bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigation of predictability and influence factors of the achieved lenticule thickness in small incision lenticule extraction
Authors: Wu Fang , Yin Houfa , Chen Xinyi , Yang Yabo 
Published: March 2020

AbstractBackgroundTo evaluate the differences between the predicted and achieved lenticule thickness (ΔLT) after small incision lenticule extraction (SMILE) surgery and investigate relationships between ΔLT and predicted lenticule thickness in SMILE.MethodsA total of 184 eyes from 184 consecutive patients who underwent SMILE were included in this prospective study. One eye for each patient was randomly selected and included for statistical analysis. To achieve emmetropia, nomogram adds 10% correction of spherical refractive. An ultrasound pachymetry measurement and Scheimpflug camera corneal topography were obtained before and at 3 months after SMILE. The achieved lenticule thickness was calculated by comparing the preoperative examinations with postoperative examinations using ultrasound pachymetry and Pentacam software measurements. The pupil center and corneal vertex were selected as the 2 locations for measurement calculation on Pentacam. Analysis of variance (ANOVA) was performed to compare mean pachymetry values using different instruments. Linear regression analyses were performed between the VisuMax readout lenticule thicknesses and the measured maximum corneal change, between ΔLT and predicted lenticule thickness.ResultsOn average, the achieved lenticule thickness measured with ultrasound pachymetry was 13.02 ± 8.87 μm thinner than the predicted lenticule thickness. The proportion of ΔLT in predicted values is 11.9% (ultrasound) and about 15% (Pentacam). Linear regression analysis showed significant relationships between the predicted and each achieved lenticule thickness. Each ΔLT was significantly related to predicted lenticule thickness (ultrasound:R2 = 0.242; pupil center from Pentacam:R2 = 0.230).ConclusionsAn overestimation of achieved lenticule thickness was evident in this study which may exclude eligible SMILE patient. Also, our results showed that 10% increase of spherical refractive correction in the nomogram is appropriate. Furthermore, clinicians should subtract 10% of the predicted lenticule thickness to calculate the residual corneal stroma bed thickness.
Case report of first-episode psychotic symptoms in a patient with early-onset Alzheimer’s disease
Authors: Li Xiao , Xiong Zhenzhen , Liu Yaya , Yuan Yiwen , Deng Junfeng , Xiang Weiyi , Li Zhe 
Published: March 2020

Abstract
Background
Alzheimer’s disease (AD) is a neurodegenerative disorder featuring the behavioral and psychological symptoms of dementia. Patients with early-onset AD that exhibits first as psychotic symptoms usually lack obvious cognitive impairment, so they may be misdiagnosed with late-onset schizophrenia.

Case presentation
We report a patient who had prominent psychotic symptoms at the age of 60 and was initially diagnosed with very-late-onset-schizophrenia-like psychosis. Psychotic symptoms disappeared rapidly after treatment with olanzapine, and the patient later showed extrapyramidal symptoms and decline in cognitive function. Brain magnetic resonance imaging (MRI) showed frontotemporal atrophy, and positron emission tomography (PET) showed extensive areas of hypometabolism in the frontal cortex and head of the caudate nucleus. The patient’s SORL1 gene was found to carry a heterozygrous mutation (c.296A > G). The patient was eventually diagnosed with early-onset AD.

Conclusions
Our case suggests that clinicians should consider the possibility of early-onset AD in middle-aged or elderly patients whose first symptoms are the behavioral and psychological symptoms of dementia. To distinguish early-onset AD from late-onset schizophrenia, clinicians should evaluate cognitive function, perform MRI and PET, and search for SORL1 mutations.
Insight into blood pressure targets for universal coverage of hypertension services in Iran: the 2017 ACC/AHA versus JNC 8 hypertension guidelines
Authors: Mahdavi Mahdi , Parsaeian Mahboubeh , Mohajer Bahram , Modirian Mitra , Ahmadi Naser , Yoosefi Moein , Mehdipour Parinaz , Djalalinia Shirin , Rezaei Nazila , Haghshenas Rosa , Pazhuheian Forough , Madadi Zahra , Sabooni Mahdi , Razi Farideh , Samiee Siamak Mirab , Farzadfar Farshad 
Published: March 2020

Abstract
Background
We compared the prevalence, awareness, treatment, and control of hypertension in Iran based on two hypertension guidelines; the 2017 ACC/AHA –with an aggressive blood pressure target of 130/80 mmHg- and the commonly used JNC8 guideline cut-off of 140/90 mmHg. We shed light on the implications of the 2017 ACC/AHA for population subgroups and high-risk individuals who were eligible for non-pharmacologic and pharmacologic therapies.

