bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and cultural appropriateness of psychosocial interventions for paediatric burn patients and caregivers: A systematic review.
Authors: Williams Hayley , Hunter Kate , Clapham Kathleen , Ryder Courtney , Kimble Roy , Griffin Bronwyn 
Published: February 2020

Abstract
Background: Paediatric burns are highly painful and traumatising injuries that are overrepresented among Aboriginal and Torres Strait Islander people. Paediatric burn patients’ pain remains poorly managed by pharmacological interventions, leading to increased anxiety, distress and trauma in patients and their caregivers. Non-pharmacological psychosocial interventions have been suggested as effective in reducing pain and psychological morbidities among paediatric burn patients and their caregivers; however, the degree of effectiveness and appropriateness for Aboriginal and Torres Strait Islander people is unclear. Methods: A non-date restricted systematic review was conducted through four databases. Studies published in English assessing psychosocial interventions on paediatric burn patients’ physical pain along with theirs and/or their caregiver’s anxiety, distress, or trauma symptoms were identified and included in this review. Included studies were assessed for their ability to reduce one of the outcomes of interests and for their reflection of Aboriginal and Torres Strait Islander peoples’ perspectives of health. Results: Of the 3,178 identified references, 17 were eligible. These include distraction based techniques (n=8), hypnosis/familiar imagery (n=2), therapeutic approaches (n=4), and patient preparation/procedural control (n=3). Distraction techniques incorporating procedural preparation reduced pain, while discharge preparation and increased ‘patient control’ reduced patient and caregiver anxiety; and internet based Cognitive Behaviour Therapy reduced short-term but not long-term post-traumatic stress symptoms. No interventions reflected Aboriginal and Torres Strait Islander peoples’ perspectives of health; and few targeted caregivers and focused on reducing their symptoms. Conclusions: The development and assessment of psychosocial interventions to appropriately meet the needs of Aboriginal and Torres Strait Islander paediatric burn patients is required.
iTRAQ-based quantitative proteomic of tobacco (Nicotiana tabacum L.) identified major host proteins involved in photosystems throughout the aging process
Authors: He Conglian , Sun Shubin , Tang Yun , He Chenggang , Li Pengfei , Xu Tianyang , Zhao Gaokun , Zou Congming , Lin Zhonglong , Chen Yi 
Published: February 2020

Abstract
Background Leaf senescence is one of the most common manifestations in plant senescence and has an important effect on photosynthesis. However, the molecular regulation of leaf senescence in response to photosynthesis is still poorly understood. To gain insight into the molecular mechanisms underpinning tobacco, we integrated photosynthesis, organelle ultrastructural, and proteomic analyses of tobacco leaves during senescence. Results The photosynthetic rate, intercellular CO 2 concentration, tomatal conductance, transpiration rate showed a downward trend and the stability of organelle decreased with the increasing of tobacco leaves age. iTRAQ and PRM verification were used to analyze the proteins expressed in different periods based on photosynthetic physiology and ultramicroscopic observation. A total of 321, 319, 223 diﬀerentially expressed proteins (DEPs) were identified from over maturity (OM) vs immature (IM), OM vs well maturity (WM) and WM vs IM, respectively, including 122/199, 124/195 and 125/98 up/down proteins, respectively. KEGG analysis of DEPs was significantly enriched in metabolic pathways, biosynthesis of secondary metabolites, microbial metabolism in diverse environments, starch and sucrose metabolism. In addition, down-regulated proteins were also involved in metabolic pathways such as carbon sequestration of photosynthetic organisms and photosynthesis. Furthermore, PRM analysis indicated that iTRAQ is highly reliable. Conclusions Our study provided important technical references for screening photosynthetic host proteins of tobacco leaf senescence and revealing the molecular mechanism during the senescence of tobacco leaves.
Implementation of a Quality Improvement Strategy to Increase Outpatient Kidney Transplant Referrals
Authors: Farouk Samira , Atallah Sarah , Campbell Kirk N , Vassalotti Joseph A , Uribarri Jaime 
Published: February 2020

