bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diffuse Pigmented Lesions in the Outer Retina: An Unusual Fundus Appearance
Authors: Benson Matthew D. , Rubin Uriel , Cheema Marvi , MacDonald Ian M. , Tennant Matthew T.S. , Hinz Brad J. , Somani Rizwan 
Published: October 2019

Purpose: This report describes and provides a differential diagnosis for a patient with unusual bilateral retinal pigmented lesions. Methods: A 40-year-old woman was found to have multiple flat, gray lesions scattered across her fundi, becoming larger and more confluent toward the periphery. There were small drusenlike deposits in her foveae. The hyperpigmented lesions demonstrated hypoautofluorescence with thickening of the retinal pigment epithelium and disruption of the overlying layers on optical coherence tomography (OCT). Full-field electroretinography revealed generalized reduced a- and b-wave amplitudes. Results: Chest x-ray, breast ultrasound, mammography, and pelvic ultrasound findings were negative for malignant etiologic factors. Panel testing results for hereditary retinal dystrophy were negative. Conclusions: Although the clinical and OCT appearance of the lesions is similar to congenital grouped pigmentation, the symmetric and bilateral nature of ocular findings coupled with electroretinographic changes suggest a possible retinal dystrophy. This case adds to the phenotypic diversity of pigmented fundus lesions.
Untapped CHRO Potential: From Partnering to Chairing the Board
Authors: Dwarakanath P. 
Published: October 2019

In the changing business landscape most shareholders and investors when making their investment decisions not just look at a firm’s profitability but also consider its corporate citizenship model through its governance practices, leadership talent, ethical behaviour and environmental awareness. Over the years the role of human resource function has transformed from focusing on just ‘hatch, match and dispatch’ to becoming an active partner in business decisions and serving the interests of not just employees but also investors, shareholders and community at large. Increasingly the focal point of regulators is on the nomination and remuneration committee (NRC). This further emphasises the need of HR to act as not only the eyes and ears of the NRC but also as its heart to guide and influence on key people matters. To gain the trust of board members, HR professionals must parallel the vision of the CEO and develop a strong business acumen and customer-focused mindset. It also calls for the HR professionals to act as ‘Credible Activists’ in creating the right culture, candour and openness in engaging and partnering with the board/committee members and key stakeholders. In addition to the board and NRC, HR also needs to gain the confidence of the audit committee, corporate social responsibility (CSR) committee and its shareholders. The time perhaps has come to include chief human resource officer (CHRO) as a key management personnel in the organisation and ‘earn a seat at the board’. Hence it is vital for HR professionals to be future ready and develop their skills such that their contribution in the organisational growth is amplified.
Real-world experience of venetoclax with azacitidine for untreated patients with acute myeloid leukemia
Authors: Winters Amanda C. , Gutman Jonathan A. , Purev Enkhtsetseg , Nakic Molly , Tobin Jennifer , Chase Stephanie , Kaiser Jeff , Lyle Lindsey , Boggs Chelsey , Halsema Keri , Schowinsky Jeffrey T. , Rosser Julie , Ewalt Mark D. , Siegele Bradford , Rana Vishal , Schuster Steven , Abbott Diana , Stevens Brett M. , Jordan Craig T. , Smith Clayton , Pollyea Daniel A. 
Published: October 2019

Key Points
Responses and survival with venetoclax for “real-world” AML patients were promising but inferior to those treated in a clinical trial. Compared with induction, response rates are as high as would be predicted and venetoclax patients had a lower than expected early death rate.
Targeting chronic lymphocytic leukemia with N-methylated thrombospondin-1–derived peptides overcomes drug resistance
Authors: Pramil Elodie , Herbi Bastian Linda , Denèfle Thomas , Nemati Fariba , Xiao Malina , Lardé Eva , Maloum Karim , Roos-Weil Damien , Chapiro Elise , Le Garff-Tavernier Magali , Davi Frédéric , Decaudin Didier , Sarfati Marika , Nguyen-Khac Florence , Merle-Béral Hélène , Karoyan Philippe , Susin Santos A. 
Published: October 2019

Key PointsN-methylated thrombospondin-1 mimetic peptides selectively kill the leukemic CD5+ B cells, sparing mature and precursor nontumor cells. CD47 peptide triggering eliminates drug-resistant CLL cells by inducing an original form of cell death regulated by G proteins.
Properties of low-density cement-bonded composite panels manufactured from polystyrene and jute stick particles
Authors: Rana Md Nasim , Islam Md Nazrul , Nath Suresh Kumar , Das Atanu Kumar , Ashaduzzaman Md , Shams Md Iftekhar 
Published: October 2019

