bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictive factors of rapid linear renal progression and mortality in patients with chronic kidney disease
Authors: Ali Ibrahim , Chinnadurai Rajkumar , Ibrahim Sara T. , Green Darren , Kalra Philip 
Published: July 2020

Abstract
Background Risk factors predictive of rapid linear chronic kidney disease (CKD) progression and its associations with end-stage renal disease (ESRD) and mortality requires further exploration, particularly as patients with linear eGFR trajectory represent a clear paradigm for understanding true CKD progression. Methods A linear regression slope was applied to all outpatient estimated glomerular filtration rate (eGFR) values for patients in the Salford Kidney Study who had ≥2years follow-up, ≥4 eGFR values and baseline CKD stages 3a-4. An eGFR slope (ΔeGFR) of ≤-4ml/min/1.73m2/yr defined rapid progressors, whereas -0.5 to +0.5ml/min/1.73m2/yr defined stable patients. Binary logistic regression was utilised to explore variables associated with rapid progression and Cox proportional hazards model to determine predictors for mortality prior to ESRD. Results There were 157 rapid progressors (median ΔeGFR -5.93ml/min/1.73m2/yr) and 179 stable patients (median ΔeGFR -0.03ml/min/1.73m2/yr). Over 5 years, rapid progressors had an annual rate of mortality or ESRD of 47 per 100 patients compared with 6 per 100 stable patients. Factors associated with rapid progression included younger age, female gender, higher diastolic pressure, higher total cholesterol:high density lipoprotein ratio, lower albumin, lower haemoglobin and a urine protein:creatinine ratio of >50g/mol. The latter three factors were also predictive of mortality prior to ESRD, along with older age, smoking, peripheral vascular disease and heart failure. Conclusions There is a heterogenous interplay of risk factors associated with rapid linear CKD progression and mortality in patients with CKD. Furthermore, rapid progressors have high rates of adverse outcomes and require close specialist monitoring.
Parathyroid hormone (1-34) promotes the effects of 3D printed scaffold-seeded bone marrow mesenchymal stem cells on meniscus regeneration
Authors: Zhao Wen , Zou Tong , Cui Hao , Lv Yangou , Gao Dengke , Ruan Chenmei , Zhang Xia , Zhang Yihua 
Published: July 2020

Abstract
Background: Cell-based tissue engineering represents a promising management for meniscus repair and regeneration. The present study aimed to investigate whether the injection of parathyroid hormone (PTH) (1-34) could promote the regeneration and chondroprotection of 3D printed scaffold seeded with bone marrow mesenchymal stem cells (BMSCs) in a canine total meniscal meniscectomy model. Methods: 3D printed poly(e-caprolactone) scaffold seeded with BMSCs was cultured in vitro, and the effects of in vitro culture time on cell growth and matrix synthesis of the BMSCs-scaffold construct were evaluated by microscopic observation and cartilage matrix content detection at 7, 14, 21, and 28 days. After that, the tissue-engineered meniscus based on BMSCs–scaffold cultured for the appropriate culture time was selected for in vivo implantation. Sixteen dogs were randomly divided into four groups: PTH + BMSCs–scaffold, BMSCs–scaffold, total meniscectomy, and sham operation. The regeneration of the implanted tissue and the degeneration of articular cartilage were assessed by gross, histological, and immunohistochemical analysis at 12 weeks postoperatively.Results: In vitro study showed that the glycosaminoglycan (GAG)/DNA ratio and the expression of collagen type II (Col2) were significantly higher on day 21 as compared to the other time points. In vivo study showed that, compared with the BMSCs–scaffold group, the PTH + BMSCs–scaffold group showed better regeneration of the implanted tissue and greater similarity to native meniscus concerning gross appearance, cells composition, and cartilage extracellular matrix deposition. This group also showed less expression of terminal differentiation markers of BMSC chondrogenesis as well as lower cartilage degeneration with less damage on the knee cartilage surface, higher expression of Col2, and lower expression of degeneration markers.Conclusions: Our results demonstrated that PTH (1-34) promotes the regenerative and chondroprotective effects of the BMSCs–3D printed meniscal scaffold in a canine model, and thus their combination could be a promising strategy for meniscus tissue engineering.
Association of hemoglobin glycation index and its interaction with obesity /family history of hypertension on hypertension risk: a community-based cross-sectional survey
Authors: Mi Jing , Song Jian , Zhao Yingying , wu xue-sen 
Published: July 2020