Abstract
Background: Kidney transplantation remains the optimal therapy for patients with end stage kidney disease (ESKD), though a small fraction of patients on dialysis are on organ waitlists. An important barrier to preemptive kidney transplantation and successful waitlisting is timely referral to a kidney transplant center. We implemented a quality improvement strategy to improve outpatient kidney transplant referrals in a single center academic outpatient nephrology clinic.
Methods: Over a 3 month period (July 1 - September 30, 2016), we assessed the baseline kidney transplantation referral rate at our outpatient nephrology clinic for patients 18 - 75 years old with an estimated glomerular filtration rate (eGFR) of less than 20 mL/min/1.73m 2 (2 values over 90 days apart). Charts were manually reviewed by two reviewers to look for kidney transplant referrals and documentation of discussions about kidney transplantation. We then performed a root cause analysis to explore potential barriers to kidney transplantation. Our intervention began on July 1, 2017 and included the implementation of a column in the electronic medical record (EMR) which displayed the patient's last eGFR as part of the clinic schedule. Physicians were given a document listing their patients to be seen that day with an eGFR of < 20 mL/min/1.73m 2 .
Results: 54 unique patients with eGFR ≤ 20 ml/min/1.73 m 2 were identified who were seen in the Clinic between July 1, 2016 and September 30, 2016. 29.6% (16) eligible patients were referred for kidney transplantation evaluation. 69.5% (37) of these patients were not referred for kidney transplant evaluation. 46.3% (25) did not have documentation regarding kidney transplant in the EMR. Following the intervention, 66 unique patients met criteria for eligibility for kidney transplant evaluation. Kidney transplant referrals increased to 60.6% (p < 0.001).
Conclusions: Our pilot implementation study of a strategy to improve outpatient kidney transplant referrals showed that a free, simple, scalable intervention can significantly improve kidney transplant referrals in the outpatient setting Next steps include further study of the impact of early referral to kidney transplant centers on preemptive and living donor kidney transplantation as well as successful waitlisting.
Innovative use of data sources: A Cross-sectional study of Data Linkage Practices across European Countries
Authors: Haneef Romana , Delnord Marie , Vernay Michel , Bauchet Emmanuelle , Gaidelyte Rita , Oyen Herman Van , Or Zeynep , Pérez-Gómez Beatriz , Palmieri Luigi , Achterberg Peter , Tijhuis Mariken , Zaletel Metka , Mathis-Edenhofer Stefan , Májek Ondřej , Haaheim Håkon , Tolonen Hanna , Gallay Anne 
Published: February 2020

Abstract
Background The availability of data generated from different sources is increasing with the possibility to link these data sources together. However, linked administrative data can be complex to use and may require advanced expertise and skills in statistical analysis. The main objectives of this study were to describe the current use of data linkage at the individual level and the artificial intelligence (AI) in routine public health activities, and to identify the related health outcome and intervention indicators and determinants of health for non-communicable diseases. Method We performed a survey across European countries to explore the current practices applied by national institutes of public health and health information and statistics for innovative use of data sources (i.e., the use of data linkage and/or the AI). Results The use of data linkage and the AI at national institutes of public health and health information and statistics in Europe varies. The majority of European countries use data linkage in routine by applying a deterministic method or a combination of two types of linkages (i.e., deterministic & probabilistic) for public health surveillance and research purposes. The use of AI to estimate health indicators is not frequent at national institutes of public health and health information and statistics. Using linked data, 46 health outcome indicators related to seven health conditions, 34 indicators related to determinants and 23 to health interventions were estimated in routine. Complex data regulation laws, lack of human resources, skills and problems with data governance, were reported by European countries as obstacles to link different data sources in routine for public health surveillance and research. Conclusions Our results highlight that the majority of European countries have integrated data linkage in routine public health activities but a few use the AI. A sustainable national health information system and a robust data governance framework allowing to link different data sources are essential to support evidence-informed health policy development process. Building analytical capacity and awareness of the added value of data linkage in national institutes is necessary for improving the utilization of linked data in order to improve the monitoring of public health activities.
Differences in huperzine A yield when different amino acids were added for in vitro thallus culture of Huperzia serrata (Thunb)Trev and gene expression analysis
Authors: YuXuan Ye , YiSheng Tu , Xiao Yu , Qian Huang , Huihui Yuan 
Published: February 2020

