bluuebunny/crossref_metadata_2025_split huggingface dataset:
Different source of sample strains corresponds to different characteristics of patients with non-tuberculous mycobacterium.
Authors: Pan Xinling , Zhao Jin , Jin Xiaoling , Ji Songjun 
Published: July 2020

Abstract
Background: The non-tuberculous mycobacteria (NTM) strains are important in the diagnosis of pulmonary diseases. However, the different source of the sample may correspond to different characteristics of both NTM disease and infected patients and these aspects have not been investigated. Methods: Samples isolated from different sources in inpatients with NTM strains were comprehensively analyzed in this study, including basic information, laboratory examination and coexisting diseases.Results: A total of 242 inpatients with NTM strains were considered in this study. Sputum (n=129) and bronchoalveolar lavage fluid (BALF, n=50) were the most common samples among patients with NTM strains from whom a sample was collected from a single source (n=179). The patients with NTM-positive BALF differed in age, gender, acid fast assay, the percentage of presence of chronic obstructive pulmonary disease (COPD) and bronchiectasis, and symptom duration compared to the patients with NTM-positive sputum. The patients with COPD were older and mainly male, with longer symptom duration, with higher rates of smoking history and prostatic hyperplasia than those without COPD. Patients with bronchiectasis were mainly females, with a lower percentage of them with a tuberculosis history and smoking history compared to patients without bronchiectasis. Excluding the patients with COPD and bronchiectasis, patients with NTM-positive sputum were older, with positive results in acid-fast assay and T. spot assay compared to patients with NTM-positive BALF. Conclusions: The different specimen source in NTM patients was associated with different patients’ characteristics, and its choice could be influenced by presence of COPD and bronchiectasis. Patients with COPD and bronchiectasis differed in gender and smoking history, thus, these aspects should be comprehensively analyzed during the investigation of patients with pulmonary NTM infection.
An Evaluation of Bioenergy Industry Sustainability Impacts on Forest Degradation in The EU 28 Region
Authors: Alsaleh Mohd , Abdul-Rahim A.S. 
Published: July 2020

Abstract
Bioenergy industry is a proven option to replace fossil fuels in the heat supply and partly in the transport sector and generation of electricity. The aim of this study is to investigate the empirical model pertaining whether bioenergy use and institutional quality impact forestry destruction in European Union countries. To achieve this, a selection of 28 European countries covering 1990–2018 was employed. Also, the Pooled OLS, Fixed Effect, Random Effect and Least Square Dummy Variable Corrected approaches were applied to regress the developed model. The findings referred that bioenergy use within institutional framework significantly participated to reduce forest degradation in the European Union countries. In developed countries, institutional quality indicator was negatively pertained to forest degradation. This shows that efficient institutions and governments can add to reducing forest degradation in the developed countries in European Union. The reduction of forest degradation in European Union countries can be achieved by interacting bioenergy use and government effectiveness indicators. Thus, policy makers should (1) stimulate the sustainability criteria of bioenergy application end-uses (2) intensify the quality of institutions, and (3) ensure the bioenergy use under effective governance.
Insights Into The Broad Antibacterial Spectrum Of Bacteriocin Isolated From Probiotic Lactobacillus Fermentum LMEM22 Strain
Authors: Halder Debashis , Mandal Manisha , Pal Nishith Kumar , Mandal Shyamapada 
Published: July 2020

Abstract
This communication aims to validate the probiotic attributes of the Lactobacillus fermentum LMEM22 strain, safety profiling, 16S rRNA gene sequence analysis, and bacteriocin characterization. The bacteriocin of 13.1 kDa (based on the glycine-SDS-PAGE analysis) was isolated from L. fermentum LMEM22 curd strain (NCBI GenBank with accession No. MH380182), the identity for which was confirmed by 16S rRNA gene sequence analysis. The probiotic properties and safety profiles were authenticated in vitro systems. The zone diameter of inhibition from the L. fermentum LMEM22 bacteriocin action, following agar-well diffusion, ranged 19 – 23 mm and 17 – 24 mm, respectively, for gram-negative and gram-positive bacteria. On enzymatic treatment with proteinase K and trypsin the bacteriocin lost the bacterial growth inhibition capacity, and it was found insensitive against α-amylase action, authenticating its proteinaceous nature. The γ-haemolytic L. fermentum LMEM22 strain, for which gelatinase and DNase activities were negative, had tolerance to high sodium chloride concentration range (2 – 6.5%), low pH (2 – 4%), and bile salts (0.125 – 0.5%). This study, thus, authenticated the probiotic attributes of L. fermentum LMEM22 strain for safe consumption by the people, and the usefulness of bacteriocin isolated, as a valued protein antibiotic for the prevention and treatment of multidrug resistant bacterial infection.
Improving surgical patient’s knowledge about safe use of opioids: A Randomized Controlled Trial
Authors: Doherty Helen R , Lam Enoch , Garstka Maria , Chuang Junior , Wong David Tai , Urbach David R , DiRenna Tania , Chung Frances , Wong Jean 
Published: July 2020