Abstract
Background: Hemoglobin glycation index (HGI) is considered to be a convenient measurable indicator to assess the inter-individual variation of HbA1c. In the present study, we tested the relationship between HGI and risk of hypertension, and further explored the possible interacting influences of HGI with other such factors on hypertension risk among Chinese individuals.Methods : The eligible subjects were chosen from a community-based cross-sectional survey in China. We collected relevant data and clinical indicators for each participant. HGI was calculated as “measured HbA1c-predicted HbA1c” and divided into four categories according to quartile. The following indicators were used to assess interactive effects：(1) relative excess risk due to interaction (RERI); (2) attributable proportion due to interaction (AP); and (3) synergy index (SI). Statistical analysis was performed using R software.Results: Specifically, 1777 eligible participants were selected in this cross-sectional survey. There were 433 subjects who were identified to have hypertension (24.4%). A significant increase in the prevalence of hypertension from Q1 to Q4 of HGI was observed (P<0.001). Multivariable logistic model demonstrated that subjects at the highest HGI group had a substantially increased risk of being hypertensive than subjects in the first quartile of HGI, as indicated by the OR value of 1.87(95%CI: 1.26-2.78). Moreover, a significant interaction between family history of hypertension and HGI on hypertension risk was detected (RERI:1.36,95%CI:0.11-2.63; AP: 0.43, 95%CI:0.17-0.69; and SI:2.68, 95% CI:1.10-6.48). The interactive effect between HGI and abdominal obesity was also found to be significant, as estimated by the value of RERI (1.04, 95%CI:0.24-1.85), AP (0.33, 95% CI: 0.11-0.56) and SI (1.96, 95%CI:1.01-3.79). However, in the analysis of the interaction between HGI and general obesity, only the AP value (0.28, 95%CI: 0.01-0.54) was observed to be significant.Conclusion: High HGI was independently associated with the risk of hypertension. Moreover, HGI significantly shared interactions with obesity and family history of hypertension that influenced the risk of hypertension.
Establishing Cross-Systems Collaborations for Implementation: Protocol for a Longitudinal Mixed Methods Study
Authors: Bunger Alicia C. , Chuang Emmeline , Girth Amanda , Lancaster Kathryn E. , Gadel Fawn , Himmeger Marla , Saldana Lisa , Powell Byron J. , Aarons Gregory A 
Published: July 2020

Abstract
Background: Cross-system interventions can help integrate services across different service delivery systems but require organizations to establish strong collaborative relationships for implementation. Contingency theory suggests that the effectiveness of different collaborative strategies (i.e. specific ways organizations align operations and services) varies by context. This paper describes a study of different strategies for fostering collaboration between child welfare and substance abuse treatment agencies and the conditions under which they are effective for implementation. We also describe the development and piloting of the Collaborating Across Systems for Program Implementation (CASPI) tool—a decision-making guide intended to help researchers and organizational leaders identify and use appropriate collaborative strategies for their context. Methods/Design: This multisite longitudinal, mixed methods study, leverages a naturally occurring implementation initiative -- in up to 17 Ohio counties -- to implement Ohio START (Sobriety Treatment and Reducing Trauma). START is a child welfare model that requires strong collaboration with local substance use treatment organizations to promote integrated services. During the first two years, we will identify collaborative strategies associated with improved START implementation (penetration and fidelity) and service delivery outcomes (timeliness), given system, and organizational features. We will conduct a convergent mixed methods study drawing on worker surveys, agency documents, administrative data, formal partner agreements, and group interviews. Data will be integrated and analyzed using Qualitative Comparative Analysis (QCA). To develop the CASPI, an expert panel comprised of implementation experts, and community stakeholders will convene to synthesize our findings and develop contents (including a decision tree). During the final year of the study, we will assess the acceptability, appropriateness, and feasibility of the CASPI in a randomized vignette experiment, and a pilot-test with 3 child welfare agencies that have not yet implemented START. Discussion: Our results will lay the groundwork for a larger controlled trial that will test the CASPI’s effectiveness for supporting effective and efficient implementation of cross-system interventions like START. The CASPI is expected to help leaders and researchers select and use collaboration strategies tailored to their context and be applicable in a wide range of settings including rural communities. Our work also advances system-level implementation strategies.Trial Registration: NCT03931005, Registered April 29, 2019, https://clinicaltrials.gov/ct2/show/NCT03931005
Linking the westernised oropharyngeal microbiome to the immune response in Chinese immigrants
Authors: Guo Jing , Zhang Xiaoping , Saiganesh Aarti , Peacock Christopher , Chen Shu , Dykes Gary , Hales Belinda , Souëf Peter Le , Zhang Guicheng(Brad) 
Published: July 2020

