bluuebunny/crossref_metadata_2025_split huggingface dataset:
A complex intervention for multimorbidity in primary care: A feasibility study
Authors: Birke Hanne , Jacobsen Ramune , Jønsson Alexandra BR , Guassora Ann Dorrit Kristiane , Walther Marie , Saxild Thomas , Laursen Jannie T , Vall-Lamora Maria Helena Dominquez , Frølich Anne 
Published: July 2020

Aim:To assess the feasibility of a patient-centered complex intervention for multimorbidity (CIM) based on general practice in collaboration with community health-care centers and outpatient clinics.Methods:Inclusion criteria were age ≥18 years, diagnoses of two or more of three chronic conditions (diabetes, chronic obstructive pulmonary disease (COPD), and chronic heart conditions), and a hospital contact during the previous year. The CIM included extended consultations and nurse care manager support in general practice and intensified cross-sectorial collaboration. Elements included a structured care plan based on patients’ care goals, coordination of services, and, if appropriate, shifting outpatient clinic visits to general practice, medication review, referral to rehabilitation, and home care. The acceptability dimension of feasibility was assessed with validated questionnaires, observations, and focus groups.Results:Forty-eight patients were included (mean age 72.2 (standard deviation (SD) 9.5, range 52–89); 23 (48%) were men. Thirty-seven patients had two diseases; most commonly COPD and cardiovascular disease (46%), followed by diabetes and cardiovascular disease (23%), and COPD and diabetes (15%). Eleven (23%) patients had all three conditions. Focus group interviews with patients with multimorbidity identified three main themes: (1) lack of care coordination existed across health-care sectors before the CIM, (2) extended consultations provided better care coordination, and (3) patients want to be involved in planning their treatment and care. In focus groups, health-care professionals discussed two main themes: (1) patient-centered care and (2) culture and organizational change. Completion rates for questionnaires were 98% (47/48).Conclusions:Patients and health-care professionals found the CIM acceptable.
How do emerging market SMEs utilize resources in the face of environmental uncertainty?
Authors: Temouri Yama , Shen Kathy , Pereira Vijay , Xie Xuanli 
Published: July 2020

Using the resource-based view of the firm, this article examines how different resources are used by small- and medium-sized enterprises (SMEs) in response to environmental uncertainty in an emerging market context. A survey was conducted involving 212 owners, CEOs, or managing directors of SMEs in the United Arab Emirates (UAE) to explore the drivers of firm growth strategies. Our empirical results show that higher environmental uncertainty, in terms of market and regulatory uncertainty, drives SMEs to pursue a more exploratory instead of an exploitative growth strategy. Our results also show that SMEs pursuing more of an exploratory growth strategy focus predominantly on intangible resources such as human capital and social capital while firms pursuing more of an exploitative growth strategy focus more on financial resources. The results from our study provide valuable insights for how managers can structure, bundle, and leverage different resources for developing their strategies based on their level of perceived environmental uncertainty. The policy implications from our study are that support for SMEs should be multi-faceted depending on the combination of uncertainty faced and type of strategy chosen by SMEs. JEL CLASSIFICATION: M10; M19; M13
Transverse testicular ectopia with Müllerian duct remnant in an incarcerated congenital inguinal hernia – a case report
Authors: Kotb Mostafa , Hassan Ahmed , Abouheba Mohamed 
Published: July 2020

AbstractBackgroundTransverse testicular ectopia (TTE) is a rare anomaly characterized by both testes descending through a single inguinal canal. In this report, the diagnosis of TTE was discovered in the event of an incarcerated congenital inguinal hernia in a neonate.Case presentationWe present a case of TTE accompanied by persistent Müllerian duct structures (PMDS) that had been discovered incidentally during inguinal exploration of a 26-day-old boy who presented with an incarcerated congenital inguinal hernia on the right side and left cryptochidism on the left side. The pathogenesis, approach and proposed management of TTE are discussed.ConclusionTTE is an extremely rare anomaly, especially in neonates, and should be suspected in patients presenting with inguinal hernia on one side and cryptorchidism on the other side.
Why do hospital prescribers continue antibiotics when it is safe to stop? Results of a choice experiment survey
Authors: Roope Laurence S. J. , Buchanan James , Morrell Liz , Pouwels Koen B. , Sivyer Katy , Mowbray Fiona , Abel Lucy , Cross Elizabeth L. A. , Yardley Lucy , Peto Tim , Walker A. Sarah , Llewelyn Martin J. , Wordsworth Sarah 
Published: July 2020

