bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Theory of Planned Behavior-Based Education in Adopting the Urinary Tract Infection Prevention Behavior in Pregnant Women: A Randomized Controlled Trial
Authors: Moradpour Sheida , Shahnazi Hossein , Hassanzadeh Akbar 
Published: August 2020

Abstract
Background: Urinary tract infection (UTI) is a common infection in women, and it is more likely to occur during pregnancy due to mechanical and hormonal changes in pregnant women. Urinary tract infections can cause many complications for both mother and fetus. Given the roles of health behavior in the prevention of urinary tract infections and the nature of the theory of planned behavior-based education in behavioral change, the present study aimed to determine the effect of the theory of planned behavior-based education in teaching the urinary tract infection prevention behavior in pregnant women.Methods: The present study was a randomized controlled trial in which 100 pregnant women, who visited the comprehensive health service centers of Zarinshahr City, were randomly divided into two groups, intervention and control, containing 50 individuals. The data collection tools were a urine test and a questionnaire designed based on the theory of planned behavior. Five education sessions were held based on the constructs of the theory of planned behavior. We analyzed the effect of education review and data using independent t-tests, Mann-Whitney test, chi-square test, and repeated measures ANOVA (analysis of variance) one and three months after the educational intervention.Results: After implementing the educational intervention, the mean scores of knowledge and constructs of the theory of planned behavior significantly increased in the intervention group over time (P <0.001), while the difference was not significant in the control group over time. After the educational intervention, the incidence of urinary tract infections was 4.3 % in the intervention group and 21.3% in the control group.Conclusion: Given the positive effect of education based on the theory of planned behavior in changing the pregnant mothers' behavior, the theory can be used as a suitable intervention framework for implementing the educational programs to prevent urinary tract infections.Trial registration: Name: Iranian Registry of Clinical Trials. Registration number: IRCT20170214032575N1. Registration date: 2019-12-12 [retrospectively registered].
Investigation of the association between family members’ satisfaction with patient care in the Intensive Care Unit, spirituality and resilience
Authors: Papathanasiou Iokasti , Tzenetidis Vasileios , Nikolentzos Athanasios , Sarafis Pavlos , Constantinou Maria , Malliarou Maria 
Published: August 2020

Abstract
Background: The admission of a patient in the Intensive Care Unit (ICU) is a traumatic experience for the patient himself and his support group which mainly consists of his family members. The psychological burden of the family members increases, as they experience negative feelings. The implementation of family-centered care helps family members to satisfy their needs, eliminates psychological impact and improves patient’s health outcomes. The aim of this study is to investigate the family members’ satisfaction with patient care in the ICU, their perceived stress, spirituality and resilience.Methods: One hundred and four family members of patients admitted in the ICU for greater than 48 hours between January and March 2019 were enrolled. The questionnaire included the following psychometric tools: the Family Satisfaction with care in the Intensive Care Unit scale, the Perceived Stress Scale, the Connor – Davidson Resilience Scale, the Daily Spiritual Experience Scale and the Acute Physiology and Chronic Health Evaluation Scale.Results: The mean value of satisfaction with care was 88,9%, of satisfaction with decision making was 79,1% and of the overall satisfaction was 85%. Resilience was associated with perceived stress (p<0,001) and with spirituality (p= 0,019). Spirituality was associated with satisfaction with care (p= 0.013), with satisfaction with decision making (p= 0,018) and with the overall satisfaction (p= 0,003).Conclusions: Family members were highly satisfied. Those with higher spirituality score were more satisfied and those who were more resilient had less perceived stress. These data suggest that interventions should aim at increasing resilience and providing spiritual assistance to family members of ICU treated patients.
The Association Between Mechanical Power and Mortality in Ventilated Patients with Pneumonia
Authors: Wu Huang-Pin , Chu Chien-Ming , Chuang Li-Pang , Lin Shih-Wei , Leu Shaw-Woei , Chang Ko-Wei , Liu Pi-Hua , Kao Kuo-Chin 
Published: August 2020