AbstractThis study was conducted to evaluate the properties of cement-bonded composite (CBC) manufactured using jute stick particles and expanded polystyrene (EPS) beads to reduce the density of CBC for mitigating the main limitation of CBC in its applications. The CBCs were manufactured by using cement, jute stick particle, EPS and jute fiber by cold pressing having the pressure of 5 MPa and pressing time of 24 h. CBCs were also manufactured by replacing the jute stick particles with EPS beads, the processing conditions remaining the same. There were at least 5 replications for each type of board. Waste jute fibers were added for improving the degenerated mechanical properties of CBC caused by the addition of EPS beads. Important physical properties, i.e., density, water absorption (WA) and thickness swelling (TS) and mechanical properties, i.e., modulus of elasticity (MOE) and modulus of rupture (MOR) of the manufactured CBCs were tested following the Malaysian Standards. Higher percentage of EPS beads significantly reduced the density of CBCs and the lowest density (0.91 ± 0.02 g/cm3) was found when the EPS beads replaced 30% jute stick particles. As expected, mechanical properties decreased with the gradual replacement of jute stick particles by EPS beads. However, the degraded mechanical properties significantly increased when waste jute fibers were added in the CBCs. Addition of EPS beads in CBCs reduced the density, which might increase the potentiality for the utilization of cement-bonded composites for various applications.
blaVIM- and blaOXA-mediated carbapenem resistance among Acinetobacter baumannii and Pseudomonas aeruginosa isolates from the Mulago hospital intensive care unit in Kampala, Uganda
Authors: Aruhomukama Dickson , Najjuka Christine F. , Kajumbula Henry , Okee Moses , Mboowa Gerald , Sserwadda Ivan , Mayanja Richard , Joloba Moses L. , Kateete David P. 
Published: October 2019

Abstract

Background
Between January 2015 and July 2017, we investigated the frequency of carbapenem resistant Acinetobacter baumannii (CRAB) and carbapenem resistant Pseudomonas aeruginosa (CRPA) at the Mulago Hospital intensive care unit (ICU) in Kampala, Uganda. Carbapenemase production and carbapenemase gene carriage among CRAB and CRPA were determined; mobility potential of carbapenemase genes via horizontal gene transfer processes was also studied.

Methods
Clinical specimens from 9269 patients were processed for isolation of CRAB and CRPA. Drug susceptibility testing was performed with the disk diffusion method. Carriage of carbapenemase genes and class 1 integrons was determined by PCR. Conjugation experiments that involved blaVIM positive CRAB/CRPA (donors) and sodium azide resistant Escherichia coli J53 (recipient) were performed.

Results
The 9269 specimens processed yielded 1077 and 488 isolates of Acinetobacter baumannii and Pseudomonas aeruginosa, respectively. Of these, 2.7% (29/1077) and 7.4% (36/488) were confirmed to be CRAB and CRPA respectively, but 46 were available for analysis (21 CRAB and 25 CRPA). Majority of specimens yielding CRAB and CRPA were from the ICU (78%) while 20 and 2% were from the ENT (Ear Nose & Throat) Department and the Burns Unit, respectively. Carbapenemase assays performed with the MHT assay showed that 40 and 33% of CRPA and CRAB isolates respectively, were carbapenemase producers. Also, 72 and 48% of CRPA and CRAB isolates respectively, were metallo-beta-lactamase producers. All the carbapenemase producing isolates were multidrug resistant but susceptible to colistin. blaVIM was the most prevalent carbapenemase gene, and it was detected in all CRAB and CRPA isolates while blaOXA-23 and blaOXA-24 were detected in 29 and 24% of CRAB isolates, respectively. Co-carriage of blaOXA-23 and blaOXA-24 occurred in 14% of CRAB isolates. Moreover, 63% of the study isolates carried class 1 integrons; of these 31% successfully transferred blaVIM to E. coli J53.