Methods
Data was obtained from the Iran national STEPS 2016 study. Participants included 27,738 adults aged ≥25 years as a representative sample of Iranians. Regression models of survey design were used to examine the determinants of prevalence, awareness, treatment, and control of hypertension.

Results
The prevalence of hypertension based on JNC8 was 29.9% (95% CI: 29.2–30.6), which soared to 53.7% (52.9–54.4) based on the 2017 ACC/AHA. The percentage of awareness, treatment, and control were 59.2% (58.0–60.3), 80.2% (78.9–81.4), and 39.1% (37.4–40.7) based on JNC8, which dropped to 37.1% (36.2–38.0), 71.3% (69.9–72.7), and 19.6% (18.3–21.0), respectively, by applying the 2017 ACC/AHA. Based on the new guideline, adults aged 25–34 years had the largest increase in prevalence (from 7.3 to 30.7%). They also had the lowest awareness and treatment rate, contrary to the highest control rate (36.5%) between age groups. Compared with JNC8, based on the 2017 ACC/AHA, 24, 15, 17, and 11% more individuals with dyslipidaemia, high triglycerides, diabetes, and cardiovascular disease events, respectively, fell into the hypertensive category. Yet, based on the 2017 ACC/AHA, 68.2% of individuals falling into the hypertensive category were eligible for receiving pharmacologic therapy (versus 95.7% in JNC8). LDL cholesterol< 130 mg/dL, sufficient physical activity (Metabolic Equivalents≥600/week), and Body Mass Index were found to change blood pressure by − 3.56(− 4.38, − 2.74), − 2.04(− 2.58, − 1.50), and 0.48(0.42, 0.53) mmHg, respectively.

Conclusions
Switching from JNC8 to 2017 ACC/AHA sharply increased the prevalence and drastically decreased the awareness, treatment, and control in Iran. Based on the 2017 ACC/AHA, more young adults and those with chronic comorbidities fell into the hypertensive category; these individuals might benefit from earlier interventions such as lifestyle modifications. The low control rate among individuals receiving treatment warrants a critical review of hypertension services.
Frequency of discussing and documenting advance care planning in primary care: secondary analysis of a multicenter cross-sectional observational study
Authors: Hamano Jun , Oishi Ai , Morita Tatsuya , Kizawa Yoshiyuki 
Published: March 2020

Abstract
Background
To improve the quality of advance care planning (ACP) in primary care, it is important to understand the frequency of and topics involved in the ACP discussion between patients and their family physicians (FPs).

Methods
A secondary analysis of a previous multicenter cross-sectional observational study was performed. The primary outcome of this analysis was the frequency of and topics involved in the ACP discussion between outpatients and FPs. In March 2017, 22 family physicians at 17 clinics scheduled a day to assess outpatients and enrolled patients older than 65 years who were recognized by FPs as having regular visits. We defined three ACP discussion topics: 1) future decline in activities of daily living (ADL), 2) future inability to eat, and 3) surrogate decision makers. FPs assessed whether they had ever discussed any ACP topics with each patient and their family members, and if they had documented the results of these discussions in medical records before patients were enrolled in the present study. We defined patients as being at risk of deteriorating and dying if they had at least 2 positive general indicators or at least 1 positive disease-specific indicator in the Japanese version of the Supportive and Palliative Care Indicators Tool.

Results
In total, 382 patients with a mean age of 77.4 ± 7.9 years were enrolled, and 63.1% were female. Seventy-nine patients (20.7%) had discussed at least one ACP topic with their FPs. However, only 23 patients (6.0%) had discussed an ACP topic with family members and their FPs, with the results being documented in their medical records. The topic of future ADL decline was discussed and documented more often than the other two topics. Patients at risk of deteriorating and dying discussed ACP topics significantly more often than those not at risk of deteriorating and dying (39.4% vs. 16.8%, p < 0.001).

Conclusion
FPs may discuss ACP with some of their patients, but may not often document the results of this discussion in medical records. FPs need to be encouraged to discuss ACP with patients and family members and describe the decisions reached in medical records.
Physical characteristics and antimicrobial properties of Apis mellifera, Frieseomelitta nigra and Melipona favosa bee honeys from apiaries in Trinidad and Tobago
Authors: Brown Elijah , O’Brien Michel , Georges Karla , Suepaul Sharianne 
Published: March 2020

Abstract
Background
Honey is a versatile and complex substance consisting of bioactive chemicals which vary according to many bee and environmental factors. The aim of this study was to assess the physical and antimicrobial properties of five honey samples obtained from three species of bees; two stingless bees, Frieseomelitta nigra and Melipona favosa and one stinging bee, Apis mellifera (fresh and aged honey). Samples were acquired from apiaries across Trinidad and Tobago. An artificial honey, made from sugar, was also used for comparison.