Abstract
Background
Deciding whether to discontinue antibiotics at early review is a cornerstone of hospital antimicrobial stewardship practice worldwide. In England, this approach is described in government guidance (‘Start Smart then Focus’). However, < 10% of hospital antibiotic prescriptions are discontinued at review, despite evidence that 20–30% could be discontinued safely. We aimed to quantify the relative importance of factors influencing prescriber decision-making at review.

Methods
We conducted an online choice experiment, a survey method to elicit preferences. Acute/general hospital prescribers in England were asked if they would continue or discontinue antibiotic treatment in 15 hypothetical scenarios. Scenarios were described according to six attributes, including patients’ presenting symptoms and whether discontinuation would conflict with local prescribing guidelines. Respondents’ choices were analysed using conditional logistic regression.

Results
One hundred respondents completed the survey. Respondents were more likely to continue antibiotics when discontinuation would ‘strongly conflict’ with local guidelines (average marginal effect (AME) on the probability of continuing + 0.194 (p < 0.001)), when presenting symptoms more clearly indicated antibiotics (AME of urinary tract infection symptoms + 0.173 (p < 0.001) versus unclear symptoms) and when patients had severe frailty/comorbidities (AME = + 0.101 (p < 0.001)). Respondents were less likely to continue antibiotics when under no external pressure to continue (AME = − 0.101 (p < 0.001)). Decisions were also influenced by the risks to patient health of continuing/discontinuing antibiotic treatment.

Conclusions
Guidelines that conflict with antibiotic discontinuation (e.g. pre-specify fixed durations) may discourage safe discontinuation at review. In contrast, guidelines conditional on patient factors/treatment response could help hospital prescribers discontinue antibiotics if diagnostic information suggesting they are no longer needed is available.
Age related differences in phylogenetic diversity, prevalence of Shiga toxins, Intimin, Hemolysin genes and select serogroups of Escherichia. coli from pastured meat goats detected in a longitudinal cohort study
Authors: Ndegwa Eunice , Alahmde Aber , Kim Chyer , Kaseloo Paul , O’Brien Dahlia 
Published: July 2020

Abstract
Background
Little is known on significance, diversity and characteristics of gut E. coli in goats despite their importance as food animals globally. We characterized the temporal dynamics in diversity of E. coli in fecal samples from a cohort of goat kids and adult meat goats on pasture over a one-year period. Isolates were characterized based on phylogenetic grouping, virulence genes; shiga toxins 1 and 2 (Stx1&Stx2) (STEC), intimin (eaeA), hemolysin (hly) and select important sero-groups (026, 045, 0103, 0126 and 0146) using molecular methods.

Results
A total of 516 E. coli isolates were screened. Prevalence of virulence genes and STEC was 65 and 56% respectively. Prevalence of virulence genes and STEC was significantly higher in goat kids less than six months (76% /66%) than adults (48% /28%). Isolates with virulence profiles of two or more genes were also higher in young goat kids (50%) than adults (20%). Entero-pathogenic E. coli (EPEC-eaeA gene only) were mostly from pre-weaned goat kids while hly gene only isolates were significantly higher in adults. The stx1, stx2 and hly genes peaked around weaning (60, 63 and 52%) respectively. Goats kids were mostly hosts to group D (59%) while adults older than one year had B1 (75%) isolates. Group D isolates were most abundant at weaning (64%) and diarrhea samples (74%). Group B2 isolates overall (6%) were mostly detected around weaning (63%) while A isolates were 4% overall. Twenty-four isolates belonged to sero-groups 026, 0103 and 0146 with 70% of the isolates detected around weaning. Nineteen of these isolates were STEC with most harboring the stx1/stx2/hly/eae (25%) profile. Most belonged to O26 sero-group (75%) and phylogroup D (75%).