Abstract
Background Currently, it is not routine practice to provide standardized patient education for safe postoperative opioid use. The objective of our study was to evaluate the impact of an educational pamphlet for surgical patients on knowledge about safe use, proper storage, and disposal of opioids.Methods This multi-center randomized controlled study recruited 100 patients in the pre-operative clinic. Inclusion criteria were English-speaking, ≥ 18 years, able to give informed consent, and not on opioids for chronic pain or within the past 30 days. All patients completed a baseline knowledge questionnaire (maximum score 38) on opioid safety. Patients were randomized to intervention: educational pamphlet, or control: standard care (no pamphlet) group. Questionnaires were repeated immediately post-education in the intervention group, and at 15, and 30 days after surgery in both groups. The primary outcome was change in knowledge score post-education in the intervention compared to control group. Secondary outcomes were immediate post-education, 15, and 30-day score, and answering safe storage, and disposal questions correctly.Results Between groups, the post-education score immediately after the intervention was higher in the intervention vs. control group baseline 34.2 [95% CI 33.1–35.3] vs 28.3 [95% CI 26.6–29.9]; P < 0.0001). In the intervention vs control group, mean scores were higher 31.6 (95% CI 30.5–32.7) vs 29.1 (95% CI 27.9–30.2; P = .002) at 15 days, and 32.4 (95%CI 31.4–33.5) vs 30.5 (95% CI 29.2–31.7; P = .017) at 30 days. Within the intervention group, the mean score immediately post-education (34.2 [95% confidence interval (CI) 33.1–35.3]) was higher than baseline (27.8 [95% CI 26.3–29.3]); P < 0.0001. Within the intervention group, the difference in mean score versus baseline was 3.8 (95% CI 2.1–5.5) at 15 days, and 4.6 (95% CI 2.9–6.3) at 30 days, (P < 0.05 for all timepoints). For safe disposal, a correct answer was given (intervention vs control group) by 100% vs 89.7% at 30 days (P = 0.04).Conclusions Within the intervention group, there was a significant improvement in knowledge on safe opioid use immediately post-education, and retention of knowledge at 15 and 30 days postoperatively. The intervention group had better knowledge scores compared to the baseline control group, and 15 and 30 days after surgery.Trial Registration: This study was registered in clinicaltrials.gov: NCT03959787 on May 22, 2019.
Developments in asthma incidence and prevalence in Alberta between 1995 and 2015
Authors: Bosonea Ana-Maria , Sharpe Heather , Wang Ting , Bakal Jeffrey A , Befus Dean , Svenson Lawrence W , Vliagoftis Harissios 
Published: July 2020

