bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moderately High Tenofovir Diphosphate in Dried Blood Spots Indicates Drug Resistance in Viremic Persons Living with HIV
Authors: Yager Jenna Lynn , Coyle Ryan Patrick , Coleman Stacey Summer , Ellison Lucas , Zheng Jia-Hua , Bushman Lane , Gardner Edward Michael , Morrow Mary , MaWhinney Samantha , Anderson Peter L. , Justice Kiser Jennifer , Castillo-Mancilla Jose Ramon 
Published: November 2019

Background: Tenofovir diphosphate (TFV-DP) in dried blood spots (DBS) is a strong predictor of viral suppression in persons living with HIV (PLWH). Its association with antiretroviral therapy (ART) resistance remains unknown. Methods: Blood was collected in PLWH receiving TDF-containing ART enrolled in a 48-week study. Tenofovir diphosphate/emtricitabine triphosphate (FTC-TP) were quantified from the same sample as HIV viral load (VL) in PLWH who developed resistance within ≤12 months. Results: The study enrolled 807 participants, of whom 10 had new resistance-conferring mutations. Among these, median (interquartile range) TFV-DP and HIV VL were 956 (407-1510) fmol/punch and 9840 (513-68,200) copies/mL, respectively. Five had quantifiable FTC-TP in DBS. Based on previously published data, a TFV-DP concentration of 956 fmol/punch would have an adjusted odds of virologic suppression of 32.8 versus TFV-DP <350 fmol/punch, making viremia of ∼10,000 copies/mL an unexpected outcome. Conclusion: Moderately high TFV-DP in DBS (700-1249 fmol/punch) in PLWH with high viremia suggest that antiretroviral drug resistance might be present.
A review of language regression in autism spectrum disorder and the role of language theories: Towards explanation
Authors: Clarke Kaitlyn A 
Published: November 2019

Background & aims The purpose of this study is to summarize characteristics of language regression—a phenomenon most commonly associated with autism spectrum disorder, outline language theories of early word learning, and use them to propose theoretical bases to language regression. Method Using a systematic review of the current literature in language regression and a purposive sampling of language theories, hypotheses for the cause of language regression are discussed. Results The following hypotheses were developed based on the reviewed theories of word learning: (a) Initial first words were not true words, but instead were protowords; (b) fast mapped forms never progressed to truly learned words; (c) initial first words were echoed productions of heard words; (d) the described regression is actually a maintenance of previous developmental levels with increasing chronological age. Conclusions It is possible that individuals with autism spectrum disorder are not “losing” words, but instead are not progressing in their ability to learn and use new words. Early word learning in typically developing children is seemingly similar to early development in individuals with autism spectrum disorder; however, the ability to expand from early “intermediate words” to expansive vocabularies, word combinations, and morphological variations is impeded. Clinical implications for evaluation of word “loss” and treatments are discussed.
Human ectoenzyme-expressing ILC3: immunosuppressive innate cells that are depleted in graft-versus-host disease
Authors: Hazenberg Mette D. , Haverkate Nienke J. E. , van Lier Yannouck F. , Spits Hergen , Krabbendam Lisette , Bemelman Willem A. , Buskens Christianne J. , Blom Bianca , Shikhagaie Medya M. 
Published: November 2019

Key PointsEcto+ ILC neutralize extracellular ATP and suppress autologous T cells via the production of adenosine. Human acute GVHD is associated with a depletion of tissue ecto+ ILC3 and a reduction in serum adenosine levels.
Sptlc1 is essential for myeloid differentiation and hematopoietic homeostasis
Authors: Parthibane Velayoudame , Acharya Diwash , Srideshikan Sargur Madabushi , Lin Jing , Myerscough Dru G. , Abimannan Thiruvaimozhi , Vijaykrishna Nagampalli , Blankenberg Daniel , Bondada Lavanya , Klarmann Kimberly D. , Fox Stephen D. , Andresson Thorkell , Tessarollo Lino , Acharya Usha , Keller Jonathan R. , Acharya Jairaj K. 
Published: November 2019