Conclusion
To our knowledge this is the first study to highlight longitudinal age related differences in E. coli phylogenetic diversity, abundance of virulence genes and select important sero-groups in goats. Differences detected suggest a possible role of age and weaning stress in influencing E. coli diversity in the gut of goats. The findings are relevant to both animal and public health to advise on further studies on caprine E. coli isolates as animal and human pathogens.
Association of genotype III of dengue virus serotype 3 with disease outbreak in Eastern Sudan, 2019
Authors: Eldigail Mawahib H. , Abubaker Hazem A. , Khalid Fatima A. , Abdallah Tajeldin M. , Musa Hassan H. , Ahmed Mohamed E. , Adam Gamal K. , Elbashir Mustafa I. , Aradaib Imadeldin E. 
Published: July 2020

Abstract
Background
Dengue fever (DF) is an arthropod-borne disease caused by dengue virus (DENV). DENV is a member of the genus Flavivirus in the family Flaviviridae. Recently, DENV has been reported as an important emerging infectious viral pathogen in Sudan. Multiple outbreaks and sporadic cases of DF have been frequently reported in the eastern region of Sudan. The present study was conducted to confirm DENV outbreak in Kassala State, eastern Sudan, 2019, and to provide some information on the molecular characterization of the DENV isolate associated with the disease outbreak.

Methods
A hundred serum samples were collected during the outbreak from residents of Kassala State, Sudan, 2019. ELISA was used to detect DENV non structural protein NS1 (DENV-NS1) in acute phase sera sampled during the disease outbreak. RT-PCR assays were used to amplify a fragment of the capsid/pre-membrane region (CprM) of the viral polyprotein gene. The PCR products of the amplified CprM region of the viral polyprotein gene were purified and partial sequences were generated and used to confirm the specificity of DENV sequences and to identify the virus serotype. Phylogenetic tree was constructed to determine the genotype of DENV associated with the outbreak.

Results
Using DENV-NS1 ELISA assay, DENV infection was confirmed in 23% sampled sera. The detection of DENV RNA was made possible using group-specific RT-PCR assay. The virus was serotyped as DENV serotype 3 (DENV-3) using DENV serotype-specific RT-PCR assay. Phylogenetic analysis of the partial CprM sequences of the viral polyprotein gene indicates that the virus belonged to genotype III of DENV-3.

Conclusion
The scientific data presented in this investigation confirmed that genotype III of DENV-3 was associated with the disease outbreak in eastern Sudan, 2019. The study represents the first report on molecular characterization of DENV-3 in Sudan.
Pseudoscientific beliefs and psychopathological risks increase after COVID-19 social quarantine
Authors: Escolà-Gascón Álex , Marín Francesc-Xavier , Rusiñol Jordi , Gallifa Josep 
Published: July 2020

Abstract
Background
The health crisis caused by COVID-19 has led many countries to opt for social quarantine of the population. During this quarantine, communication systems have been characterized by disintermediation, the acceleration of digitization and an infodemic (excess and saturation of information). The following debate arises: Do the levels related to the psychotic phenotype and pseudoscientific beliefs related to the interpretation of information vary before and after social quarantine?

Objectives
This research aims to examine the psychological effects of social quarantine on the psychotic phenotype and pseudoscientific beliefs-experiences of the general nonclinical population. The following hypothesis was posed: social quarantine alters the levels of magical thinking, pseudoscientific beliefs and anomalous perceptions due to quarantine.

Methods
A pre- and posttest analysis design was applied based on the difference in means, and complementary Bayesian estimation was performed. A total of 174 Spanish subjects responded to different questionnaires that evaluated psychopathological risks based on psychotic phenotypes, pseudoscientific beliefs and experiences before and after quarantine.

Results
Significant differences were obtained for the variables positive psychotic symptoms, depressive symptoms, and certain perceptual alterations (e.g., cenesthetic perceptions), and a significant increase in pseudoscientific beliefs was also observed. The perceptual disturbances that increased the most after quarantine were those related to derealization and depersonalization. However, paranoid perceptions showed the highest increase, doubling the initial standard deviation. These high increases could be related to the delimitation of physical space during social quarantine and distrust towards information communicated by the government to the population. Is it possible that social alarmism generated by the excess of information and pseudoscientific information has increased paranoid perceptual alterations?