Conclusions
CRAB and CRPA prevalence at the Mulago Hospital ICU is relatively low but carbapenemase genes especially blaVIM and blaOXA-23 are prevalent among them. This requires strengthening of infection control practices to curb selection and transmission of these strains in the hospital.
Impact of metformin on the risk and treatment outcomes of tuberculosis in diabetics: a systematic review
Authors: Yu Xinyu , Li Ling , Xia Liangtao , Feng Xin , Chen Fan , Cao Shiyi , Wei Xiang 
Published: October 2019

Abstract

Background
Tuberculosis (TB) remains one of the infectious diseases with a leading cause of death among adults worldwide. Metformin, a first-line medication for the treatment of type 2 diabetes, may have potential for treating TB. The aims of the present systematic review were to evaluate the impact of metformin prescription on the risk of tuberculosis diseases, the risk of latent TB infection (LTBI) and treatment outcomes of tuberculosis among patients with diabetic mellitus.

Methods
Databases were searched through March 2019. Observational studies reporting the effect of metformin prescription on the risk and treatment outcomes of TB were included in the systematic review. We qualitatively analyzed results of included studies, and then pooled estimate effects with 95% confidence intervals (CIs) of different outcome using random-effect meta-analyses.

Results
This systematic review included 6980 cases from 12 observational studies. The meta-analysis suggested that metformin prescription could decrease the risk of TB among diabetics (pooled odds ratio [OR], 0.38; 95%CI, 0.21 to 0.66). Metformin prescription was not related to a lower risk of LTBI (OR, 0.73; 95%CI, 0.30 to 1.79) in patients with diabetes. Metformin medication during the anti-tuberculosis treatment is significantly associated with a smaller TB mortality (OR, 0.47; 95%CI, 0.27 to 0.83), and a higher probability of sputum culture conversion at 2 months of TB disease (OR, 2.72; 95%CI, 1.11 to 6.69) among patients with diabetes. The relapse of TB was not statistically reduced by metformin prescription (OR, 0.55; 95%CI, 0.04 to 8.25) in diabetics.

Conclusions
According to current observational evidence, metformin prescription significantly reduced the risk of TB in patients with diabetes mellitus. Treatment outcomes of TB disease could also be improved by the metformin medication among diabetics.
Uridine diphosphate glucuronosyl transferase 1A (UGT1A1) promoter polymorphism in young patients with sickle cell anaemia: report of the first cohort study from Nigeria
Authors: Olatunya Oladele Simeon , Albuquerque Dulcineia Martins , Akanbi Ganiyu Olusola , Aduayi Olufunso Simisola , Taiwo Adekunle Bamidele , Faboya Opeyemi Ayodeji , Kayode Tolorunju Segun , Leonardo Daniela Pinheiro , Adekile Adekunle , Costa Fernando Ferreira 
Published: October 2019

Abstract

Background
(TA) n repeat sequence (rs8175347) of UGT1A1 gene promoter polymorphism is associated with serum bilirubin levels and gallstones among different sickle cell anaemia (SCA) populations. There are no data on UGT1A1 polymorphisms and their impact on Nigerian SCA patients. In this study, we determined the distribution of the UGT1A1 (TA) n genotypes among a group of young Nigerian SCA patients and healthy controls. In addition, the influence of UGT1A1 (TA) n genotypes on the laboratory and clinical events among the patients was determined.

Methods
The distribution of the UGT1A1 (TA) n genotypes among 101 young Nigerian SCA patients and 64 normal appropriate controls were determined and studied. The UGT1A1 (TA) n genotypes were further classified into subgroups and used to differentiate the clinical events and laboratory parameters of the patients.

Results
Four (TA) n alleles:(TA)5, 6, 7, and 8 were found. These were associated with 10 genotypes: TA5/5, 5/6, 5/7, 5/8, 6/6, 6/7, 6/8, 7/7, 7/8, 8/8. The normal (wild-type)-(TA) 6/6), low- (TA) 7/7, 7/8, 8/8), intermediate- (TA) 5/7, 5/8, 6/7, 6/8), and high-activity (TA) 5/5, 5/6,) genotypes were found in 24.8, 24.8, 41.5, and 8.9% patients and 20.3, 15.6, 61, and 3.1% controls respectively. The general genotype distribution of the patients and control group were not significantly different. There were significant differences in serum bilirubin and lactate dehydrogenase (LDH) of the patients when differentiated by the UGT1A1 (TA) n genotypes (p<0.05). Asymptomatic gallstones were found in 5.9% of patients and were significantly of the low-activity genotypes sub-group 5 (20%) vs 1(1.3%) p = 0.0033. Although, bilirubin and fetal hemoglobin (HbF) of patients with gallstones were significantly different from those without gallstone, only the serum bilirubin was associated with UGT1A1 (TA) n genotypes on multivariate analysis (p < 0.0001).