Abstract
Background: Human microbiota plays a fundamental role in modulating the immune response. Western environment and lifestyle are envisaged to alter the human microbiota with a new microbiome profile established in Chinese immigrants, which fails to prime the immune system. Here, we investigated how differences in composition of oropharyngeal microbiome may contribute to patterns of interaction between the microbiome and immune system in Chinese immigrants living in Australia.Methods: We recruited 44 adult Chinese immigrants: newly-arrived (n=22, living in Australia <6 months) and long-term Chinese immigrants (n=22, living in Australia >5 years), with age and gender matched. Oropharyngeal swabs, serum and whole blood were collected. The 16s ribosomal RNA gene from the swabs was sequenced on the Illumina MiSeq platform. Innate immune responses were determined by 23 Toll-like receptors (TLR) pathway cytokines, while adaptive immune responses were determined by IgG-associated response to specific microbial/viral pathogens.Results: The relative abundance of the genus Leptotrichia was higher in long-term immigrants as compared to that in newly-arrived Chinese immigrants, while the genus Deinococcus was significantly lower in long-term Chinese immigrants. The genera uncultured Lachnospiraceae, Erysipelotrichaceae UCG-007, Veillonella, and Actinomycetales_ambiguous taxa were negatively correlated with cytokine IL-6 in long-term Chinese immigrants (rho range: -0.46 ~ -0.73). With respect to adaptive immunity, several microbial taxa were significantly associated with IgG1 responsiveness to microbial antigens in long-term immigrants, while a significant correlation with IgG1 responsiveness to viral antigens was detected in newly-arrived immigrants. Conclusions: The composition of the oropharyngeal microbiome varies between newly-arrived and long-term Chinese immigrants. Specific microbial taxa are significantly associated with immunological parameters but with different association patterns between newly-arrived and long-term Chinese immigrants.
Determinants of Low APGAR score in Newborns Delivered at Lemlem Karl General Hospital, Northern Ethiopia, 2018: A Case Control Study
Authors: Gebremedhin Mussie Mulugeta , Gebremichael Mengistu Welday , Gebremichael Berhane Gebreegizabiher , Reda Mihrete-ab Mehari , Hailu Tesfay Adhena , Gebremeskel Gebrekiros Aregawi , Tlaye Kenean Getaneh , Meikena Henok Kumsa , Yimer Nigus Bililign 
Published: July 2020

Abstract
BACKGROUND: The Apgar score is a method to quickly summarize the health of newborn children. It establishes a simple and clear classification of newborns, which could be used to predict survival and to compare methods of resuscitation and perinatal experience across hospitals and obstetric practices. Low Apgar score is associated with various immediate and long-term adverse health outcomes of newborns. Hence; in order to decrease the risk/complications, identifying the determinant factors of low Apgar is crucial to act on the modifiable risk factors. This study is aimed to investigate the determinant factors of a low Apgar score in newborn children.METHOD: The study was conducted in Lemelem Karl general hospital; northern Ethiopia. An institutional-based unmatched, case-control study was implemented. Data were retrieved from medical charts of 662 newborns’ mothers who gave birth in the hospital from Sep 2014 to Sep 2017. Among these, 221 of them were cases (charts of mothers whose newborns’ fifth minute Apgar score was <7) and 441 of them were controls (charts of mothers whose newborns’ Apgar score was 7 and above). Data was collected using a pretested and structured checklist using systematic sampling and data was entered & analyzed using SPSS version 20. Binary and multivariable logistic regression was done to determine the association and statistical significance was declared at P-value of ≤0.05. RESULTS: This study revealed that low Apgar score was significantly associated with antepartum hemorrhage [Adjusted odss ratio (AOR) 3.509; 95% confidence interval (CI) 1.526-8.067), P= 0.003], pregnancy-induced hypertensive disorders [AOR 2.69; 95% CI (1.351-5.357), P= 0.005], prolonged second stage of labor [AOR 2.63; 95% CI (1.399-4.944), P= 0.003], Cesarean delivery [AOR 2.005; 95%CI (1.223-3.287), P= 0.006],meconium-stained liquor [AOR 6.955; 95% CI (3.721-13.001), P<0.001], and low birth weight [AOR 4.38; 95% CI (2.216-8.657), P<0.001].CONCLUSION: Result from this study showed a remarkable linkage of low Apgar score with antepartum hemorrhage, pregnancy-induced hypertensive disorders, meconium-stained liquor, and low birth weight. Therefore, meticulous antenatal care and labour management service are recommended to prevent low Apgar score and the concomitant neonatal death.
Sedentary Behaviour Among General Practitioners: A Systematic Review
Authors: Mayne Richard S. , Hart Nigel D. , Heron Neil 
Published: July 2020