Abstract
Background：the secondary metabolite of H. serrata, huperzine A (HupA) can be used in the treatment of Alzheimer’s disease and can improve the cognitive function of patients. The use of in vitro culture and secondary metabolism engineering to obtain secondary metabolites is the most effective method to solve a lack of HupA sources and protect H. serrata as a natural resource. This study was based on the in vitro thallus culture conditions for H. serrate, and different concentrations of alkaloid precursor amino acids (lysine, aspartic acid, and trytophan) were added. We found that addition of different amino acids to thallus cultures had different effects on HupA accumulation. Transcriptome sequencing was carried out on thalli with significant differences in the HupA content due to treatment with different amino acids for differential analysis, and real-time fluorescence quantitative PCR was used for validation to examine the functional genes involved in exogenous amino acid regulation of HupA accumulation in thalli.Results：We found that addition of 1 mmol·L−1 aspartic acid (D) solution promoted HupA accumulation, at a level of 84.05 μg·g−1 dry weight (DW), which was 1.29-fold that of the control (CK: 65.15 μg·g−1 DW). Addition of 4 mmol·L−1 lysine (K) solution significantly inhibited HupA accumulation, at a level of 48.42 μg·g−1 DW, which was 0.75-fold that of the control.Transcriptome sequencing-bioinformatics alignment analysis of the aforementioned materials showed that in GO alignment analysis, functions were annotated for 16,258 unigenes. From the statistical analysis of the DEGs of the three groups, we found that there were 1046, 782, and 1586 DEGs for CK vs D, CK vs K, and D vs K, respectively, with D vs K having the most DEGs. DEGs that were enriched in KEGG metabolic pathways and validated by fluorescence quantitative PCR included PANK1, GDH2, APX, HA1, ND4L, and COX1. Conclusions：The above results showed that HupA content differences in D and K treatments were directly proportional to DEGs. Gene expression differences are the molecular basis that affects HupA accumulation in in vitro thallus cultures. PANK1 and GDH2 encode enzymes that synthesize an alkaloid intermediate.
A randomized pilot study to evaluate graft-first versus fistula-first vascular access strategy in older patients with advanced kidney disease: results of a feasibility study Pilot and Feasibility Studies
Authors: Murea Mariana , Geary Randolph L , Houston Denise K , Edwards Matthew S , Robinson Todd W , Davis Ross P , Hurie Justin B , Williams Timothy K , Velazquez-Ramirez Gabriela , Bagwell Benjamin , Tuttle Audrey B , Moossavi Shahriar , Rocco Michael V , Freedman Barry I , Williamson Jeff D , Divers Jasmin 
Published: February 2020

Abstract
Background. Although older adults encompass 40% of patients with advanced chronic kidney disease (CKD), it remains unclear which long-term hemodialysis (HD) vascular access type, arteriovenous (AV) fistula (AVF) or AV graft (AVG), is optimal with respect to effectiveness and patient satisfaction. Clinical outcomes based on the initial AV access type have not been evaluated in randomized controlled trials. This pilot study tested the feasibility of randomizing older adults with CKD to initial AVF versus AVG vascular access surgery. Methods: Patients 65 years or older with pre-dialysis CKD or incident end-stage kidney disease (ESKD) and no prior AV vascular access intervention were randomized in a 1:1 ratio to undergo surgical placement of either AVF-first or AVG-first after providing informed consent. Trial feasibility was evaluated as (i) recruitment of ≥70% of eligible participants, (ii) ≥50% to 70% of participants undergo placement of index AV access within 90 to 180 days of enrollment, respectively, (iii) ≥80% adherence to study-related assessments, and (iv) ≥70% of participants who underwent index AV access placement will have a follow-up duration of ≥12 months after index surgery date. Results: Between September 2018 and October 2019, 81% (44/54) of eligible participants consented and were enrolled in the study; 11 had pre-dialysis CKD and 33 ESKD. After randomization, 100% (21/21) assigned to AVF-first surgery and 78% (18/23) assigned to AVG-first surgery underwent index AV access placement within a median (1st, 3rd quartile) of 5.0 (1.0, 14.0) days and 13.0 (5.0, 44.3) days, respectively, after referral to vascular surgery. The completion rates for study-specific assessments ranged between 40.0 and 88.6%. At median follow-up of 215.0 days, 5 participants expired, 7 completed 12 months of follow-up, and 29 are actively being followed. Assessments of grip strength, functional independence and vascular access satisfaction were completed by >85% of patients who reached pre-specified post-operative assessment time point. Conclusions: Results from this study reveal it is feasible to enroll and randomize older adults with CKD to one of two different HD vascular access placement surgeries. The study can progress with minimum protocol adjustments to a multisite clinical trial.
Surgical treatment strategies for extra-pelvic intravenous leiomyomatosis
Authors: Li Hua , Xu Jing , Lin Qiaowei , Zhang Yong , Zhao Yun , Tong Hanxing , Tu Ruiqin , Xu Demin , Wang Chunsheng , Lu Weiqi 
Published: February 2020