Abstract
Background: Recent studies reported that mechanical power (MP) has been associated with increased mortality in patients with acute respiratory distress syndrome (ARDS). We aimed to investigate the association between 28-day mortality and MP in patients with severe pneumonia. Methods: In total, 313 patients with severe pneumonia were enrolled. Serial MP was recorded daily for either 21 days or until ventilator support was no longer required. The associations between all variables and 28-day mortality were analyzed using binary logistic regression analyses. Results: The ARDS group (106 patients) demonstrated lower age, higher Acute Physiology and Chronic Health Evaluation II score, lower history of diabetes mellitus, high incidences of shock and jaundice, higher MP and driving pressure on Day 1, and higher death within 28 days than the non-ARDS group. Regression analysis revealed that MP was an independent factor associated with 28-day mortality (odds ratio, 1.041; 95% confidence interval, 1.013-1.071). MP persisted high in non-survivors and low in survivors among the ARDS group, the non-ARDS group and all patients.Conclusions: MP was associated with the 28-day mortality in ventilated patients with severe pneumonia both in the ARDS and non-ARDS groups. MP had better predicted value for 28-day mortality than driving pressure.
Genetic selection for growth drives differences in intestinal microbiota composition and parasite disease resistance in gilthead sea bream
Authors: Piazzon M. Carla , Naya-Català Fernando , Perera Erick , Palenzuela Oswaldo , Sitjà-Bobadilla Ariadna , Pérez-Sánchez Jaume 
Published: August 2020

Abstract
Background The key effects of intestinal microbiota in animal health has led to an increasing interest in manipulating these bacterial populations to improve animal welfare. The aquaculture sector is no exception and in the last years many studies have described these populations in different fish species. However, this is not an easy task, as intestinal microbiota is composed of very dynamic populations that are influenced by different factors, such as diet, environment, host age and genetics. In the current study, we aimed to determine whether the genetic background of gilthead sea bream ( Sparus aurata ) influences the intestinal microbial composition, how these bacterial populations are modulated by dietary changes, and the effect of selection by growth on intestinal disease resistance. To that aim, three different groups of five families of gilthead sea bream that were selected during two generations for fast, intermediate or slow growth (F3 generation) were kept together in the same open-flow tanks and fed a control or a well-balanced plant-based diet during nine months. Six animals per family and dietary treatment were sacrificed and the adherent bacteria from the anterior intestinal portion were sequenced. In parallel, fish of the fast- and slow-growth groups were infected with the intestinal parasite Enteromyxum leei and the disease signs, prevalence, intensity and parasite abundance were evaluated. Results No differences were detected in alpha diversity indexes among families, and the core bacterial architecture was the prototypical composition of gilthead sea bream intestinal microbiota, indicating no dysbiosis in any of the groups. The plant-based diet significantly changed the microbiota in the intermediate- and slow-growth families, with a much lower effect on the fast-growth group. Interestingly, the smaller changes detected in the fast-growth families potentially accounted for more changes at the metabolic level when compared to the other families. Upon parasitic infection, the fast-growth group showed significantly lower disease signs and parasite intensity and abundance than the slow-growth animals. Conclusions These results show a clear genome-metagenome interaction indicating that the fast-growth families harbor a microbiota that is more flexible upon dietary changes. These animals also showed a better ability to cope with intestinal infections.
Completely inverted uterus secondary to uterine rhabdomyosarcoma mistaken for a cervical tumor and removed vaginally: case report and literature review
Authors: Jiang Jingjing , Peng Hongfa 
Published: August 2020

Abstract
Background Uterine rhabdomyosarcoma(RMS) is an extremely rare, underrecognized malignant tumor. It usually affects young women and has a dismal prognosis.Case presentation A 19-year-old nulliparous girl presented to our institution with venous sinus thrombosis who subsequently developed complete uterine inversion, which was mistaken for a cervical tumor and removed vaginally. She experienced uncontrollable occurrence of multiple tumors and died within 6 months.Conclusion Our case illustrates the typical presentation and aggressive behavior of uterine RMS. Abnormal uterine bleeding(AUB) in young women should be a sign to screen for uterine neoplasms. Anatomy should be fully evaluated before proceeding toward surgical intervention to ensure the correct procedure is done.
Early Electrocardiographic Indices for Predicting Chronic Doxorubicin-Induced Cardiotoxicity: Retrospective Case Series Study
Authors: Kinoshita Toshio , Yuzawa Hitomi , Natori Kazuhiko , Wada Ryo , Yao Shintaro , Yano Kensuke , Akitsu Katsuya , Koike Hideki , Shinohara Masaya , Fujino Tadashi , Shimada Hideaki , Ikeda Takanori 
Published: August 2020