Abstract
BackgroundSedentary behaviour is when someone is awake, in a sitting, lying or reclining posture and is an independent risk factor for multiple causes of morbidity and mortality. A dose-response relationship has been demonstrated, whereby increasing sedentary time corresponds with increasing mortality rate. This study aimed to identify current levels of sedentary behaviour among General Practitioners (GPs), by examining and synthesising how sedentary behaviour has been defined and measured in the primary care literature.MethodsA systematic review was conducted to identify studies relating to levels of sedentary behaviour among GPs. Searches were performed using Medline®, Embase®, PscycINFO and Web of Science, from inception of databases until January 2020. Articles were assessed for quality and bias, with extractionof relevant data.ResultsThe search criteria returned 1707 studies. 34 full texts were reviewed and 2 studies included in the final review. Both were cross-sectional surveys using self-reported estimation of sedentary time within the International Physical Activity Questionnaire (IPAQ).Keohane et al. examined GP trainees and GP trainers in Ireland. 60% reported spending in excess of 7 hours sitting each day, 24% between 4 and 7 hours, and 16% less than or equal to 4 hours. Suija et al. examined female GPs in Estonia. The mean reported daily sitting time was 6 hours and 36 minutes, with 56% sitting for over 6 hours per day. Both studies were of low methodological quality and high risk of bias.ConclusionThere is a paucity of research examining current levels of sedentary behaviour among GPs. Objective data is needed to determine GPs’ current levels of sedentary behaviour, in order to identify ways of reducing this, if possible, as well as facilitating better GP education for patients regarding reducing sedentary behaviour.
iTRAQ-based Comparative Proteomic Analysis of Differences in the Protein Profiles of Stems and Leaves From Two Alfalfa Genotypes
Authors: Sun Hao , Yu Jie , Zhang Fan , Kang Junmei , Li Mingna , Wang Zhen , Liu Wenwen , Zhang Jiaju , Yang Qingchuan , Long Ruicai 
Published: July 2020

Abstract
Background:To explore the molecular regulatory mechanisms of early stem and leaf development, proteomic analysis was performed on leaves and stems of F genotype alfalfa, with thin stems and small leaves, and M genotype alfalfa, with thick stems and large leaves.Results:Based on fold-change thresholds of >1.20 or <0.83 (p<0.05), a large number of proteins were identified as being differentially enriched between the M and F genotypes: 249 downregulated and 139 upregulated in stems and 164 downregulated and 134 upregulated in leaves. The differentially expressed proteins in stems were mainly involved in amino acid biosynthesis, phenylpropanoid biosynthesis, carbon fixation, and phenylalanine metabolism. The differentially expressed proteins in leaves were mainly involved in porphyrin and chlorophyll metabolism, phenylpropanoid biosynthesis, starch and sucrose metabolism, and carbon fixation in photosynthetic organisms. Six differentially enriched proteins were mapped onto the porphyrin and chlorophyll metabolism pathway in leaves of the M genotype, including five upregulated proteins involved in chlorophyll biosynthesis and one downregulated protein involved in chlorophyll degradation. Eleven differentially enriched proteins were mapped onto the phenylpropanoid pathway in stems of the M genotype, including two upregulated proteins and nine downregulated proteins.Conclusion:Enhanced chlorophyll synthesis and decreased lignin synthesis provided a reasonable explanation for the larger leaves and lower levels of stem lignification in M genotype alfalfa. This proteomic study aimed to classify the functions of differentially enriched proteins and to provide information on the molecular regulatory networks involved in stem and leaf development.
Physical Exercise for Seniors with Dementia: Potential Benefits Perceived by Formal Caregivers
Authors: Sampaio Arnaldina , Marques-Aleixo I , Seabra A , Mota J , Carvalho J 
Published: July 2020

