bluuebunny/crossref_metadata_2025_split huggingface dataset:
Repetitive Negative Thinking is associated with Subjective Cognitive Decline in older adults: a cross-sectional study
Authors: Schlosser Marco , Demnitz-King Harriet , Whitfield Tim , Wirth Miranka , Marchant Natalie L. 
Published: September 2020

Abstract
Background: In the absence of a cure or effective treatment for dementia, attention has shifted towards identifying risk factors for prevention. Subjective Cognitive Decline (SCD) describes self-perceived worsening of cognition despite unimpaired performance on neuropsychological tests. SCD has been associated with an increased dementia risk and steeper memory decline. Repetitive negative thinking (RNT) is a transdiagnostic process that manifests across several mental health disorders associated with increased vulnerability to dementia. RNT has thus been proposed as a candidate marker of risk for dementia and, relatedly, could contribute to the manifestation of SCD. We aimed to investigate the relationship between SCD and RNT alongside other proposed psychological risk/protective factors for dementia and cognitive decline. Methods: In a cross-sectional online survey, 491 older adults (mean=64.9 years, SD=4.2; 63.1% female) completed measures of RNT, personality traits, purpose in life, worry, rumination, and meditation practice. SCD was assessed continuously via self-perceived cognitive function (Neuro-QoL) and categorically via endorsement (yes/no) of memory complaints. Regression models, using a stepwise backwards elimination, were built to assess associations between SCD, demographics, and all risk/protective factors.Results: A total of 24.2% of participants reported memory complaints. In the final prediction models, RNT was the only psychological variable associated with lower self-perceived cognitive function and with a higher likelihood of memory complaints. Conclusions: This study empirically corroborates the theoretical relationship between SCD and RNT. Longitudinal studies are needed to establish whether RNT is a prodromal symptom or an independent risk factor, and whether RNT can be a promising construct for future research on SCD and dementia risk.
Acetate Ringer's solution versus 0.9% saline for septic patients: study protocol for a multi-center parallel controlled trial
Authors: Liu Fang , Zhang Jing , Zhu Yuan , Su Lianjiu , Li Yiming , He Li , Yu Li , Peng Zhiyong 
Published: September 2020

Abstract
Background: Previous study drew different conclusions on significant differences between saline and balanced crystalloid solution infused in critical illness but both the statistical difference in sepsis subgroup. Thus, we will specifically focus on septic patients in this study to compare the effects of saline and balanced solution. We hypothesize that effects of saline on acute kidney injury (AKI) are related to the underline AKI severity and total volumes of infusion.Methods/design: The investigators designed a pragmatic, multi-center parallel controlled trial recruiting 312 patients who are diagnosed as sepsis/septic shock in the intensive care unit (ICU) and will be assigned with either acetate Ringer’s solution or saline in the corresponding month. Patients with an end-stage renal disease (ESRD) or who need renal replacement therapy (RRT) prior to or at the time of enrollment are excluded. Enrolled patients will be regarded as with mild, moderate or severe sepsis on the basis of the severity of their illness, and will be divided into subgroups according to their initial renal function and various intravenous infusion volumes when being analyzed. The primary outcome is major adverse kidney events within 28 days (MAKE28), including the composite of in-hospital death, receipt of new renal replacement therapy, or persistent renal dysfunction. Secondary outcomes include 28 days-mortality, internal environment disturbance, incidence and duration of vasoactive drug treatment, duration of mechanical ventilation, duration of RRT and ICU and hospital length of stay.Results and conclusions: To our knowledge, this study will be the first to focus on septic patients and provide credible and evident data on the comparison of outcome between acetate Ringer’s solution and saline for intravenous infusion in adult septic patients on the basis of baseline renal function and infusion volumes taken into consideration.Trial registration: ClinicalTrials.gov, identifiers: NCT03685214. Registered on August 15th, 2018. https://clinicaltrials.gov/ct2/show/NCT03685214
Timing of Antiretroviral Therapy for HIV-Infected Patients with Cytomegalovirus Retinitis: Study Protocol of a Multi-Center Prospective Randomized Controlled Trial
Authors: He Xiao-Qing , Huang Yin-Qiu , Zeng Yan-Ming , Qin Yuan-Yuan , Tang Sheng-Quan , Xu Xiao-Lei , Harypursat Vijay , Lu Yan-Qiu , Liu Min , Yuan Jing , Chen Yaokai 
Published: September 2020

