be important for perioperative morbidity, even in patients with normal preoperative levels in pediatric population. We here intend to determine the perioperative factors associated with the reduction in serum albumin within 2 postoperative days compared with the preoperative level (∆ALB) and its influence on the perioperative outcome in a pediatric general surgical cohort. Methods: This single-center retrospective review included 939 patients who underwent Roux-en-Y hepaticojejunostomy between August 2010 and Aug 2019. Based on the mean valure of ∆ALB (14.6%), patients were separated into two groups, including a high ∆ALB group (≥14.6%) and a low ∆ALB group (<14.6%). Multivariable logistic regression analyses were performed to determine the independent risk factors for the reduction in serum albumin. Propensity score matching was performed to adjust for any potential selection bios for the two groups. In 366 matched patients, influences of operating time on perioperative outcomes, including postoperative recovery, complications measurement, and length of hospital stay between the two groups were analyzed. Results: For all 996 patients reviewed, 939 patient records were enrolled into the final analysis. Controlling for other factors, multivariate analysis showed that the high CRP on POD 3 or 4 (odds ratio[OR] =2.36 [95% CI, 1.51-3.86]; p =0.007), presence of Charcot's triad (OR=1.73[95% CI, 1.05-2.83]; p = 0.031), the longer operating time (OR=1.18[95% CI, 1.00 -1.53]; p=0.014) were factors that predicted the high ∆ALB level. The high ∆ALB level was associated with postoperative gastrointestinal functional recovery, reflected by the first defecation (p= 0.013) and first bowel movement (p=0.019) and the high occurrence of postoperative complications (16.1% vs 10.9%, OR, 1.57; 95 %CI, 1.02-2.41, P=0.0026). The mean length of postoperative stay was longer than that of patients with ∆ALB < 14.0% group, although no statistic significant was stained (p=0.057). Conclusions: We showed that change in albumins was associated with postoperative outcomes. The risk factors for ∆ALB could be intervened in the perioperative period to permit patients gain a safe recovery and discharge after major abdominal operations.
In vitro synergistic potentials of novel antibacterial combination therapies against Salmonella enterica serovar Typhimurium
Authors: Hossain Md. Akil , Park Hae-Chul , Lee Kwang-jick , Park Sung-Won , Park Seung-Chun , Kang JeongWoo 
Published: May 2020

Abstract
Background: The antibiotics generally used in farm animals are rapidly losing their effectiveness all over the world as bacteria develop antibiotic resistance. Like some other pathogenic bacteria multidrug-resistant strains of Salmonella enterica serovar Typhimurium (S. Typhimurium) are also frequently found in animals and humans which poses a major public health concern. New strategies are needed to block the development of resistance and to prolong the life of traditional antibiotics. Thus, this study aimed to increase the efficacy of existing antibiotics against S. Typhimurium by combining them with opportunistic phenolic compounds gallic acid (GA), epicatechin, epicatechin gallate, epigallocatechin and hamamelitannin. Fractional inhibitory concentration indexes (FICI) of phenolic compound-antibiotic combinations against S. Typhimurium were determined. Based on the FICI and clinical importance, 1 combination (GA and ceftiofur) was selected for evaluating its effects on the virulence factors of this bacterium. Viability of Rattus norvegicus (IEC-6) cell in presence of this antibacterial combination was evaluated.Results: Minimum inhibitory concentrations (MICs) of GA, epigallocatechin and hamamelitannin found against different strains of S. Typhimurium were 256, (512–1024), and (512–1024) μg/mL, respectively. Synergistic antibacterial effect was obtained from the combination of erythromycin-epicatechin gallate (FICI: 0.50) against S. Typhimurium. Moreover, additive effects (FICI: 0.502–0.750) were obtained from 16 combinations against this bacterium. The time-kill assay and ultrastructural morphology showed that GA-ceftiofur combination more efficiently inhibited the growth of S. Typhimurium compared to individual antimicrobials. Biofilm viability, and swimming and swarming motilities of S. Typhimurium in presence of GA-ceftiofur combination were more competently inhibited than individual antimicrobials. Viabilities of IEC-6 cells were more significantly enhanced by GA-ceftiofur combinations than these antibacterials alone.Conclusions: This study suggests that GA-ceftiofur combination can be potential medication to treat S. Typhimurium-associated diarrhea and prevent S. Typhimurium-associated blood-stream infections (e.g.: fever) in farm animals, and ultimately its transmission from animal to human. Further in vivo study to confirm these effects and safety profiles in farm animal should be undertaken for establishing these combinations as medications.
Temporal and spatial trends of ischemic heart disease burden in Chinese and subgroup populations from 1990 to 2016 : data from the 2016 global burden of disease study
Authors: Wang Chenran , Wang Chunping , Liu Mi , Chen Zhe , Liu Shiwei 
Published: May 2020