Methods
Physical properties such as appearance, pH, moisture content, sugar content and specific gravity were determined. Antimicrobial activity was assessed utilizing the agar diffusion assay and comparison to a phenol equivalence. The broth microdilution test was performed to determine the minimum inhibitory concentrations (MICs) and the minimum bactericidal concentrations (MBCs) of the five honey samples against four common pathogens, including Staphylococcus aureus, Escherichia coli, Streptococcus pyogenes and Haemophilus influenzae.

Results
All honey samples were acidic, with pH values ranging from 2.88 (M. favosa of Tobago) to 3.91 (fresh A. mellifera). Sugar content ranged from 66.0 to 81.6% with the highest values detected in stinging bee honeys of the A. mellifera (81.6 and 80.5°Bx). Moisture content ranged from 16.9% for aged A. mellifera honey (from Trinidad) to 32.4% for F. nigra honey (from Tobago). The MICs (2 to 16%) and MBCs (2 to 32%) of stingless bee honeys were lower than that of stinging bee and artificial honeys (16 to > 32%). Stingless bee honeys also exhibited a broad spectrum of antimicrobial activity against both Gram-positive and Gram-negative organisms with higher phenol equivalence values (4.5 to 28.6%) than the A. mellifera honeys (0 to 3.4%) against the isolates tested. M. favosa honey of Tobago displayed the greatest antimicrobial activity as indicated by the high phenol equivalence and low MIC and MBC values.

Conclusions
Stingless bee honeys from Tobago showed the greatest antimicrobial activity when compared to the other honeys used in this study. M. favosa honey of Tobago showed the most potential for use as medicinal honey.
GC-MS analysis of Myrtus communis extract and its antibacterial activity against Gram-positive bacteria
Authors: Mir Mushtaq A. , Bashir Nasreena , Alfaify Abdulkhaleg , Oteef Mohammed D. Y. 
Published: March 2020

Abstract
Background
Myrtus communis is a typical plant of Mediterranean area. The different parts of this plant such as berries, branches, and leaves have been used worldwide as a traditional/folk medicine for the treatment of various ailments and diseases.

Methods
Ethanolic leaf extract of the plant was prepared by Soxhlet extraction method. Zone of inhibition, minimum inhibitory concentration and minimal bactericidal concentration were determined by well diffusion method and microplate alamar blue assay. GC-MS analysis was carried out to identify the compounds present in the extract. Microscopy and ImageJ software were used respectively for morphology and cell-length measurements. GraphPad Prism was used for statistical analysis.

Results
The ethanolic extract showed strong inhibitory effect against Gram-positive and acid-fast bacteria with significant inhibition-zone size (9–25 mm), MIC (4.87–78 μg/ml), as well as MBC (0.3–20 mg/ml). However, no effect was observed on the growth of Gram-negative bacteria. The growth inhibition was found to be associated with the damage of cell wall as the extract-treated cells were sensitive to cell wall-targeting antibiotics and displayed the cell wall damage-depicting morphological defects. GC-MS analysis confirmed the presence of novel compounds in addition to the most representative compounds of the essential oils/extracts of M. communis of other country origins.

Conclusion
These results demonstrate that M. communis leaf extract could be the source of compounds to be used for the treatment of Gram-positive bacterial infections. This is the first report, which provides insights into the mechanism of action of the extract in inhibiting the growth of Gram-positive bacteria.
Relationships between academic self-efficacy, learning-related emotions, and metacognitive learning strategies with academic performance in medical students: a structural equation model
Authors: Hayat Ali Asghar , Shateri Karim , Amini Mitra , Shokrpour Nasrin 
Published: March 2020

AbstractRecognition of the factors affecting the medical students’ academic success is one of the most important challenges and concerns in medical schools. Hence, this study aimed to investigate the mediating effects of metacognitive learning strategies and learning-related emotions in the relationship between academic self-efficacy with academic performance in medical students.MethodsThe present study was carried out on 279 students of medicine studying at Shiraz University of Medical Sciences. The students filled out three questionnaires: academic emotions (AEQ), metacognitive learning strategies, and academic self-efficacy questionnaires. The data were analyzed using SPSS and Smart PLS3.ResultsThe results of structural equation modeling revealed that the students’ self-efficacy has an impact on their learning-related emotions and metacognitive learning strategies, and these, in turn, affect the students’ academic performance. Moreover, learning-related emotions influence the metacognitive learning strategies, which in turn mediate the effect of emotions on academic performance.DiscussionThe results of this study revealed that metacognitive strategies and learning-related emotions could play a mediating role in the relationship between students’ self-efficacy and academic performance.
The International Conference on Intelligent Biology and Medicine 2019: computational methods for drug interactions
Authors: Ning Xia , Zhang Chi , Wang Kai , Zhao Zhongming , Mathé Ewy 
Published: March 2020