Abstract
Background: Cytomegalovirus retinitis (CMVR) is an important opportunistic infection (OI) occurring mainly in patients with acquired immunodeficiency syndrome (AIDS), and has the potential to cause severe visual impairment and blindness among AIDS patients. Subsequent to the adoption and implementation of widespread antiretroviral therapy (ART), the prognosis of AIDS-associated CMVR has been substantially improved. Nevertheless, there remains some controversy with regards to the optimal timing for ART initiation in patients with an established CMVR diagnosis. We therefore designed the present study in order to investigate the optimal timing for ART initiation in AIDS/CMVR patients.Methods: This will be a prospective, randomized controlled trial to be performed at 17 hospitals in mainland China. A total of 300 participants with CMVR will be randomly assigned to an early ART initiation group (ART initiation within 2 weeks after anti-CMV therapy), or a deferred ART initiation group (initiation of ART more than 2 weeks after anti-CMV therapy) at a 1:1 ratio. All participants will receive 48-weeks of follow-up after anti-CMV therapy initiation. Our primary outcome will be the incidence of visual loss (to a visual acuity worse than 20/40 or 20/200) in the two groups during the 48-week follow-up period. Secondary outcomes will include changes in HIV virological suppression and serum CD4+ T-cell counts, the incidence of mortality, retinitis progression (movement of the peripheral border of a CMV lesion ≥ ½ disc diameter, or occurrence of a new CMV lesion), retinal detachment, immune recovery uveitis (IRU), and other OIs and adverse events between the two study groups during the 48 weeks of follow-up. Discussion:The study aims to investigate the optimal timing for ART initiation in AIDS/CMVR patients. We hope to be able to extract robust clinical evidence for use in optimal AIDS/CMVR management should our trial be successful.Trial registration: This research was registered as one of the twelve clinical trials under the name of a general project “A study for precision diagnosing and treatment strategies in difficult-to-treat AIDS cases and HIV-infected patients with highly fatal or highly disabling opportunistic infections”, ChiCTR1900021195. Registered 1 February 2019, http://www.chictr.org.cn/showproj.aspx?proj=35362.
Community Intervention for Child Tuberculosis Active Contact Investigation and Management: Study Protocol for A Cluster Randomized Trial
Authors: Vasiliu Anca , Eymard-Duvernay Sabrina , Tchounga Boris , Atwine Daniel , de Carvalho Elisabete , Ouedraogo Sayouba , Kakinda Michael , Tchendjou Patrice , Turyahabwe Stavia , Kuate Albert Kuate , Tiendrebeogo Georges , Dodd Peter J , Graham Stephen M , Cohn Jennifer , Casenghi Martina , Bonnet Maryline 
Published: September 2020

Abstract
Background: There are major gaps in the management of pediatric tuberculosis (TB) contact investigation for rapid identification of active tuberculosis and initiation of preventive therapy. This study aims to evaluate the impact of a community-based intervention as compared to facility-based model for the management of children in contact with bacteriologically confirmed pulmonary TB adults in low-resource high-burden settings.Methods/design: This multicenter cluster-randomized trial is composed of three phases: I, baseline phase in which retrospective data are collected, quality of data recording in facility registers is checked and expected acceptability and feasibility of the intervention is assessed; II, intervention phase with enrolment of index cases and contact cases in either facility- or community based models; and III, explanatory phase including endpoint data analysis, cost effectiveness analysis and post-intervention acceptability assessment by heath care providers and beneficiaries. The study uses both quantitative and qualitative analysis methods. The community-based intervention includes identification and screening of all household contacts, referral of contact with TB-suggestive symptoms to the facility for investigation, and household initiation of preventive therapy with follow-up of eligible child contacts by community healthcare workers, i.e. all young (<5 years) child contacts or older (5-14 years) child contacts living with HIV, and with no evidence of TB disease. Twenty clusters representing TB diagnostic and treatment facilities with their catchment areas are randomized in a 1:1 ratio to either the community-based intervention arm or the facility-based standard of care arm in Cameroon and Uganda. The primary endpoint is the proportion of eligible child contacts who initiate and complete the preventive therapy. The sample size is of 1500 child contacts to identify a 10% difference between the arms with the assumption that 60% of children will complete the preventive therapy in the standard of care arm.Discussion: This study will provide evidence of the impact of a community-based intervention on household child contact screening, and management of TB preventive therapy in order to improve care and prevention of childhood TB in high low resource high-burden settings.Trial registration: the study has been registered on the 6th of February 2019 on ClinicalTrials.gov with the number NCT03832023 (https://clinicaltrials.gov/ct2/show/NCT03832023?term=CONTACT&cond=Tuberculosis&cntry=UG&draw=2&rank=1 )
Transcription strategies related to photosynthesis and nitrogen metabolism of wheat in response to nitrogen deficiency
Authors: Liu Xin , Yin Chengmiao , Xiang Li , Jiang Weitao , Xu Shaozhuo , Mao Zhiquan 
Published: September 2020