Abstract
Background: Dealing with chemotherapy-related cardiac dysfunction (CTRCD) remains a significant problem complicated by the difficulty in early detection of cardiotoxicity. Electrocardiogram (ECG) is expected to be the most realistic methodology due to lower cost-performance and non-invasiveness. We investigated the long-term visual fluctuations in the ECG waveforms in patients with chronic doxorubicin (DOX)-induced cardiotoxicity to identify ECG indices for the early detection of cardiotoxicity. Methods: We conducted a retrospective case series study by reviewing the medical records of 470 consecutive patients with malignant lymphoma who were treated with DOX at our institute between January 2010 and December 2017. Of them, 23 (4.9%) patients developed left ventricular dysfunction and were diagnosed with CTRCD using echocardiography. We assessed the ECG indices on 12-lead ECG recordings before and after treatment in 15 patients; eight patients were excluded due to conduction disturbances or atrial fibrillation. Results: CTRCD was detected at a median of 475 (interquartile range, IQR: 341–1333) days after initiating chemotherapy. The evaluation of ECG indices preceding CTRCD development was performed 93 (IQR: 52–232) days before the detection of CTRCD. In the stage of CTRCD, the most significant ECG change was T-wave flattening in leads V3–V6 (12 patients, 80%). Additionally, QTa prolongation was observed in leads I and aVL (n=10, 66%), leads II, III, and aVF (n=9, 60%), and leads V3–V6 (n=10, 73%). These ECG changes were not observed before the treatment but were detected mildly in the pre-CTRCD stage, which subsequently worsened in the CTRCD stage.Conclusions: This study indicated that T-wave changes and QTa prolongation may be useful as an early indicator before the onset of CTRCD in patients with DOX-induced cardiotoxicity.
A K-mer Based Approach for Virus Classification Identifies Coronavirus Infections and Viral Associations in Human and Plant Microbiomes
Authors: Garcia Benjamin , Simha Ramanuja , Garvin Michael , Furches Anna , Jones Piet , Gazolla Joao , Hyatt P. Doug , Schadt Christopher W , Pelletier Dale , Jacobson Daniel 
Published: August 2020

Abstract
BackgroundViruses are an underrepresented taxa in the study and identification of microbiome constituents; however, they play an essential role in health, microbiome regulation, and transfer of genetic material. Only a few thousand viruses have been isolated, sequenced, and assigned a taxonomy, which further limits the ability to identify and quantify viruses in the microbiome. Additionally, the vast diversity of viruses represents a challenge for classification, not only in constructing a viral taxonomy, but also in identifying similarities between a virus’ genotype and its phenotype. However, the diversity of viral sequences can be leveraged to classify their sequences in metagenomic and metatranscriptomic samples.MethodsTo identify and quantify viruses in transcriptomic and genomic samples, we developed a dynamic programming algorithm for creating a classification tree out of 715,672 metagenome viruses. To create the classification tree, we clustered proportional similarity scores generated from the k-mer profiles of each of the metagenome viruses. We then integrated the viral classification tree with the NCBI taxonomy for use with ParaKraken (a parallelized version of Kraken), a metagenomic/transcriptomic classifier. The resulting Kraken2 database of the metagenomic viruses can be found here: https://www.osti.gov/biblio/1615774 and is compatible with Kraken2.ResultsTo illustrate the breadth of our utility for classifying viruses with ParaKraken, especially samples without virus-induced pathophysiology, we analyzed data from a plant metagenome study identifying the differences between two Populus genotypes in three different compartments and on a human metatranscriptome study identifying the differences between Autism Spectrum Disorder patients and controls in post mortem brain tissue. In the Populus study, we identified genotype and compartment-specific viral signatures, while in the Autism study we identified a significant increase in abundance of eight viral sequences in post mortem brains. We also show the potential accuracy for classifying viruses by utilizing the NCBI viral databases to identify the uniqueness of viral sequences and to identify pathogenic viruses in known COVID-19 and cassava brown streak virus infection samples.ConclusionViruses represent an essential component of the microbiome. The ability to classify viruses represents the compulsory first step in better understanding their role in the microbiome. The viral classification method presented here allows for a more complete identification of viral sequences for use in identifying associations between viruses and the host and viruses and other microbiome members and can be used with any tool that utilizes a taxonomy for classification (such as Kraken).
The Writing On The Wall Intravitreal Injection Compliance During The COVID-19 Pandemic and Its Foreseeable Consequences
Authors: Wasser Lauren M , Weill Yishay , Brosh Koby , Magal Itay , Potter Michael , Strassman Israel , Gelman Evgeny , Koslowsky Meni , Zadok David , Hanhart Joel 
Published: August 2020