Key PointsSptlc1 is essential for myeloid differentiation during hematopoiesis; ER stress prevents myeloid development in Sptlc1 mutant mice. Accumulation of fatty acid promotes ER stress in Sptlc1 mutant myeloid progenitors.
Using a machine learning algorithm to predict acute graft-versus-host disease following allogeneic transplantation
Authors: Arai Yasuyuki , Kondo Tadakazu , Fuse Kyoko , Shibasaki Yasuhiko , Masuko Masayoshi , Sugita Junichi , Teshima Takanori , Uchida Naoyuki , Fukuda Takahiro , Kakihana Kazuhiko , Ozawa Yukiyasu , Eto Tetsuya , Tanaka Masatsugu , Ikegame Kazuhiro , Mori Takehiko , Iwato Koji , Ichinohe Tatsuo , Kanda Yoshinobu , Atsuta Yoshiko 
Published: November 2019

Key Points
The machine learning algorithms produced clinically reasonable and robust risk stratification scores for aGVHD. Predicting scores for aGVHD also demonstrated the link between risk of development of aGVHD and overall survival after HSCT.
Effectiveness of digital health using the transtheoretical model to prevent or delay type 2 diabetes in impaired glucose tolerance patients: protocol for a randomized control trial
Authors: Alzeidan Rasmieh , Shata Zeinab , Hassounah Marwah Mazen , Baghdadi Leena Rashad , Hersi Ahmad , Fayed Amel , Kashour Tarek , Elmorshedy Hala 
Published: November 2019

AbstractBackgroundThere is high prevalence of prediabetes and type 2 diabetes mellitus (T2DM) in Saudi Arabia that is still increasing. Early diagnosis of prediabetes, and immediate, effective intervention is yet unestablished. Conventional health promotion approaches are used to educate prediabetic patients. Behavior modification is very effective in prediabetics to delay T2DM. Thus, the main objective of this study is to examine the effect of the new behavioral model, the Transtheoretical Model short messages (text 4 change) to modify lifestyle to prevent or delay the onset of T2DM, through promotion of a healthy diet and increased physical activity, in impaired glucose tolerance patients. Another objective is to estimate the impact of this model on markers of cardiovascular and metabolic risks as T2DM is one of the modifiable risk factors to prevent cardiovascular diseases.MethodsThis is a randomized controlled trial. One thousand and sixteen, eligible Saudi adults will be recruited from the Heart Health Promotion study (HHP), which was conducted at the King Saud University from July 2013 to April 2014. These adults were at a higher risk of developing T2DM within 2–3 years. The research team’s database has a contact list and they will recruit individuals over 6–8 weeks. All participants will be randomized at a 1:1 ratio into two groups, receive group education about lifestyle modifications and written information about diet and physical activity. Text 4 change SMS texts will be sent only to the intervention group. All participants will be assessed at baseline, 6, 12, 18, 24, 30, and 36 months for behavioral change using a World Health Organization (WHO) STEPS questionnaire and for glycated hemoglobin, biochemical and anthropometric measurements using standard methods.DiscussionThis new approach for promoting the importance of behavior modification in prediabetics is expected to delay and/or prevent the development of T2DM in Saudi Arabia, subsequently reducing the risk of cardiovascular morbidity and mortality too. Results from this study will promote an innovative and high-tech way to decrease the burden of cardiovascular diseases in Saudi Arabia.Trial registrationInternational Standard Randomized Control Trial, registration numberISRCTN10857643. Registered 4 June, 2018.
Determinants of efficiency growth of county-level public hospitals-evidence from Chongqing, China
Authors: Liu Jing , He Beibei , Xu Xiaolan , Zhou Leming , Li Jiang , Wang Gongru , Chen Yingyao 
Published: November 2019

Abstract
Background
The reform of county-level public hospitals is a breakthrough in the new era of healthcare reform in China and has attracted considerable attention since 2012. Continuous and efficient operations of hospital are primary concerns of this reform. To ensure the effectiveness of county-based intervention reform measures in Chongqing, it is significant to understand how hospital and county characteristics are associated with county-level public hospital efficiency due to significant development differences between counties. This study identifies the trajectory of hospital efficiency over time and determinants. It will also provide preliminary references for advancing reform.

Methods
This study employs data from the Chongqing Regional Health Information Platform, Chongqing Health and Family Planning Statistical Yearbook, and Chongqing Statistical Yearbook for 2012–2016. A three-level growth model is used to estimate the efficiency growth trajectories within the contexts of hospitals and counties.