Conclusion
This study highlights the contribution of UGT1A1 polymorphisms, a non-globin genetic factor, to the laboratory and clinical manifestations of young Nigerian SCA patients for the first time. It also shows that children with co-inheritance of low UGT1A1 (TA) n affinity genotypes may be at risk of gallstone, hence the need to follow them up.
Association of medication non-adherence with short-term allograft loss after the treatment of severe acute kidney transplant rejection
Authors: Al-Sheyyab Ahmed , Binari Laura , Shwetar Mohammed , Ramos Everly , Kapp Meghan E. , Bala Stefanie , Wilson Nikita , Forbes Rachel C. , Helderman J. Harold , Abdel-Kader Khaled , Concepcion Beatrice P. 
Published: October 2019

AbstractBackgroundMedication non-adherence is a risk factor for acute kidney transplant rejection. The association of non-adherence with short-term allograft loss in patients who develop acute rejection and are subsequently treated with maximal therapy is unknown.MethodsWe conducted a retrospective single center cohort study of adult patients who developed acute rejection from January 2003 to December 2017 and were treated with lymphocyte depletion. Clinicopathologic characteristics including adherence status were collected and descriptive statistics utilized to compare groups. The primary outcome was all-cause graft loss at 6 months after acute rejection treatment. A multivariable logistic regression quantified the association of non-adherence with the outcome.ResultsA total of 182 patients were included in the cohort, of whom 71 (39%) were non-adherent. Compared to adherent patients, non-adherent patients were younger (mean age 37y vs 42y), more likely to be female (51% vs 35%) and developed acute rejection later (median 2.3y vs 0.5y from transplant). There were no differences in estimated glomerular filtration rate or need for dialysis on presentation, Banff grade, or presence of antibody mediated rejection between the 2 groups. Overall, 48 (26%) patients lost their grafts at 6 months after acute rejection treatment. In adjusted analysis, non-adherence was associated with all-cause graft loss at 6 months after acute rejection treatment [OR 2.64 (95% CI 1.23–5.65,p = 0.012].ConclusionsAfter adjusting for common confounders, non-adherent patients were at increased risk for short-term allograft loss after a severe acute rejection despite lymphocyte depletion. This finding may aid clinicians in risk stratifying patients for poor short-term outcomes and treatment futility.
Developing nephrology services in low income countries: a case of Tanzania
Authors: Furia Francis F. , Shoo Jacqueline , Ruggajo Paschal J. , Kilonzo Kajiru , Basu Gopal , Yeates Karen , Varughese Santosh , Svarstad Einar , Kisanga Onesmo 
Published: October 2019

Abstract

Background
The burden of kidney diseases is reported to be higher in lower- and middle-income countries as compared to developed countries, and countries in sub-Saharan Africa are reported to be most affected. Health systems in most sub-Sahara African countries have limited capacity in the form of trained and skilled health care providers, diagnostic support, equipment and policies to provide nephrology services. Several initiatives have been implemented to support establishment of these services.

Methods
This is a situation analysis to examine the nephrology services in Tanzania. It was conducted by interviewing key personnel in institutions providing nephrology services aiming at describing available services and international collaborators supporting nephrology services.

Results
Tanzania is a low-income country in Sub-Saharan Africa with a population of more than 55 million that has seen remarkable improvement in the provision of nephrology services and these include increase in the number of nephrologists to 14 in 2018 from one in 2006, increase in number of dialysis units from one unit (0.03 unit per million) before 2007 to 28 units (0.5 units per million) in 2018 and improved diagnostic services with introduction of nephropathology services. Government of Tanzania has been providing kidney transplantation services by funding referral of donor and recipients abroad and has now introduced local transplantation services in two hospitals. There have been strong international collaborators who have supported nephrology services and establishment of nephrology training in Tanzania.

Conclusion
Tanzania has seen remarkable achievement in provision of nephrology services and provides an interesting model to be used in supporting nephrology services in low income countries.
Non-survivor patients with malignant middle cerebral artery infarction showed persistently high serum malondialdehyde levels
Authors: Lorente Leonardo , Martín María M. , Abreu-González Pedro , Sabatel Rafael , Ramos Luis , Argueso Mónica , Solé-Violán Jordi , Cáceres Juan J. , Jiménez Alejandro , García-Marín Victor 
Published: October 2019

Abstract

Objective
Previously there have been found higher circulating malondialdehyde levels during the first week of ischemic stroke in patients with worst neurological functional outcome, and at moment of ischemic stroke in non-survivor patients. Thus, the aim of our study was to determine the potential role of serum malondialdehyde levels during the first week of a severe cerebral infarction to mortality prediction.