Abstract
Background: Asthma is a chronic respiratory disease characterized by reversible bronchoconstriction and airway inflammation. According to Statistics Canada in 2014, 8.1% of Canadians aged 12 and older reported having asthma diagnosed by a health care professional. Therefore, in 2014 there were an estimated 274,661 persons with asthma in Alberta. Most epidemiological studies estimate prevalence and incidence using survey-based data, which has limitations. The Ontario Asthma Surveillance Information System (OASIS) group has developed and validated an algorithm for epidemiologic asthma studies using provincial health databases. In Alberta, there are some studies using provincial databases, but most are restricted to Emergency Department visits and do not represent the entire asthma population. Using the validated asthma definition for epidemiologic studies, we performed an analysis of the Alberta Health administrative databases to investigate and report province-wide asthma prevalence, incidence and mortality in Alberta from 1995 to 2015. Methods: Data from administrative databases, provided by Alberta Health, was analyzed to determine age and sex specific prevalence, incidence and mortality of the asthma population. The population cohort was all individuals residing in the province of Alberta, ages 0 to 99 from 1995-2015. Kendall’s Tau coefficient test was used to ascertain whether the observed trends were statistically significant. Results: Between 1995 and 2015, the age-standardized incidence of asthma decreased by more than 50% in both males and females. Prevalence; however, increased 3-fold over the 20 years for both genders from 3.9% to 12.3% (Tau=1.00, p<0.0001) in females and from 3.5% to 11.6% (Tau=1.00, p<0.0001) in males. Thus, in 2015 there were 496,927 people with asthma in Alberta. All-cause mortality in the asthma population decreased over time, in both females (Tau=-0.71, p<0.0001) and males (Tau=-0.69, p=0.0001). For the last several years, all-cause mortality was higher in those with asthma. There were ~7 deaths/1000 in the population with asthma versus ~5 deaths/1000 in those without asthma. Conclusions: The incidence of asthma decreased in both females and males while prevalence continued to increase, but at a slower rate than previously. All-cause mortality in asthma patients was higher than in those without asthma, but both decreased over time.
Impact of a Diagnostic Therapeutic Educational Pathway (DTEP) Self-Management Program for Asthma Management in Preschool Children
Authors: Guarnaccia Sebastiano , Quecchia Cristina , Festa Andrea , Magoni Michele , Zenoni Giuseppe , D'Agata Emanuele , Brivio Valentina , Zanardini Elena , Scarcella Carmelo , Gretter Valeria , Facchetti Susanna , Gasparotti Cinzia , Pluda Ada , Frassine Malica , Limina Rosa Maria , Spiazzi Raffaele , Badolato Raffaele , Bender Bruce , Donato Francesco 
Published: July 2020

Abstract
BACKGROUND: Preschool children with clinically-diagnosed asthma have a higher rate of emergency department visits and consume more resources for management than older children. However, no clinical trials have been performed measuring the impact of a combined diagnostic, therapeutic and educational pathway regimen for evaluation of wheezing control in children aged less than 6 years so far. The purpose of the present study was to assess the impact of a pediatric program developed in Italy, the Diagnostic Therapeutic Educational Pathway (DTEP), for asthma management in children less than 6 years old attending an asthma referral center.METHODS: This is a retrospective population-based cohort study performed in children with asthma aged 0-5 years, attending at “Io e l’Asma center”, Brescia, Italy between September 2007 and December 2014. The incidence rates (IRs) of hospitalization, emergency room visits, use of outpatient services and drug usage for dyspnea, wheezing, or respiratory symptoms were evaluated for time periods prior to and after DTEP intervention.RESULTS: A total of 741 patients, aged 0-5 years completed the DTEP, including 391 and 350 children aged 0-2 and 3-5 years, respectively. The percentage of children aged 0-2 and 3-5 years showing improved control of wheezing symptoms during the 1st to 3rd visit interval as a result of the DTEP intervention increased from 39.5% to 60.9% and from 25.5% to 75.5%, respectively. During these periods, the IRs showed a significant decrease for all outcomes, from-8.6% to -80.4%. Although specific IRs for drug prescriptions declined, particularly for LABA plus corticosteroids, antibiotics, and systemic corticosteroids, they increased for SABA, inhaled corticosteroid and leukotriene receptor antagonist usage.CONCLUSIONS: The results suggest that, an integrated DTEP program for preschool children not only can provide a real-world assessment for improved wheezing control, but also a measure for reduction of adverse therapeutic related outcomes.
Prevalence and predictors of severe metabolic acidosis in chronic kidney disease stage 3-5
Authors: Aledan Hayder , Rasheed Jawad 
Published: July 2020

Abstract
Background and objective Metabolic acidosis is a common metabolic complication of chronic kidney disease with different frequencies across stages of CKD. The objective of the study was to estimate the prevalence and study predictors for development of severe metabolic acidosis in CKD stage 3–5.Methods It was a cross-sectional study of patients aged > 18 years with metabolic acidosis and stage 3–5 CKD for 1 year at two medical centers in Iraq. The prevalence of severe metabolic acidosis and correlation with patients’ characteristics were studied using Fisher exact test for categorical variables and nonparametric independent samples Mann-Whitney U T test. Predictors for severe metabolic acidosis was analyzed using multiple logistic regression.Results Among 117 patients with CKD stage 3–5 and metabolic acidosis, severe metabolic acidosis was reported in 14.5%. It was more frequent in stage 5 CKD compared to stage 4 CKD (64.7% vs 35.3%). Correlation of severe metabolic acidosis was statistically significant with urinary tract obstruction, glomerular diseases, reduced cortical thickness on ultrasonography, anemia, hyperkalemia, hypocalcemia and hyperphosphatemia. By multivariate analysis, female sex, urinary tract obstruction and glomerular diseases were predictors for development of severe metabolic acidosis.Conclusion Severe metabolic acidosis was common in stage 5 CKD. Female sex, urinary tract obstruction and glomerular diseases were predictors for development of severe metabolic acidosis.
In hospital cost assessment and prevalence of Total Hip Arthroplasty in China: A 10-years real-world study
Authors: Yuan Mingcheng , Shakya Hirose , Wang Hao-Yang , Luo Zhenyu , Xiao Ke , Zhou Zong-ke 
Published: July 2020