Results
The intra-hospital level factors that affect the initial efficiency include government financial assistance, daily charge per bed, total assets turnover, number of hospital healthcare technicians, and medical costs per 100-yuan medical income. Inter-hospital variance is explained by hospital type. Inter-county level factors affecting the growth rate include the number of healthcare technicians per 1000 people and population density of the county. The interaction effect of the number of hospital healthcare technicians, hospital type, and number of healthcare technicians per 1000 people on hospital efficiency growth is significant.

Conclusions
This study identifies determinants that contribute to efficiency changes in public county-hospitals over time by using a three-level growth model. The differences in efficiency are associated with intra-hospital, inter-hospital, and inter-county characteristics in Chongqing, which provides useful insight into government decision-making and the progress of reform. The stability and reasonable increase in the number of healthcare technicians in a county are the key factors that improve the efficiency. Further reform should focus on maternal and child healthcare hospitals for increasing investment and implementing government compensation.
Current state of knowledge of basic life support in health professionals of the largest city in Pakistan: a cross-sectional study
Authors: Irfan Babar , Zahid Ibrahim , Khan Muhammad Sharjeel , Khan Omar Abdul Aziz , Zaidi Shayan , Awan Safia , Bilal Sobia , Irfan Omar 
Published: November 2019

AbstractBackgroundBasic Life Support (BLS) is the recognition of sudden cardiac arrest and activation of the emergency response system, followed by resuscitation, and rapid defibrillation. According to WHO, Pakistan has one of the highest mortality rates from accidental deaths therefore assessment and comparison of BLS knowledge in health professionals is crucial. We thereby aim to assess and compare the knowledge of BLS in doctors, dentists and nurses.MethodsA multi-centric cross-sectional survey was conducted in Karachi at different institutions belonging to the private as well as government sector from January to March 2018. We used a structured questionnaire which was adapted from pretested questionnaires that have been used previously in similar studies. Descriptive statistics were analyzed using SPSS v22.0, where adequate knowledge was taken as a score of at least 50%.P < 0.05 was considered as significant. Logistic regression was used to identify the factors affecting the knowledge regarding BLS in health care professionals.ResultsThe responders consisted of 140 doctors, nurses and dentists each. Only one individual (dentist) received a full score of 100%. In total, 58.3% of the population had inadequate knowledge. Average scores of doctors, dentists and nurses were 53.5, 43.3 and 38.4% respectively. Doctors, participants with prior training in BLS and those with 6 to 10 years after graduation were found to be a significant predictor of adequate knowledge, on multivariate analysis.ConclusionEven though knowledge of BLS in doctors is better than that of dentists and nurses, overall knowledge of health care professionals is extremely poor. Present study highlights the need for a structured training of BLS for health care workers.
Factors of patient satisfaction in adult outpatient departments of private wing and regular services in public hospitals of Addis Ababa, Ethiopia: a comparative cross-sectional study
Authors: Geberu Demiss Mulatu , Biks Gashaw Andargie , Gebremedhin Tsegaye , Mekonnen Tesfaye Hambisa 
Published: November 2019

Abstract
Background
Knowing the factors for patient satisfaction is an important and direct indicator of quality of health care which is essential for providers to fill their gaps. Although few studies have been conducted on patient satisfaction in Ethiopia; but there is limited evidence for comparing patient satisfaction and associated factors in the public and private wing of the health services. Thus, this study aimed to investigate factors of patient satisfaction in adult outpatient departments in the private wing and regular services at public hospitals of Addis Ababa, Ethiopia.

Methods
A comparative institution based cross-sectional study was conducted from March to April 2018. A total of 955 systematically selected patients were interviewed by using an interviewer-administered structured questionnaire. Binary logistic regression analysis was performed. In the multivariable logistic regression analysis p value < 0.05 and adjusted odd ratio (AOR) with 95% confidence interval (CI) were used to identify the associated factors.