Abstract
Background: Agricultural yield is closely associated with nitrogen application. Thus, reducing the application of nitrogen without affecting agricultural production remains a challenging task. To understand the metabolic, physiological, and morphological response of wheat (Triticum aestivum) to nitrogen deficiency, it is crucial to identify the genes involved in the activated signaling pathways.Results: We conducted a hydroponic experiment using a complete nutrient solution (N1) and a nutrient solution without nitrogen (N0). Wheat plants under nitrogen-deficient conditions (NDC) showed decreased crop height, leaf area, root volume, photosynthetic rate, crop weight, and increased root length, root surface area, root/shoot ratio. It indicates that nitrogen deficiency altered the phenotype of wheat plants. Furthermore, we performed a comprehensive analysis of the phenotype, transcriptome, GO pathways, and KEGG pathways of DEGs identified in wheat grown under NDC. It showed up-regulation of Exp (24), and Nrt (9) gene family members, which increased the nitrogen absorption and down-regulation of Pet (3), Psb (8), Nar (3), and Nir (1) gene family members hampered photosynthesis and nitrogen metabolism. Conclusions: We identified 48 candidate genes that were involved in improved photosynthesis and nitrogen metabolism in wheat plants grown under NDC. These genes may serve as molecular markers for genetic breeding of crops.
Susceptibility Loci for Pancreatic Cancer in the Brazilian Population
Authors: Aoki Mateus , Stein Angelika , de Oliveira Jaqueline Carvalho , Chammas Roger , Uno Miyuki , Canzian Federico 
Published: September 2020

Abstract
Background: Pancreatic adenocarcinoma (PA) is a very aggressive cancer and has one of the poorest prognoses. Usually the diagnosis is late and resistant to conventional treatment. Environmental and genetic factors contribute to the etiology, such as tobacco and alcohol consumption, chronic pancreatitis, diabetes and obesity. Somatic mutation in pancreatic cancer cells are known and SNP profile by GWAS could access novel genetic risk factors for this disease in different population context. Here we describe a SNP panel for Brazilian pancreatic cancer, together with clinical and epidemiological data. Methods: 78 pancreatic adenocarcinoma and 256 non-pancreatic cancer subjects had 25 somatic SNP genotyped by real-time PCR. Unconditional logistic regression methods were used to assess the main effects on PA risk, using allelic, co-dominant and dominant inheritance models. Results: 9 SNPs were nominally associated with pancreatic adenocarcinoma risk, with 5 of the minor allele conferring protective effect while 4 related as risk factor. In epidemiological and clinical data, tobacco, diabetes and pancreatitis history were significant related to pancreatic adenocarcinoma risk. Conclusion: We could assess for the first time some SNPs related with PA in Brazilian populations, a result that could be used for genetic screening in risk population such as familial pancreatic cancer, smokers, alcohol users and diabetes patients.
Transcriptomic Biomarker Pathways Associated with Death in HIV-infected Patients with Cryptococcal Meningitis
Authors: Louis Irina St. , Musubire Abdu K , Meya David B , Nabeta Henry W , Mohei Hesham , Boulware David R , Bohjanen Paul R 
Published: September 2020