Abstract
Background: Extra-pelvic intravenous leiomyomatosis (IVL) extending into inferior vena cava (IVC) or heart (i.e. intracardiac leiomyomatosis, ICL) is an extremely rare benign disease. No consensus has been reached on the optimal surgical strategy. The aim of this study is to introduce four types of one-stage surgical strategies including less invasive options and a guideline to select patient-specific strategy for this disease.Methods: Twenty-four patients of extra-pelvic IVLs receiving one-stage resections at the Zhongshan Hospital from July 2011 to November 2019 were reviewed retrospectively. Base on the initial experiences of the indiscriminate choices of tumor thrombectomies through sterno-laparotomy under cardiopulmonary bypass (CPB) in 6 ICLs, an anatomy-based guideline for four types of surgical strategies was developed and applied for the next 18 patients. Results: Under the direction of guideline, tumor thrombectomies through single laparotomy were applied without CPB in 2 ICLs and 4 IVLs confined in IVC, or with CPB in 7 ICLs. Guideline-directed double-incisions with CPB were applied in only 5 ICLs, including 1 receiving mini-thoracotomy and 4 receiving sternotomy because of tumor adherences with right atriums in 2 and with pulmonary arteries in 2. All 24 patients accomplished one-stage panhysterectomy, bilateral adnexectomy and complete resections of intracaval and intracardiac tumors. For residual pelvic intravenous tumors in 19 patients, 17 received macroscopically complete resections while the other 2 failed because of high risk of hemorrhage. Intraoperative blood losses, operation time and hospitalization expense in the single-laparotomy non-CPB group were significantly lesser than the other groups. In CPB groups, inpatient stay and hospitalization expense in the single-incision group were significantly lesser than the double-incisions group. All patients were alive and free of recurrences during a mean follow-up of 35.4±27.2 months (range, 1–100 months). The pelvic tumor residues in 2 patients remained unchanged for 51 and 52 months since operation, respectively. Conclusions: For various extra-pelvic IVLs, the 4 types of surgical strategies including less invasive options are feasible, providing these are selected by a guideline base on the tumor extension and morphology. The proposed guideline is believed to accommodate more patients receiving less invasive surgery without compromising the curative effect.
The effect of a 5-year hand hygiene initiative, consisting of the 5 Components, the 5 Steps, and the Hand Hygiene Self-Assessment Framework, an interrupted time-series study.
Authors: Suzuki Yumi , Morino Motoko , Morita Ichizo , Yamamoto Shigenori 
Published: February 2020

Abstract
Background:A World Health Organization (WHO) guideline-based multimodal hand hygiene (HH) initiative consisting of the 5 Components, the 5 Steps, and the HH Self-Assessment Framework (HHSAF) was introduced hospital-wide to a nonteaching Japanese hospital for 5 years. The objective of this study was to assess the effect of this initiative in terms of changes in alcohol-based hand rub (ABHR) consumption and HHSAF score.Methods:The consumption of monthly hospital-wide ABHR was calculated as ml per patient day (PD). The change in ABHR consumption was analysed by an interrupted time series analysis, with a preintervention period of 36 months and an intervention period of 60 months. The correlation between annual ABHR consumption and the HHSAF score was estimated using Pearson’s correlation coefficients.Results:A statistically significant increase was found in the monthly ABHR consumption (change in slope: + 0.479 ml/PD, p < 0.01). Annual ABHR consumption was strongly correlated with the annual HHSAF score (r = 0.971, p < 0.01).Conclusions:A 5-year, 5-step, WHO-based HH initiative significantly increased ABHR consumption. Our study suggested that the HHSAF score can be a good process measure to improve HH in a single facility, as ABHR consumption increased with the HHSAF score.
Implementing a Combined Infection Prevention and Control with Antimicrobial Stewardship Joint Programme to Prevent Caesarean Section Surgical Site Infections and Antimicrobial Resistance: a Tanzanian Tertiary Hospital Experience
Authors: Gentilotti Elisa , De Nardo Pasquale , Nguhuni Boniface , Piscini Alessandro , Damian Caroline , Vairo Francesco , Chaula Zainab , Mencarini Paola , Torokaa Peter , Zumla Alimuddin , Nicastri Emanuele , Ippolito Giuseppe 
Published: February 2020