AbstractIn this editorial, we briefly summarize the International Conference on Intelligent Biology and Medicine 2019 (ICIBM 2019) that was held on June 9–11, 2019 at Columbus, Ohio, USA. Then, we introduce the two research articles included in this supplement issue. These two research articles were selected after careful review of 105 articles that were submitted to the conference, and cover topics on deep learning for drug-target interaction prediction and data mining and visualization of high-order drug-drug interactions.
What matters to me – a web-based preference elicitation tool for clients in long-term care: a user-centred design
Authors: van Leersum Catharina M. , Moser Albine , van Steenkiste Ben , Reinartz Marion , Stoffers Esther , Wolf Judith R. L. M. , van der Weijden Trudy 
Published: March 2020

AbstractBackgroundDuring the process of decision-making for long-term care, clients are often dependent on informal support and available information about quality ratings of care services. However, clients do not take ratings into account when considering preferred care, and need assistance to understand their preferences. A tool to elicit preferences for long-term care could be beneficial. Therefore, the aim of this qualitative descriptive study is to understand the user requirements and develop a web-based preference elicitation tool for clients in need of long-term care.MethodsWe applied a user-centred design in which end-users influence the development of the tool. The included end-users were clients, relatives, and healthcare professionals. Data collection took place between November 2017 and March 2018 by means of meetings with the development team consisting of four users, walkthrough interviews with 21 individual users, video-audio recordings, field notes, and observations during the use of the tool. Data were collected during three phases of iteration: Look and feel, Navigation, and Content. A deductive and inductive content analysis approach was used for data analysis.ResultsThe layout was considered accessible and easy during the Look and feel phase, and users asked for neutral images. Users found navigation easy, and expressed the need for concise and shorter text blocks. Users reached consensus about the categories of preferences, wished to adjust the content with propositions about well-being, and discussed linguistic difficulties.ConclusionBy incorporating the requirements of end-users, the user-centred design proved to be useful in progressing from the prototype to the finalized tool ‘What matters to me’. This tool may assist the elicitation of client’s preferences in their search for long-term care.
Leptospira infection and shedding in dogs in Thailand
Authors: Altheimer Kerstin , Jongwattanapisan Prapaporn , Luengyosluechakul Supol , Pusoonthornthum Rosama , Prapasarakul Nuvee , Kurilung Alongkorn , Broens Els M. , Wagenaar Jaap A. , Goris Marga G. A. , Ahmed Ahmed A. , Pantchev Nikola , Reese Sven , Hartmann Katrin 
Published: March 2020

Abstract
Background
Leptospirosis is a widespread zoonosis and has been recognized as a re-emerging infectious disease in humans and dogs, but prevalence of Leptospira shedding in dogs in Thailand is unknown. The aim of this study was to determine urinary shedding of Leptospira in dogs in Thailand, to evaluate antibody prevalence by microscopic agglutination test (MAT) and enzyme-linked immunosorbent assay (ELISA), and to assess risk factors for Leptospira infection.
In Northern, Northeastern, and Central Thailand, 273 stray (n = 119) or client-owned (n = 154) dogs from rural (n = 139) or urban (n = 134) areas were randomly included. Dogs that had received antibiotics within 4 weeks prior to sampling were excluded. No dog had received vaccination against Leptospira. Urine was evaluated by real-time polymerase chain reaction (PCR) specific for lipL32 gene of pathogenic Leptospira. Additionally, urine was cultured for 6 months in Ellinghausen-McCullough-Johnson-Harris (EMJH) medium. Antibodies were measured by ELISA and MAT against 24 serovars belonging to 15 serogroups and 1 undesignated serogroup. Risk factor analysis was performed with backwards stepwise selection based on Wald.