Abstract
Background: The rising costs of total hip arthroplasty (THA) have resulted in a substantial economic burden to the people of China and Chinese health-care system. The objective of this study was to assess the in-hospital costs associated with primary total hip arthroplasty and efforts to contain these costs by ascertaining factors responsible for the rise in cost.Methods: In-hospital costs of 8111 patients (3878 male and 42337female) who underwent elective primary unilateral hip arthroplasty were extracted from our institution between January 2009 and December 2018 and reviewed. The number of yearly procedures was recorded. All hospital related charges were categorized into 9 groups based on hospital-based supplies and services. The correlation between total in hospital cost and 9 groups were assessed using Pearson’s coefficient. The same method was used for correlating hospital stay and bed charge.Results: The substantial rise in yearly procedure volume was observed. The number of procedures had risen from 306 in 2009 to 1024 in 2018, an incidence increased by more than threefold. The average cost for THAs procedure was ¥53468.03 ± 4833 in 2009 that rose by approximately 10% in 2018 (¥58593.62 ± 4801). The mean cost observed over the study period was ¥62980.21 ± 6314.673. The charges analyzed in all categories expect the hospital bed cost increased during the study period. The joint implant was the most expensive supply item contributing ~ 75% of the total in-hospital cost. Labor cost covered only ~ 10% and bed charge 0.93% of the total charge. The rise in total in-hospital cost strongly correlated with increase in implant cost (Pearson’s correlation (r) = 0.908, α > 0.05). The mean total hospital stays declined from 16.11 ± 8.19 days in 2009 to 6.13 ± 2.65 days in 2018. The mean post-operative stay had also reduced from 9.12 ± 4.88 to a third (3.01 ± 1.80) during the same period. The hospital cost and bed charge also strongly correlated (r = 0.931, α > 0.05)Conclusions: The number of hip arthroplasty procedures performed annually in China is growing rapidly. An incidence rose by threefold over 10-year period in the present study and we predict an unprecedented rise in the incidence in coming years due to an aging population and improving economic conditions in China. The hospital stay was significantly reduced and early discharge within 3 days postoperatively was a noteworthy outcome. Implant cost remained the largest single expense. As a result, some patients who are medical candidates for total joint arthroplasty, may not have access to care due to relatively high financial barrier. Hence it is important to note that significant patient benefits may be realized by efforts to reduce the cost of the prosthesis in China.
MicroRNA-497-5p stimulates osteoblast differentiation through HMGA2-mediated JNK signaling pathway
Authors: Zhao Huiqing , Yang Yexiang , Wang Yang , Feng Xiaolei , Deng Adi , Ou Zhaolan , Chen Biying 
Published: July 2020

Abstract
Background: Osteoporosis (OP) has the characteristics of the decline in bone mineral density and worsening of bone quality, contributing to higher risk of fractures. Some microRNAs (miRNAs) have been validated as possible mediators of osteoblast differentiation. We herein aimed to clarify whether miR-497-5p regulates differentiation of osteoblasts in MC3T3-E1 cells.Methods: The expression of miR-497-5p in OP patients and controls was measured by RT-qPCR, and its expression changes during osteoblast differentiation were determined as well. The effects of miR-497-5p on differentiation of MC3T3-E1 cells were studied using MTT, ALR staining and ARS staining. The target gene of miR-497-5p was predicted by TargetScan, and the effects of its target gene on differentiation and the pathway involved were investigated.Results: miR-497-5p expression expressed poorly in OP patients and its expression was upregulated during MC3T3-E1 cell differentiation. Overexpression of miR-497-5p promoted mineralized nodule formation and the expression of RUNX2 and OCN. miR-497-5p targeted high mobility group AT-Hook 2 (HMGA2), while upregulation of HMGA2 inhibited osteogenesis induced by miR-497-5p mimic. miR-497-5p significantly impaired the c-Jun NH2-terminal kinase (JNK) pathway, whereas HMGA2 activated this pathway. Activation of the JNK pathway inhibited the stimulative role of miR-497-5p mimic in osteogenesis.Conclusions: miR-497-5p inhibits development of OP by hampering osteogenesis via targeting HMGA2. We hence conclude that targeting miR-497-5p might be an attractive therapeutic option for OP.
Isolation and characterization of the polyhexamethylene biguanide hydrochloride-resistant fungus, Purpureocillium lilacinum
Authors: Yamamoto Takako , Takahashi Hiroki , Alimu Yikelamu , Kusuya Yoko , Hosoya Kouichi , Shigemune Naofumi , Nagai Satoshi , Yaguchi Takashi 
Published: July 2020