Abstract
Background: The social and economic impact of dementia urge for calls to develop accessible and sustainable care for seniors with dementia (SwD). Physical exercise has been seen as a beneficial non- pharmacological therapy in the prevention and management of Dementia, and possible benefits may not impact only the participants, but also indirectly their Caregivers. Thus, this study aimed to analyze the effects of an exercise intervention on functional capacity, neuropsychiatry symptoms and quality of life (QoL) of institutionalized older adults with dementia, perceived by their formal caregivers. Methods: Sixty-four institutionalized older adults (from both genders, aged 65–93 yrs. old), clinically diagnosed with dementia, were divided into two groups: control group (CG, n= 26) and exercise group (EG, 6-month supervised multicomponent exercise intervention n= 38). Nine caregivers (female, aged 28-47 yrs old) from nine different nursing homes, reported about care receiver’s functional capacity (Katz index), quality of life (QoL-AD) and behavioural and psychological symptoms (BPSD) in dementia (NPI) before and after 6 months of an exercise intervention (aerobic, muscular resistance, flexibility and postural exercises). Results: A two-way ANOVA, with repeated measures, revealed significant group and time interactions on Total Katz index and NPI-score. The CG's performance functional capacity and total BPSD score worsen over time while in EG maintains these values after the exercise intervention. Moreover, formal caregiver´s distress triggered by apathy, disinhibition and aberrant motor behavior increased in CG while after 6 months of an exercise intervention no alterations were seen regarding these distress causes in EG. No significant main effects were observed for total QoL-AD.Conclusions: Overall results show that after the exercise intervention, SwD from the EG, was capable of preserving the functional capacity and neuropsychiatric symptoms were attenuate, contributing to a lower load of distress for the caregivers.Trial registration: clinicaltrials.gov, NCT04095962. Registered 19 September 2019, https://clinicaltrials.gov/ct2/show/NCT04095962
Association of Shared Decision Making with Inpatient Satisfaction: A Cross-Sectional Study
Authors: Luo Huiwen , Liu Guohua , Lu Jing , Xue Di 
Published: July 2020

Abstract
Background: We assess inpatient perceived shared decision making (SDM) and test the association of SDM with inpatient satisfaction in public tertiary hospitals in Shanghai, China.Methods: A cross-sectional survey was conducted with 2585 inpatients in 47 public tertiary hospitals in Shanghai in July and August 2018. We assessed SDM overall and 4 aspects of SDM and tested the factors that influenced SDM and the association of SDM with patient satisfaction (patient satisfaction with physician services, medical expenses, outcomes and inpatient care overall), adopting multilevel mixed linear regression models.Results: The positive response rate (PRR) for SDM overall among the inpatients of public tertiary hospitals in Shanghai was high (95.30%), while the PRR for “My physician informed me of different treatment alternatives” was relatively low (88.63%). In addition, inpatients who underwent surgery during admission had higher PRRs and adjusted PRRs for SDM overall than those who did not undergo surgery (96.01% vs. 95.00% and 94.15% vs. 92.99%, respectively). Based on three-level mixed regression models, the study showed that inpatients with positive responses for SDM overall had higher adjusted satisfaction rates (SRs) for physician services, medical expenses, outcomes and inpatient care overall (98.89%, 91.73%, 98.44% and 97.34%, respectively) than those without positive responses (88.91%, 72.44%, 88.66% and 87.86%, respectively). The greatest differences in adjusted SRs between inpatients with or without positive responses for SDM were found for inpatient satisfaction with medical expenses and informed consent in SDM.Conclusions: Inpatient PRRs for SDM in public tertiary hospitals in Shanghai are high overall but are lower for information about alternatives. SDM can be affected by the SDM preference of both patients and physicians, medical condition, physician workload and professional requirements. Patient satisfaction with physician services, medical expenses, treatment outcomes and inpatient care overall can be improved through good SDM.