Abstract
Background Surgical site infections after caesarean section are a leading cause of morbidity and mortality, especially in Low and Middle Income Countries. We hypothesized that combining infection prevention and control with an antimicrobial stewardship programme would decrease the rate of post- caesarean section surgical site infections at the Obstetrics & Gynaecology Department of a Tanzanian tertiary hospital. Methods A first survey was conducted to assess the burden of post-CS SSI. Thereafter, an intervention was introduced including: 1. formal on-the-job training on infection prevention and control; 2. evidence-based education on antimicrobial resistance and good antimicrobial prescribing practice. A second survey was performed to determine the impact of the intervention. The primary outcome of the study was information on the prevalence of post-caesarean section surgical site infections whereas the secondary outcome was the identification of the determinant factors of surgical site infections before/after the intervention and overall. The microbiological characteristics and patterns of antimicrobial resistance were also established. Results A total of 464 and 573 women were surveyed before and after the intervention, respectively. After the intervention, the antibiotic prophylaxis was administered to a significantly higher number of patients (98% vs 2%, p <0.001), caesarean sections were performed by more qualified operators (40% vs 28%, p =0.001), with higher rates of Pfannenstiel skin incisions (29% vs 18%, p <0.001) and of absorbable continuous intradermic sutures (30% vs 19%, p <0.001). The total number of post-caesarean section surgical site infections was 225 (48%) in the pre-intervention group and 95 (17%) in the post intervention group ( p <0.001). A low prevalence of gram-positive isolates and of methicillin-resistant Staphylococus aureus was detected in the post-intervention survey. Conclusions Further research is needed to better understand the potential of a hospital-based multidisciplinary approach to surgical site infections and antimicrobial resistance prevention in resource-constrained settings.
Up-regulation of sarcoplasmic reticulum function protects skeletal muscle against cytoplasmic calcium overload during hibernation in ground squirrels
Authors: Wang Zhe , Zhang Jie , Ma XiuFeng , Chang Hui , Peng Xin , Xu ShenHui , Wang HuiPing , Gao Yunfang 
Published: February 2020

Abstract
We investigated the potential mechanism of the (sarcoplasmic reticulum) SR in maintenance of calcium (Ca2+) homeostasis of slow-twitch muscle (soleus, SOL), fast-twitch muscle (extensor digitorum longus, EDL) and mixed muscle (gastrocnemius, GAS) in hibernating ground squirrels (Spermophilus dauricus). Results showed that cytosolic and SR Ca2+ concentrations in distinct skeletal muscle fibers increased and decreased during late torpor, respectively, but both returned to summer-active levels during early torpor. Ryanodine receptor1 (RyR1) and sarco/endoplasmic reticulum Ca2+ ATPase isoform 1 (SERCA1) protein expression increased during hibernation. Up-regulation factors of SERCA activity: Phospholamban phosphorylation increased in the SOL and GAS, β-adrenergic receptor-2 protein expression increased in the GAS, and calmodulin kinase-2 phosphorylation increased in the SOL during hibernation. Down-regulation factors of SERCA activity: Sarcolipin and SERCA1 co-localization decreased in the EDL and GAS. These data suggest that SERCA activity in skeletal muscle fibers increases likely during hibernation. FKBP12/calsequestrin1 (negative regulatory factors of RyR1) and RyR1 co-localization decreased in the GAS, indicating that the RyR1 channel opening probability increased during hibernation. Dihydropyridine receptors protein expression and its co-localization with RYR1 decreased during hibernation prompts that the contractility of skeletal muscle was weakened. Protein expression of Ca2+-binding proteins calsequestrin1 and calmodulin increased indicating that the ability of intracellular free calcium binding increased during whole hibernation period. These findings confirm that the release, uptake, and binding of free Ca2+ in the SR were enhanced in different skeletal muscles during hibernation. Up-regulation of muscular sarcoplasmic reticulum function protects skeletal muscle fibers against cytoplasmic calcium overload during hibernation in ground squirrels.