Abstract
Background: Cryptococcal meningitis (CM) is a major cause of death in HIV-infected patients in sub-Saharan Africa. Many CM patients experience cryptococcosis-associated immune reconstitution inflammatory syndrome (C-IRIS), which is often fatal. We sought to identify transcriptomic biomarker pathways in peripheral blood that are associated with, or, predict the development of death or fatal C-IRIS among patients with CM who were enrolled in the Cryptococcal Optimal ART Timing (COAT) Trial. Methods: We assessed peripheral blood gene expression using next-generation RNA sequencing in 4 groups of patients with CM: 1) no C-IRIS or Death; 2) C-IRIS survivors; 3) fatal C-IRIS; 4) Death without C-IRIS. Gene expression was assessed at the time of ART initiation, at 1, 4, and 8 weeks on ART, and at the time of C-IRIS events. Results: We identified 12 inflammatory and stress response pathways, including interferon type 1 signaling, that were upregulated at the time of ART initiation in patients with future fatal C-IRIS, as compared with survivors. The upregulation of transcripts involved in innate immunity (inflammasome, Toll-like receptor signaling), was observed at the time of fatal or nonfatal C-IRIS events. At the time of fatal C-IRIS events, numerous transcripts within fMLP, Rho family GTPases, HMGB1, and other acute phase response signaling pathways were upregulated, which reflect the severity of inflammation and systemic oxidative stress. Those who died without recognized C-IRIS also had increased expression of pathways associated with oxidative stress and tissue damage. The Partial Least Squares model estimated above mentioned pathways as predictors of fatal outcome.Conclusions: Our results showed that overactivated innate immunity, involving Toll-like receptor/inflammasome, and inflammation-induced oxidative stress, are associated with fatal outcomes. The results of this study provide insight into the molecular drivers of death and fatal C-IRIS to inform future diagnostic test development or guide targeted treatments.
Assessment of The ACG System in Dutch Primary Care Using GP’s Electronic Health Records: A Retrospective Cross-Sectional Study
Authors: Girwar Shelley-Ann M , Fiocco Marta , Sutch Stephen P , Numans Mattijs E , Bruijnzeels Marc A 
Published: September 2020

Abstract
Background Within the Dutch health care system the focus is shifting from a disease oriented approach to a more population based approach. Since every inhabitant in the Netherlands is registered with one general practice, this offers a unique possibility to perform Population Health Management analyses based on general practitioners’ (GP) registries. The Johns Hopkins Adjusted Clinical Groups (ACG) System is an internationally used method for predictive population analyses. The model categorizes individuals based on their complete health profile, taking into account age, gender, diagnoses and medication. However, the ACG system was developed with non-Dutch data. Consequently, for wider implementation in Dutch general practice, the system needs to be validated in the Dutch healthcare setting. In this paper we show the results of the first use of the ACG system on Dutch GP data. The aim of this study is to explore how well the ACG system can distinguish between different levels of GP healthcare utilization. Methods To reach our aim, two variables of the ACG System, the Aggregated Diagnosis Groups (ADG) and the mutually exclusive ACG categories were explored. The population for this pilot analysis consisted of 23,618 persons listed with five participating general practices within one region in the Netherlands. ACG analyses were performed based on historical Electronic Health Records data from 2014 consisting of primary care diagnoses and pharmaceutical data. Logistic regression models were estimated and AUC’s were calculated to explore the diagnostic value of the models including ACGs and ADGs separately with GP healthcare utilization as the dependent variable. The dependent variable was categorized using four different cut-off points: zero, one, two and three visits per year.Results The ACG and ADG models performed as well as models using International Classification of Primary Care chapters, regarding the association with GP utilization. AUC values were between 0.79 and 0.85. These models performed better than the base model (age and gender only) which showed AUC values between 0.64 and 0.71. Conclusion The results of this study show that the ACG system is a useful tool to stratify Dutch primary care populations with GP healthcare utilization as the outcome variable.
Enablers, Constraints and Extent of Implementation of the Elimination of Mother-to-child Transmission of HIV Policy Guidelines in Lira district; Application of a Policy Implementation Barometer
Authors: Namuhani Noel , Kainga Hamiliton , Obafemi Olufemi , Adelabu Adeyemi , Mukuru Moses , Tuhebwe Doreen , Ssennyonjo Aloysious 
Published: September 2020