Methods
This study was observational, prospective, and multicenter. We included patients with a severe malignant middle cerebral artery infarction (MMCAI) defined as patients with computed tomography showing acute infarction in more than of 50% of the territory and Glasgow Coma Scale (GCS) lower than 9. We determined serum concentrations of malondialdehyde on days 1, 4 and 8 of MMCAI.

Results
Serum malondialdehyde concentrations at days 1 (p < 0.001), 4 (p < 0.001), and 8 (p = 0.001) of MMCAI in non-survivor patients (n = 34) were higher than in survivor patients (n = 34). ROC curve analyses showed that serum malondialdehyde concentrations at days 1, 4, and 8 of MMCAI had an AUC (95% CI) to predict 30-day mortality of 0.77 (0.65–0.86; p < 0.001), 0.82 (0.69–0.91; p < 0.001) and 0.84 (0.70–0.93; p < 0.001) respectively.

Conclusions
The new findings of our study were that serum malondialdehyde levels during the first week of MMCAI could be used as biomarkers to mortality prediction.
Acute clouding of a trifocal intraocular lens with spontaneous resolution: a case report
Authors: Zhang Tao , Li Shaowei , Liu Chang , Zhao Ruihua , Chang Chenghe , Han Na 
Published: October 2019

Abstract

Background
Opacification of hydrophobic and hydrophilic intraocular lenses (IOLs) has been reported. Herein, we report a case of spontaneous resolution of opacification following acute clouding of a trifocal IOL, which consisted of hydrophilic acrylic material (25%) with hydrophobic surface properties, occurring in a cold region in the winter season.

Case presentation
A young adult with bilateral radiation cataract underwent phacoemulsification using a femtosecond laser and implantation of a trifocal IOL. The trifocal IOL was delivered to the operating theatre 30 min before the surgery. The outside temperature was approximately − 7 °C. The IOL package was warmed using a radiator at approximately 35 °C for 15 min. After the optical region was implanted in the eye, cloudiness was observed, which persisted throughout the operation. Complete clearing of the IOL was apparent after three postoperative hours.

Conclusion
In this case, rapid opacification and clearing of the IOL suggested an acute and transient process. IOLs should be stored and shipped at a constant temperature, and sudden temperature fluctuations should be avoided, especially in the colder seasons.
General practice referral of ‘at risk’ populations to community leisure services: applying the RE-AIM framework to evaluate the impact of a community-based physical activity programme for inactive adults with long-term conditions
Authors: Bird E. L. , Biddle M. S. Y. , Powell J. E. 
Published: October 2019

Abstract

Background
In the UK a high proportion of adults with long-term conditions do not engage in regular physical activity. General practice (GP) referral to community-based physical activity is one strategy that has gained traction in recent years. However, evidence for the real-world effectiveness and translation of such programmes is limited. This study aimed to evaluate the individual and organisational impacts of the ‘CLICK into Activity’ programme - GP referral of inactive adults living with (or at risk of) long-term conditions to community-based physical activity.

Methods
A mixed methods evaluation using the RE-AIM framework was conducted with data obtained from a range of sources: follow-up questionnaires, qualitative interviews, and programme-related documentation, including programme cost data. Triangulation methods were used to analyse data, with findings synthesised across each dimension of the RE-AIM framework.

Results
A total of 602 individuals were referred to CLICK into Activity physical activity sessions. Of those referred, 326 individuals participated in at least one session; the programme therefore reached 30.2% of the 1080 recruitment target. A range of individual-, social-, and environmental-level factors contributed to initial physical activity participation. Positive changes over time in physical activity and other outcomes assessed were observed among participants. Programme adoption at GP surgeries was successful, but the GP referral process was not consistently implemented across sites. Physical activity sessions were successfully implemented, with programme deliverers and group-based delivery identified as having an influential effect on programme outcomes. Changes to physical activity session content were made in response to participant feedback. CLICK into Activity cost £175,000 over 3 years, with an average cost per person attending at least one programme session of £535.

Conclusions
Despite not reaching its recruitment target, CLICK into Activity was successfully adopted. Positive outcomes were associated with participation, although low 6- and 12-month follow-up response rates limit understanding of longer-term programme effects. Contextual and individual factors, which may facilitate successful implementation with the target population, were identified. Findings highlight strategies to be explored in future development and implementation of GP referral to community-based physical activity programmes targeting inactive adults living with (or at risk of) long-term conditions.