Abstract
Background: Ischemic heart disease (IHD) is the leading cause of premature death which poses public health challenges worldwide. This study was to analyze how the IHD burden among Chinese and subgroup populations changes in response to temporal and spatial trends from 1990–2016. Methods : Based on data from the updated estimates in the 2016 Global Burden of Disease (GBD) study, we used years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs) to describe the IHD burden. The percentage changes were applied to illustrate temporal and spatial variations of the IHD burden stratified by age, sex, and province, over the periods 1990–2016, 1990–2005, and 2005–2016. We estimate population-attributable fraction (PAF) for 24 modifiable risk factors at the provincial level. Results: YLD rates, YLL rates, and DALY rates for IHD underwent a notable increase among all age groups and increased by 119.4%, 83.3%, and 84.5% nationally from 1990–2016. In YLD rates, an evident rise was seen in females compared to males, while males experienced a more substantial increase than that in females in YLL rates and DALY rates from 1990–2016. Compared with 1990–2005, annual average changes in overall population in YLL rates and DALY rates showed a tardier increase whereas an opposite increasing trend of YLD rates was observed between 2005 and 2016. Geographically, all provinces saw declines in the YLLs/YLDs ratio from 2005–2016, with seventeen of thirty-three provinces showing an upward trend between 1990 and 2005. Most provinces witnessed a remarkable upsurge in the age-standardised DALY rate from 1990–2016 whereas the economically advantaged region Macao saw the most marked reduction. High systolic blood pressure and high LDL cholesterol remained the two leading risk factors of IHD in all provinces in 2016. Diet high in sodium was the leading behavioral risks in twenty-eight provinces with smoking heading the list in five provinces. Conclusions: Substantial disparities in temporal and spatial trends of the IHD burden emphasize concerns for elderly men and those in economically disadvantaged regions with resource constraints. Regional differences in the IHD burden can be partly explained by modifiable risk factors.
Management of intraoperative acetabular fracture in primary total hip arthroplasty
Authors: Li Juncheng , Ji Quanbo , Ni Ming , Zheng Qingyuan , Sun Jinyang , zhang guoqiang 
Published: May 2020

Abstract
Background: Intraoperative acetabular fracture（IAF）is a rare complication of primary total hip arthroplasty（THA）. The previous reports have lacked a sufficiently large number of subjects to allow for an analysis of the causes and appropriate treatment of this problem.Methods: Between 2015 to 2018, 4,888 primary THA were enrolled. We retrospectively reviewed the records in our Total Joint Registry Database and found that 24 patients (24 hips) had sustained intraoperative acetabular fractures. Twenty-four patients（16 females and 8males）were all treated with a posterolateral approach using uncemented components. Twenty patients（83.3%）underwent supplemental screw fixation, of which 2 patients were treated with steel plate fixation. Two patients’ femoral heads were used as a graft. In 4 patients（16.7%）, the acetabular components were judged to be stable despite the fracture and no additional treatment was performed. All patients were evaluated clinically with Harris Hip Scores (HHS) and radiographically with serial X-rays which follow up for a mean period of 34.0±12.6 months. We evaluated the anatomic locations, causes, treatments, and outcome of the fractures to study the treatment method and effect of intraoperative acetabular fracture during operation. Results: The fracture rate associated with uncemented components was 0.49%. In 17(70.8%) of these patients, the fracture was noted during the impaction of the real acetabular component. Six patients（25%）with Ankylosing Spondylitis had fractures, 4 in the anterior wall, and 1 in the anterior column, because the patient with hip joint fusion needs a to pre-osteotomy before the dislocation. The HHS score increased from 30.8±9.7 preoperatively to 90.2±4.2 postoperatively. All the latest x-ray showed that the fracture did not move, and there is no translucent line formed in the acetabular cup bone interface.Conclusion: Intraoperative acetabular fractures are rare complications of THA, and most commonly occur during the implantation of the acetabular components. It is necessary to prevent the occurrence of fractures as much as possible even if the fractures are found during the operation. It should be noted that patients with ankylosing spondylitis involving hip joints during THA surgery must be careful to prevent IAFs during dislocation and pre-osteotomy.
Long non-coding RNA FAM83H-AS1 acts as an oncogenic driver in human ovarian cancer
Authors: Yuan Xiaolei , Huang Ying , Guo Man , Hu Xiaowei , Li Peiling 
Published: May 2020