Conclusions
Measures taken after quarantine indicate that perceptual disturbances, subclinical psychotic symptoms and beliefs in the pseudoscience have increased. We discuss which elements of quarantine coincide with the social marginality theory and its clinical repercussions.
Detecting the colonization of ericoid mycorrhizal fungi in Vaccinium uliginosum using in situ polymerase chain reaction and green fluorescent protein
Authors: Yang Hongyi , Zhao Xingyu , Li Lili , Zhang Jie 
Published: July 2020

Abstract
Background
Ericoid mycorrhizal fungi (EMF) play important roles in mineral cycling and plant nutrient acquisition, and they increase plant survival in nutrient-poor environments. In this study, we detected the colonization of EMF using a green fluorescent protein (GFP) expression method and in situ PCR.

Results
Genetic transformants of Cryptosporiopsis ericae and Sordariomycetes sp. expressing GFP were obtained via Agrobacterium tumefaciens-mediated transformation. GFP transformants were able to infect Vaccinium uliginosum, and their fluorescence was visible in the hair roots. Both in situ PCR and the GFP-expressing method indicated that EMF could colonize the hair roots of V. uliginosum 2 weeks after inoculation.

Conclusions
This research represents the first attempt to detect ericoid mycorrhizal colonization using in situ PCR. A GFP-expressing method is an excellent system for detecting the colonization of EMF, but it is dependent on the successful transformation and expression of the gfp gene. In situ PCR and the GFP expression may be developed as new tools to study the interactions of EMF both with ericaceous plants and with the environment.
Deep learning-based detection of seedling development
Authors: Samiei Salma , Rasti Pejman , Ly Vu Joseph , Buitink Julia , Rousseau David 
Published: July 2020

Abstract
Background
Monitoring the timing of seedling emergence and early development via high-throughput phenotyping with computer vision is a challenging topic of high interest in plant science. While most studies focus on the measurements of leaf area index or detection of specific events such as emergence, little attention has been put on the identification of kinetics of events of early seedling development on a seed to seed basis.

Result
Imaging systems screened the whole seedling growth process from the top view. Precise annotation of emergence out of the soil, cotyledon opening, and appearance of first leaf was conducted. This annotated data set served to train deep neural networks. Various strategies to incorporate in neural networks, the prior knowledge of the order of the developmental stages were investigated. Best results were obtained with a deep neural network followed with a long short term memory cell, which achieves more than 90% accuracy of correct detection.

Conclusion
This work provides a full pipeline of image processing and machine learning to classify three stages of plant growth plus soil on the different accessions of two species of red clover and alfalfa but which could easily be extended to other crops and other stages of development.
Skin testing with bendamustine: what concentration should be used?
Authors: Malinauskiene Laura , Cerniauskas Kestutis , Linauskiene Kotryna , Griguola Linas , Chomiciene Anzelika , Blaziene Audra 
Published: July 2020

AbstractWe present a case of the patient, who developed hypersensitivity reaction during the treatment of chronic lymphocytic leukemia. Bendamustine was suspected as a culprit agent. The patient as well as 3 controls underwent skin testing with the concentrations of the bendamustine described in earlier studies. We doubted the testing recommendations as all the controls developed serious local reactions. The clinical meaning of the positive skin test reaction in the patient remained unclear and questioned the safeness of recommended testing concentrations as in certain situations wrong diagnosis could be made or even harm could be done. Future investigations are needed when allergy to bendamustine is suspected.
Nrf2 promotes esophageal squamous cell carcinoma (ESCC) resistance to radiotherapy through the CaMKIIα-associated activation of autophagy
Authors: Xia Di , Zhang Xiao-Ran , Ma Yan-Li , Zhao Zhi-Jun , Zhao Ren , Wang Yan-Yang 
Published: July 2020

Abstract
Background
NF-E2-related factor 2 (Nrf2) is involved in the radiation resistance of esophageal squamous cell carcinoma (ESCC), but the underlying molecular mechanism is unclear. The purpose of our study was to explore the role of Nrf2 in the radiation resistance of ESCC and the potential molecular mechanism.