Abstract
Polyhexamethylene biguanide hydrochloride (PHMB), an antimicrobial agent, has been widely used as a disinfectant in medical industries and public facilities. However, long-term use of any antimicrobial agent increases the risk of the microorganisms developing resistance. We aimed to examine the presence of microorganisms highly resistant to PHMB to address potential medical safety and public health concerns and devise strategies to prevent resistance development. We isolated and characterized a fungus from a 20% aqueous solution of PHMB and compared its microbiological characteristics and resistance profile with those of other major antimicrobial agents. Additionally, we sequenced the genome of the isolate to predict PHMB resistance-related genes. Based on the internal transcribed spacer (ITS) region of ribosomal DNA, the fungus was identified as Purpureocillium lilacinum. Although the P. lilacinum type and resistant strains showed similar morphology, the latter had extremely low PHMB susceptibility and was able to grow in the 20% aqueous solution of PHMB, which killed the type strain. Additionally, the minimum inhibitory concentration (MIC) of PHMB against the resistant strain was approximately four times higher than that against the type strain. In contrast, the MICs of four other antimicrobial agents and seven antifungal agents against the resistant strain were either less than or equal to those against the type strain. Furthermore, MICs of PHMB against four pathogenic filamentous fungi and two yeasts were significantly lower than those against the resistant strain. Despite its specific high resistance to PHMB, no gene homologous to fungal PHMB-resistant gene was found in the genome of the resistant strain. In summary, P. lilacinum was found to be significantly more resistant to PHMB than previously reported, suggesting an unidentified novel mechanism underlying drug resistance in the fungi.
DGCR5 is activated by PAX5 and promotes pancreatic cancer via targeting miR-3163/TOP2A and activating Wnt/β-catenin pathway
Authors: Liu Shilei , Wu Xiang-song , Cai Chen , Yang Zi-yi , Li Feng-nan , Yao Wen-yan , Wu Zi-you , Dong Ping , Wang Xue-feng , Gong Wei 
Published: July 2020

Abstract
Background Long noncoding RNA DiGeorge syndrome critical region gene 5 (DGCR5) has been shown to be highly associated with cancer development. However, the biological role and molecular mechanism of DGCR5 in pancreatic cancer (PC) remains largely unknown.Methods qRT-PCR and fluorescence in situ hybridization (FISH) was performed to investigate the correlation between DGCR5 expression and prognosis and clinicopathologic characteristics of PC patients. The effects of DGCR5 on PC were studied by gain-of-function and loss-of-function experiments in vitro and in vivo. RNA sequencing, bioinformatics analyses, dual-luciferase assays, chromatin immunoprecipitation (ChIP) assay and rescue experiments provided insights into the underlying competing endogenous RNA (ceRNA) mechanism network of DGCR5 in promoting PC progression.Results DGCR5 was highly expressed in PC tissues compared with adjacent normal tissues and its high expression was associated with poor prognosis in PC patients. Furthermore, DGCR5 depletion inhibited the proliferation, migration and invasion by increasing apoptosis and inducing G0/G1 cell cycle arrest in vitro. Moreover, xenograft assay validated that DGCR5 promotes PC tumor growth in vivo. Mechanistically, DGCR5 was found to act as a ceRNA by sponging miR-3163 to regulate TOP2A and inhibit Wnt/β-catenin pathway. In addition, we found that DGCR5 downregulation could enhance the sensitivity of PC cells to gemcitabine, and ChIP assay showed that the transcription factor PAX5 could bind to the DGCR5 promoter and increase its transcription.Conclusions Our study demonstrates that DGCR5 is activated by PAX5 and promotes PC progression by sponging miR-3163 to regulate TOP2A and activating wnt/β-catenin pathway, suggesting that DGCR5 may be a potential diagnostic biomarker and therapeutic target for PC.