Abstract
Background: Intravitreal injections (IVI) of anti-vascular endothelial growth factor (anti-VEGF) agents have become the most prevalent intraocular procedure as they represent the major therapeutic modality for prevalent retinal conditions such as age-related macular degeneration (AMD) and diabetic retinopathy. Effective therapy requires adherence to a schedule of iterative IVI as well as routine clinic appointments. The ongoing Coronavirus disease 2019 (COVID-19) pandemic has resulted in the reduction of attendance at scheduled clinics visits and IVI. In this study we attempted to analyze the effect of COVID-19 on compliance with anti-VEGF therapy.Methods: A total of 636 eyes received injections during a four-week period of the COVID-19 outbreak in the Retina Clinic. The number of clinic visits for IVI during one month from March 15 to April 14 of 2020 was compared to the similar time period in each of the last four years.Results: The study demonstrates a decrease in clinic visits for IVI when compared with the same four-week interval in the four previous years. Based on the trend of the previous four years, 10.2% of the year’s total was expected for this time period. Using this model, the 636 reported number of injections for the March-April, 2020 period was ~ 5%. This represents a decrease of ~50% of the expected IVI for this time period.Conclusion: The COVID-19 outbreak in Israel severely impacted compliance with anti-VEGF treatments.
Retrospective analysis of 116 cases of exertional rhabdomyolysis in newly enrolled cadets of a military academy in Beijing
Authors: Mao Handing , Li Xin , Liu Shuyuan , Xing Ling , Zhao Jinbao , Tan Zhijun , Sun Hailong , Song Qing 
Published: August 2020

Abstract
BackgroundExertional rhabdomyolysis (ER) often occurs during prolonged intense exercise in hot environments, posing a threat to the health and safety of military personnel.ObjectiveTo investigate possible risk factors of ER and provide further empirical data for prevention and clinical treatment strategies for ER.MethodsIn this study, a systematic retrospective investigation on 116 concurrent cases of ER was conducted. Demographic, clinical, and exercise-related data were collected from both ER cases and controls which were allotted by 1:3 proportion. Conditional logistic regression analyses were performed to calculate the significance of the association between each potential risk (or protective) factors and ER.ResultsThe adjusted ER prediction model finally included the following variables that significantly increased (or decreased) the risk of acquiring ER: age (odds ratios [OR] 0.59, 95% confidence interval [CI]0.45–0.79), body mass index (BMI, OR 1.11, 95%CI 1.01–1.24), dark-colored urine after training (OR 2.98, 95%CI 1.58–5.64), frequent fruit consumption (OR 0.54, 95%CI 0.29–0.98), active hydrating habit (OR 0.31, 95%CI 1.58–5.64), water replenishment ≥ 2L on the training day (OR 0.18, 95%CI 0.06–0.54), water replenishment ≥ 500 ml within 1 hour before training (OR 0.32, 95%CI 0.11–0.90), lack of physical exercise in the last half-year (OR 3.23, 95%CI 1.34–7.80).ConclusionsIn military training, emphasis should be placed on incremental adaptation training prior to more intense training, and close attention should be paid to overweight and previously sedentary recruits. Fluid replenishment before exercise, increased fruit intake, and proper potassium supplementation may help to prevent ER.
The Multiple Stakeholder Approach to Real-world Evidence Generation: the Results of the Jandhyala Method in Observing Expert Consensus on Quality Indicators of Rare Disease Patient Registries (RDRs) by Stakeholder Group
Authors: Jandhyala Ravi 
Published: August 2020