Abstract
Background Ovarian cancer (OC) is one of the most aggressive women cancers with increasing incidence and mortality rates worldwide. Long non-coding RNAs (lncRNAs) could as major players in OC process. Although FAM83H antisense RNA1 (FAM83H-AS1) is demonstrated play an important roles in a many cancers, the detailed function and mechanism has not been reported in OC. Methods We integrated multiple kinds of bioinformatics approaches and experiments validated method to evaluate functions of FAM83H-AS1 in OC. Results Some differential expressed lncRNAs were identified between OC and normal control tissues. FAM83H-AS1 was one of most differentially expressed lncRNAs and up-regulated in multiple cancer types. Specially, expression of FAM83H-AS1 was higher in OC and showed difference in diverse stages. High FAM83H-AS1 expression is associated with worse pan-cancer and OC outcomes. FAM83H-AS1-centric network including lncRNA-miRNA, lncRNA-protein and lncRNA-mRNA ceRNA network were constructed to infer the function and mechanism of FAM83H-AS1. There were two methylation sites including cg01399317 and cg20519035 located at FAM83H-AS1. The methylation level of cg01399317 was correlated with gene expression of FAM83H-AS1. The expression level of FAM83H-AS1 was correlated with infiltration level of immune cell including macrophage, neutrphil and dendritic cell in OC patients. Lastly, qRT-PCR showed that the expression of FAM83H-AS1 was higher in OC tissues than normal control tissues. Conclusions Collectively, these results indicated that FAM83H-AS1 may act as an oncogenic driver and it may be a potential therapy target in OC.
Moral Courage and Psychological Empowerment among Nurses
Authors: Khoshmehr Zahra , Barkhordari-Sharifabad Maasoumeh , Nasiriani Khadijeh , Fallahzadeh Hossein 
Published: May 2020

Abstract
Background: Moral courage is one of the fundamental values of nursing profession and a powerful method of coping with ethical problems. Psychological empowerment is a suitable method of enabling individuals to cope mental pressures of the work environment. This study determined the correlation between moral courage and psychological empowerment of nurses.Methods: This was a descriptive cross-sectional study. A total of 180 nurses employed in different wards were selected randomly. Data were collected by Demographics Questionnaire, Sekerka’s Moral Courage Scale, and Spreitzer’s psychological empowerment Scale and analyzed with SPSS16 using descriptive and inferential statistics. Findings: The results indicated that the mean score of moral courage was 21.11±69.90 and the greatest amount of moral courage was in the dimension of “going beyond compliance”. The mean score of “psychological empowerment” was 30.9±73.58 and the greatest mean belonged to “competence”. There was a positive significant correlation between “psychological empowerment” and “moral courage and its dimensions” (P<0.05). Conclusion: The findings suggested a correlation between moral courage and psychological empowerment. Thus, nurses’ moral courage could be enhanced by reinforcing their psychological empowerment leading to increased patient satisfaction and quality care.
Measuring delay in high-risk obstetric referrals in Accra, Ghana: How long does it really take?
Authors: Owen Medge D. , Batakji Mariam , Goodman David M. , Kim Sung Min , Olufolabi Adeyemi J , Srofen Emmanuel K 
Published: May 2020

Abstract
Background

In Ghana, inefficient referral systems for managing obstetric emergencies is an obstacle to receiving optimal care. The timeliness of referral for comprehensive emergency obstetric care (CEmOC) from district or sub-district facilities to referral hospitals is unknown. The Greater Accra Regional Hospital (GARH) conducts approximately 8,000 deliveries per year that includes 70% high-risk referrals. Our aim was to characterize referrals for obstetric patients seeking care at the GARH in Accra, Ghana.
Methods

Data was collected on obstetric patients referred to the GARH from September 1 to November 30, 2017. A descriptive analysis was conducted on the following variables: location of referring facility, time from referral to arrival at GARH, mode of transport, referring diagnosis and members accompanying the patient. Data are presented as number, percent or median (IQR).
Results

Data were collected for 652 obstetric patient referrals to the GARH from 123 surrounding facilities. Transportation modes included: taxi (76.4%), ambulance (8.1%), private car (8.0%), public van (5.5%) and unknown (2.0%). Of 652 referrals, 303 (46.5%) were received during labour. The median time (IQR) from referral to arrival at GARH for 280 labouring patients was 307 (170, 1778) minutes. Midwives accompanied patients in only 71 (10.9%) of referrals; however, in these, median (IQR) referral times were 73 (34, 268) minutes. The leading referral indications included: Arrest of labour (26.3%), prior uterine scar (11.6%) and hypertensive disorders of pregnancy (11.5%). There were seven (1%) maternal deaths; four died the day of arrival. For 110 (17%) pregnancies, prolonged hospitalization was required for complications. There were 32 stillbirths (5%), including six intrapartum deaths.
Conclusions

The obstetric referral process for CEmOC is suboptimal. Most intrapartum referrals relied on public transport to reach the CEmOC facility and were unaccompanied by healthcare personnel. There is significant delay in the referral process, even in an urban setting. Delay may contribute to poor maternal and newborn outcomes.