Abstract
Background; Despite the adoption of Elimination of mother to child transmission (EMTCT) strategy in 2012, mother to child transmission of HIV remains one of the significant forms of new HIV infections among children in Uganda, accounting for 20% of new infections. However, the implementation of the EMTCT strategy in Uganda remains unclear and an under researched field. This study aimed at assessing the extent of implementation of EMTCT strategy, barriers and constraints in Lira district using the adapted Policy Implementation Barometer (PIB) approach. Methods; This was a cross sectional study that employed both quantitative and qualitative data collection methods. A Policy Implementation Barometer tool developed by a project called Supporting Policy Engagement for Evidence-based Decisions (SPEED) for Universal Health Coverage in Uganda was adopted to assess the extent of implementation of EMTCT strategy. A total of 32 interviews with health facility managers were purposively conducted from a random sample of 20 health facilities offering Antenatal clinic (ANC) services in Lira district. Quantitative data was analyzed using STATA 14. Qualitative data was analyzed using thematic content analysis approach. Results; Majority 17/32 (53.1%) of the respondents were health facility in charges, 14/32 (43.8%) were midwives and half 16/32 (50.0%) had been in service for more than five years. Half of the respondents perceived their facilities to have fully established programs for implementing EMTCT and only 2/32 (6.2%) perceived the EMTCT programs to be functioning optimally. The perceived level of EMTCT implementation was 80%. Almost all the respondents perceived the funding for EMTCT activities to be inadequate, untimely, and not sustainable. Only 4/32 (12.5%) of the respondents believed that the health workforce size was adequate to support EMTCT activities, 13/32 (40.6%) believed that health workers lacked the skills to provide EMTCT services.Conclusion/Recommendation; Overall, the perceived extent of EMTCT policy implementation was high, however slow progress was reported in some of the key policy objectives due to a number of hindrances including inadequate staff and funding. Therefore, there is a need for strategies to increase the number of health workers for EMTCT and solicit for more funding for the implementation of EMTCT strategy.
Molecular detection of Staphylococcal enterotoxins and mecA genes products in food samples collected from different areas in Khartoum state.
Authors: Yahya Mohammed , Ali Hashim Abdalbagi , Gorish Babbiker Mohammed Taher , Ali Sara Omer , Abdalrhim Eman Saif Aldein , Mergani Mawada Hamza , Elgadir Asmaa Abass Abd , Mohammed Somaya Khalid , Ahmed Salma Omer , Musa Naglaa Alsaeid , Ahmed Alaa Saeed , Abdalla Wafaa Mohammed , Hamedelnil Yousif Fadlallah , Hashim Ahmed Ibrahim , Altayeb Hisham N. 
Published: September 2020

Abstract
Background: Staphylococcal Food Poisoning is an intoxication that results from the consumption of improperly prepared or stored foods containing sufficient amounts of one or more preformed S. aureus enterotoxins. Now days many researchers worldwide noted an emerging of resistant strains Staphylococci especially for the antibiotic Methicillin. Therefore, this study was aimed to determine the existence of Staphylococcus aureus and its enterotoxins, mecA genes in food samples.Results: A total of 400 samples were collected from different areas in Khartoum state. The type of foods included Cheese, Meat products, Fish and Raw milk, 100 samples for each. out of 400 samples cultivated 137 (34.25 %) isolates were identified as S. aureus, 126 (31.5%) were identified as bacteria other than S. aureus and 137 (34.25%) were yield no growth. Of 137 S. aureus isolates, 84 were randomly selected and examined for the presence mecA and enterotoxin genes products. Oxacillin sensitivity test showed that 15(11%) of 137 S.aureus isolates were Oxacillin resistant. The PCR assay showed that mecA gene was detected in 15 of 84 (17%) S. aureus isolates. While only 2 (2.385%) out of 84 S. aureus isolates were show an enterotoxin B gene product. Conclusion: There was a relatively moderate prevalence of Methicillin resistant staphylococcus aureus with very low frequency of enterotoxin B gene in different kinds of food samples which collected from Khartoum state. These findings highlight the high potential risk for consumers of meat and dairy products especially in the absence of strict hygienic and preventive measures to avoid Staphylococcus aureus enterotoxins production in foods.