Abstract
Background:Evidence is valuable to inform decision making. Understanding stakeholder needs from the evidence of key stakeholders is empirically important to those involved in its generation. Where multiple stakeholders exist, an understanding of whether their questions are homogenous or heterogenous necessitates a dedicated approach that will be of value to those invested in the outcomes of their decisions.The pharmaceutical industry engages with non-pharmaceutical industry stakeholders: Payors, Prescribers and, under carefully controlled circumstances, patients when commercialising its medicines. This original research focussed on the differences between these groups and their pharma aligned stakeholders: Regulatory Affairs, Market Access, Commercial and Medical Affairs using measures of their common quality indicators (QIs) from rare disease patient registries.QIs were solicited using the Jandhyala method for observing item awareness and consensus from list generating questioning. They were compared for homogeneity between individual stakeholder groups and the combined pharma and non-pharma stakeholder group population.Results:All stakeholder groups were unique and suggested items peculiar to their own group.One hundred and eleven discrete QIs were identified: Commercial (8/111; 7.21%), Market Access (6/111; 5.41%), Medical Affairs (4/111; 3.60%), Regulatory Affairs (6/111; 5.41%), Patients (14/111; 12.61%), Payors (6/111; 5.41%), and Prescribers (9/111; 8.11%). Each stakeholder's proportion of unique QIs to the total was not statistically significant to the group as a whole.Non-pharma stakeholders generated 29/111 (26.13%) unique QIs, while pharma stakeholders generated 24/111 (21.62%). The total unique QIs across both stakeholder groups were 53/111 (47.75%). Two QIs were unanimously suggested and agreed upon by all stakeholder groups (7/7; 100%): 'Engages with patients and gains their buy-in' and 'Includes a core data set as part of outcomes'.There was homogeneity in consensus on common QIs between Commercial – Market Access (P=0.006), Market Access – Regulators (P=0.006), Commercial – Prescribers (P=0.001), Market Access – Prescribers (P=0.033), and Commercial – Medical Affairs (P=0.020).Conclusions:There is sufficient evidence to support a multiple stakeholder approach for generating real-world evidence. There was a mismatch between pharma and non-pharma stakeholders of 47.75% indicating redundancies of QIs on each side of this divide. Patients and Payor (non-pharma) groups have been highlighted for greater alignment with pharma stakeholder groups.
A Cost Analysis of Options for Schistosomiasis Control MDA Programs Targeting Children Aged Five Years and below in uMkhanyakude District of KwaZulu-Natal Province, South Africa
Authors: Ncube Mhlengi Vella , Chimbari Moses John 
Published: August 2020

Abstract
BackgroundSchistosomiasis negatively impacts early childhood development. Inclusion of children aged five years and below in mass drug administration (MDA) programs for controlling schistosomiasis could improve early childhood development in communities where the disease is endemic. We estimated the projected cost of implementing a schistosomiasis control MDA program for children aged five years and below in the uMkhanyakude district of South Africa.MethodWe calculated the cost of implementing a schistosomiasis MDA program targeting children aged five years and below using an economies of scaled based cost function. We further compared different labor composition simulations to determine the most affordable and available human resources to implement the program. We also explored programs to which the MDA program could be integrated; and estimated what the costs for would be. Moreover, we simulated cost-effectiveness and determined the cost drivers for each simulation considered.ResultsA ward-based outreach team (WBOT) for implementing a schistosomiasis MDA program targeting children 5 years old and below was the best labor composition option. The simulations conducted indicated that treating children in batches of 2500 using the WBOT team approach could reduce the cost of treatment by 53% compared to treating the children on batches of 500. Integrating a schistosomiasis MDA targeting children aged 5 years and below with the immunization program was estimated to cost 3% less than integration with the deworming and Vitamin A supplementation program indicating that the former option is more cost-effective. Praziquantel, the drug that is used to treat schistosomiasis contributed 59% of the total cost for such a program.Conclusion.We estimated that US$4.3 million would be needed to implement a cost effective MDA program targeting children 5 years old and blow over 3 years in uMkhanyakude district.