Results
The overall patient satisfaction was 89.3% (95% CI: 87.2–91.2). At the regular and private wings of outpatient departments it was 88.3% (95% CI: 85.4–91.2) and 90.4% (95% CI: 87.6–93), respectively. At regular service OPD, patient satisfaction was affected by female sex (AOR: 7.78; 95% CI: 2.89–20.93), long waiting time (AOR: 0.22; 95% CI: 0.07–0.73), information on the prevention of recurrent illnesses (AOR: 14.16; 95% CI: 4.58–43.83), and information on drug use and side effects (AOR: 0.22; 95% CI: 0.08–0.63). In private wing, it was affected by being in the age group of 38 to 47 years (AOR: 22.1; 95% CI: 2.39–203.6), attended elementary school (AOR: 4.69; 95% CI: 1.04–21.26), availability of drugs (AOR: 0.14; 95% CI: 0.04–0.58), and the accessibility of latrines (AOR: 6.56; 95% CI: 1.16–37.11).

Conclusions
Patient satisfaction at the private wing and regular adult OPDs’ of public hospitals had no statistically significant difference. Female sex and information on the prevention of recurrent illnesses were factors positively affected patient satisfaction at regular services, whereas at private wing OPDs’ age, attended elementary school, and accessibility of latrines were factors that positively affected patient satisfaction.
Primary pulmonary lymphoepithelioma-like carcinoma: a rare type of lung cancer with a favorable outcome in comparison to squamous carcinoma
Authors: Chen Bojiang , Chen Xuping , Zhou Ping , Yang Lan , Ren Jing , Yang Xiaodong , Li Weimin 
Published: November 2019

AbstractBackgroundPrimary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare tumor and often misdiagnosed as squamous carcinoma. In the current study, clinical characteristics and outcome of primary pulmonary LELC were systematically compared with pulmonary squamous carcinoma.MethodsForty-two cases of primary pulmonary LELC and 134 squamous carcinomas were enrolled retrospectively. Characteristic and prognosis difference between the two groups was compared, and the independent prognostic factor for pulmonary LELC was identified as well.ResultsIn comparison to squamous carcinoma, pulmonary LELC was more common in women with a younger median age and less smokers. LELC seemed to be smaller in diameter on computed tomography (CT) scans than squamous carcinoma, with scarce spiculation and vascular convergence signs. Epstein-Bar virus-encoded RNA (EBER) by in-situ hybridization was detected in 33 LELC cases, among whom 27 ones were positive in serum EBV-DNA examination. LELC patients presented a much longer median progression-free survival (PFS) than squamous carcinoma. Positive serum EBV-DNA, distant lymph node invasion, advanced clinical stage and receiving radiotherapy were correlated with the shorter PFS in LELC patients. However, only positive serum EBV-DNA was the independent PFS predictor.ConclusionPulmonary LELC looks like distinct from squamous carcinoma. Middle-aged women and nonsmokers are comparatively predominated. CT features of pulmonary LELC are relatively less-malignant. Correspondently, the progression of pulmonary LELC is seemingly favorable than squamous carcinoma and the positive serum EBV-DNA appears to be the predictor of PFS.
Expression profile analysis identifies IER3 to predict overall survival and promote lymph node metastasis in tongue cancer
Authors: Xiao Fang , Dai Yinhua , Hu Yujiao , Lu Mengmeng , Dai Qun 
Published: November 2019

Abstract
Background
Lymph node metastasis is one of the most important factors affecting the prognosis of tongue cancer, and the molecular mechanism regulating lymph node metastasis of tongue cancer is poorly known.

Methods
The gene expression dataset GSE2280 and The Cancer Genome Atlas (TCGA) tongue cancer dataset were downloaded. R software was used to identify the differentially expressed hallmark gene sets and individual genes between metastatic lymph node tissues and primary tongue cancer tissues, and the Kaplan–Meier method was used to evaluate the association with overall survival. The screening and validation of functional genes was performed using western blot, q-PCR, CCK-8, migration and invasion assays, and lymphangiogenesis was examined by using a tube formation assay.