Results
Twelve of 273 (4.4%; 95% confidence interval (CI): 2.0–6.8%) urine samples were PCR-positive. In 1/273 dogs (0.4%; 95% CI: 0.01–1.1%) Leptospira could be cultured from urine. MAT detected antibodies in 33/273 dogs (12.1%; 95% CI: 8.2–16.0%) against 19 different serovars (Anhoa, Australis, Ballum, Bataviae, Bratislava, Broomi, Canicola, Copenhageni, Coxi, Grippotyphosa, Haemolytica, Icterohaemorrhagiae, Khorat, Paidjan, Patoc, Pyrogenes, Rachmati, Saxkoebing, Sejroe). In 111/252 dogs (44.0%; 95% CI: 37.9–50.2%) immunoglobulin M (IgM) and/or immunoglobulin G (IgG) antibodies were found by ELISA. Female dogs had a significantly higher risk for Leptospira infection (p = 0.023).

Conclusions
Leptospira shedding occurs in randomly sampled dogs in Thailand, with infection rates comparable to those of Europe and the USA. Therefore, the potential zoonotic risk should not be underestimated and use of Leptospira vaccines are recommended.
Changing trajectories of serum uric acid and risk of non-alcoholic fatty liver disease: a prospective cohort study
Authors: Ma Zhimin , Xu Chaonan , Kang Xiaoping , Zhang Shan , Li Haibin , Tao Lixin , Zheng Deqiang , Guo Xiuhua , Yang Xinghua 
Published: March 2020

AbstractBackgroundIt is unclear the role of longitudinal trajectory of serum uric acid (SUA) on the development of non-alcoholic fatty liver disease (NAFLD). We aimed to determine whether longitudinal SUA trajectories are associated with the risk of new-onset NAFLD.MethodsWe explored the relationship between SUA trajectories and NAFLD in a cohort including 3822 participants. Individual’s SUA trajectories from 2012 to 2014 were defined using group-based trajectory modeling analysis in four distinct patterns: trajectory 1 (n = 991, 25.93%), trajectory 2 (n = 1421, 37.18%), trajectory 3 (n = 1156, 30.22%), and trajectory 4 (n = 254, 6.67%). The logistic regression model was used to evaluate the association between SUA changing trajectories and subsequent NAFLD until 2016. Dose–response relationship between SUA changing trajectories and NAFLD risk was evaluated through the testing of trajectory groups as a continuous variable.ResultsThe 2-year incidence of NAFLD was 13.27%. Compared with trajectory 1, the adjusted odds risk for NAFLD development was in a dose–response relationship as follows: 1.27 (95% CI 0.91–1.78) for trajectory 2, 1.89 (95% CI 1.29–2.75) for trajectory 3, and 2.34 (95% CI 1.43–3.83) for trajectory 4. And this dose–response relationship was not affected by age, sex, and abdominal obesity.ConclusionsHigher SUA changing trajectory is a risk factor for NAFLD. This finding highlights the importance of paying attention to SUA changing trajectory on the detection and prevention of NAFLD.
The elevated serum levels of calcineurin and nuclear factor of activated T-cells 1 in children with Kawasaki disease
Authors: Sun Yameng , Liu Jingjing , Geng Zhimin , Tao Yijing , Zheng Fenglei , Wang Ying , Fu Songling , Wang Wei , Xie Chunhong , Zhang Yiying , Gong Fangqi 
Published: March 2020

Abstract
Background
The calcineurin and nuclear factor of activated T-cells (CaN-NFAT) signaling pathway had been found to be associated with Kawasaki disease (KD) susceptibility and coronary artery aneurysm formation as a contributor. To evaluate serum calcineurin (CaN) and nuclear factor of activated T-cells 1(NFAT1) levels in patients with Kawasaki disease (KD).

Methods
Serum levels of CaN and NFAT1 were measured by enzyme-linked immunosorbent assay method in 66 healthy children and 74 KD patients at acute, afebrile and subacute stage.

Results
The serum levels of CaN and NFAT1 increased significantly in the acute stage, and decreased progressively in the afebrile and subacute stage, along with the reduction of C-reactive protein, white blood cells and neutrophil counts. And in the acute stage, the afebrile stage and the subacute stage, the expression of CaN and NFAT1 was upregulated significantly in KD patients compared to that in the healthy control. After the IVIG treatment, the serum levels of CaN and NFAT1 declined significantly in IVIG responders. However, the CaN and NTAT1 levels in the IVIG non-responders declined slowly. And in the afebrile stage, the NFAT1 levels were lower in KD patients with coronary artery lesions (CALs) (268.82 ± 11.96 ng/ml) than those without CALs (285.84 ± 25.13 ng/ml). However, the serum levels of CaN in KD patients with CALs had no significant difference with those in KD patients without CALs.

Conclusions
The specific regulation of CaN and NFAT1 serum levels in the course of KD was suggested that both of them were related in the development of KD.