Results
Nrf2 expression was introduced into Ec109 and KYSE-30 ESCC cells with lentivirus. CCK-8 and colony formation assays were used to evaluate the effect of Nrf2 on radioresistance in culture. The autophagy level was assessed by western blotting, flow cytometry, and confocal fluorescence microscopy. The effect of Nrf2 on the transcription of Ca2 +/calmodulin-dependent protein kinase II α (CaMKIIα) was studied by chromatin immunoprecipitation. We found that the overexpression of Nrf2 increased the radiation resistance of ESCC cells. Mechanistically, Nrf2 triggered the radiation resistance of ESCC cells by targeting CaMKIIα and subsequently activating autophagy. In addition, we found that Nrf2 directly regulated the transcription of CaMKIIα by binding to its promoter region. The effect of Nrf2 on radiation resistance was also explored in both a xenograft mouse model and ESCC patient samples. Consistent with the results of the in vitro study, high Nrf2 expression level resulted in in vivo radioresistance in an Ec109-derived xenograft mouse model. Furthermore, we also demonstrated that upregulations of both Nrf2 and CaMKIIα was closely related to lower survival rates of ESCC patients.

Conclusions
Our study reveals that Nrf2 promotes the radiation resistance of ESCC by targeting CaMKIIα and subsequently activating autophagy, which is characterized by the suppression of phosphorylated mTOR and p62, activation of Beclin 1, and transformation of LC3-I to LC3-II.
Barriers and facilitators of successful weight loss during participation in behavioural weight management programmes: a protocol for a systematic review
Authors: Thomson Meigan , Martin Anne , Logue Jennifer , Wells Valerie , Simpson Sharon A. 
Published: July 2020

Abstract
Background
Behavioural weight management programmes are effective in assisting people with overweight or obesity to lose excess body weight. Yet, many still struggle to attain their weight loss goals in such programmes. Little is understood about the factors which impact success in these programmes. Synthesising this data will allow for theory to be developed on how to improve success in such programmes. The main aim of this review will be to extract and synthesise the barriers and facilitators of successful weight loss during participation of behavioural weight loss programmes in adults living with overweight and obesity.

Methods
A systematic search of MEDLINE, Embase, PsycINFO, The Cochrane Library and CINAHL will be performed from inception onwards. Studies will also be sought by contacting experts in the field, reference and website searching. Studies will be eligible if the participants are adults living with obesity (population) undertaking or recently completed behavioural weight loss programmes (intervention) with the primary focus of weight loss (outcome). The primary outcomes will be amount of weight lost and information on barriers and/or facilitators to success. The secondary outcomes will be reasons or factors related to attrition and adherence and behaviour change techniques used in programmes. Two reviewers will screen citations and full-text data. Reviewer 1 will screen all, and reviewer 2 will screen a random 50% of articles. Data extraction will be completed by reviewer 1, and 10% will be checked by the research team. Potential conflicts will be resolved through discussion. Data will be synthesised and described narratively to show the characteristics of each study, levels of success and barriers and facilitators during programme participation. A thematic approach will be taken, and themes will be coded against the levels of the socioecological model. Quantitative data will be extracted and categorised according to these themes and presented alongside the qualitative data.

Discussion
Our findings can be used to inform how weight loss programmes can be improved to facilitate success in those at risk of failure. Results will be published in a peer-reviewed journal.

Systematic review registration
(PROSPERO CRD42019148158 )
Anti-periodicity on high-order inertial Hopfield neural networks involving mixed delays
Authors: Yao Luogen , Cao Qian 
Published: July 2020

AbstractThis paper deals with a class of high-order inertial Hopfield neural networks involving mixed delays. Utilizing differential inequality techniques and the Lyapunov function method, we obtain a sufficient assertion to ensure the existence and global exponential stability of anti-periodic solutions of the proposed networks. Moreover, an example with a numerical simulation is furnished to illustrate the effectiveness and feasibility of the theoretical results.