Results
Thirteen common hallmark gene sets were found based on Gene Set Variation Analysis (GSVA) and then subjected to differential gene expression analysis, by which 76 deregulated genes were found. Gene coexpression network analysis and survival analysis further confirmed that IER3 was the key gene associated with the prognosis and lymph node metastasis of tongue cancer patients. Knockdown of IER3 with siRNA inhibited the proliferation, colony formation, migration and invasion of Tca-8113 cells in vitro and it also inhibited the secretion and expression of VEGF-C in these cells. The culture supernatant of Tca-8113 cells could promote lymphangiogenesis and migration of lymphatic endothelial cells, and knockdown of IER3 in Tca-8113 cells suppressed these processes.

Conclusion
Our study demonstrated that IER3 plays important roles in lymphangiogenesis regulation and prognosis in tongue cancer and might be a potential therapeutic target.
Enhanced osteopontin splicing regulated by RUNX2 is HDAC-dependent and induces invasive phenotypes in NSCLC cells
Authors: Huang Jing , Chang Siyuan , Lu Yabin , Wang Jing , Si Yang , Zhang Lijian , Cheng Shan , Jiang Wen G. 
Published: November 2019

Abstract
Background
Increased cell mobility is a signature when tumor cells undergo epithelial-to-mesenchymal transition. TGF-β is a key stimulating factor to promote the transcription of a variety of downstream genes to accelerate cancer progression and metastasis, including osteopontin (OPN) which exists in several functional forms as different splicing variants. In non-small cell lung cancer cells, although increased total OPN expression was observed under various EMT conditions, the exact constitution and the underlining mechanism towards the generation of such OPN splicing isoforms was poorly understood.

Methods
We investigated the possible mechanisms of osteopontin splicing variant and its role in EMT and cancer metastasis using NSCLC cell line and cell and molecular biology techniques.

Results
In this study, we determined that OPNc, an exon 4 excluded shorter form of Opn gene products, appeared to be more potent to promote cell invasion. The expression of OPNc was selectively increased to higher abundance during EMT following TGF-β induction. The switching from OPNa to OPNc could be enhanced by RUNX2 (a transcription factor that recognizes the Opn gene promoter) overexpression, but appeared to be strictly in a HDAC dependent manner in A549 cells. The results suggested the increase of minor splicing variant of OPNc required both (1) the enhanced transcription from its coding gene driven by specific transcription factors; and (2) the simultaneous modulation or fluctuation of the coupled splicing process that depends to selective classed of epigenetic regulators, predominately HDAC family members.

Conclusion
Our study not only emphasized the importance of splicing variant for its role in EMT and cancer metastasis, but also helped to understand the possible mechanisms of the epigenetic controls for defining the levels and kinetic of gene splicing isoforms and their generations.
The potential of pregnant women as a sentinel population for malaria surveillance
Authors: Brunner Nina C. , Chacky Frank , Mandike Renata , Mohamed Ally , Runge Manuela , Thawer Sumaiyya G. , Ross Amanda , Vounatsou Penelope , Lengeler Christian , Molteni Fabrizio , Hetzel Manuel W. 
Published: November 2019

Abstract
Background
With increasing spatial heterogeneity of malaria transmission and a shift of the disease burden towards older children and adults, pregnant women attending antenatal care (ANC) have been proposed as a pragmatic sentinel population for malaria surveillance. However, the representativeness of routine ANC malaria test-positivity and its relationship with prevalence in other population subgroups are yet to be investigated.

Methods
Monthly ANC malaria test-positivity data from all Tanzanian health facilities for January 2014 to May 2016 was compared to prevalence data from the School Malaria Parasitaemia Survey 2015, the Malaria Indicator Survey (MIS) 2015/16, the Malaria Atlas Project 2015, and a Bayesian model fitted to MIS data. Linear regression was used to describe the difference between malaria test-positivity in pregnant women and respective comparison groups as a function of ANC test-positivity and potential covariates.

Results
The relationship between ANC test-positivity and survey prevalence in children follows spatially and biologically meaningful patterns. However, the uncertainty of the relationship was substantial, particularly in areas with high or perennial transmission. In comparison, modelled data estimated higher prevalence in children at low transmission intensities and lower prevalence at higher transmission intensities.

Conclusions
Pregnant women attending ANC are a pragmatic sentinel population to assess heterogeneity and trends in malaria prevalence in Tanzania. Yet, since ANC malaria test-positivity cannot be used to directly predict the prevalence in other population subgroups, complementary community-level measurements remain highly relevant.