bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Medical Professionals on Carbapenem-Resistant Pseudomonas Aeruginosa: Moderation Effect of Workload Based on the Panel Data in China
Authors: Han Meng , Zhang Xinping 
Published: January 2020

Abstract
Background: Antimicrobial resistance (AMR) causes serious increase in morbidity, mortality and costs, especially carbapenem-resistant Pseudomonas aeruginosa (CRPA). Medical professionals play an important role in tackling AMR. Available studies overlooked the impact of workload on medical professionals in the relationship between medical professionals and AMR. This study explored the relationship between medical professionals and CRPA rate and the moderation effect of medical professionals’ workload in this relationship from a macro perspective. Methods: Based on panel data in China, hierarchical regression analysis was used to explore moderation effect of workload on medical professionals and CRPA rate. Fixed-effect model was applied to estimate the moderation effect models. Medical professionals were measured by the numbers of physicians, registered nurses, pharmacists, clinical microbiologists per 1000 populations. Workload was measured by the number of daily visits of physicians. Results: The numbers of physicians, registered nurses, pharmacists and clinical technicians were signiﬁcant negative with CRPA rate (Coef. = -0.889, -0.775,-1.176, -0.822; P= 0.003, 0.003, 0.011, 0.007, respectively). Workload had significant positive moderation effect between physicians, registered nurses, pharmacists, clinical technicians and CRPA rate (Coef.= 1.270, 1.400, 2.210, 1.634; P=0.004, 0.001, 0.035, 0.003, respectively). Conclusions: Increasing medical professionals may help curb CRPA. Measures to reduce medical professionals’ workload should be implemented to improve CRPA performance further.
It is aging and not antiretroviral therapy the strongest risk factor for chronic pain in HIV-positive population ?
Authors: Kowalski Marcin , Horban Andrzej , Slomka Bartosz , Shahnazaryan Karen , Rongies Witold 
Published: January 2020

Abstract
Background. Chronic pain in HIV-positive patients is a serious health problem that
limits patients’ normal functioning both somatically and psychologically. The current
state of knowledge on the topic is insufficient, with the underlying causes of this pain
unexplained. We have attempted to answer the question if aging is more stronger risk
factor for chronic pain in HIV-infected patients, than antiretroviral therapy (ART).
Methods. This study was prospective, observational, cross-sectional study, including
consecutive HIV-infected patients under specialist care.
During their routine visit all patients reporting any pain were asked to fill in the Brief
Pain Inventory (BPI) form and were subject to a brief examination performed by a
physician who afterwards completed a Douleur Neuropathique en 4 Questions form
(DN4). Logistic regression models were used to identify factors associated with chronic
pain occurrence.
Results. A total of 196 HIV-positive subjects, 96 (48.9% of the study group) of them
reporting pain within the week prior to enrollment. The reported pain was mostly (75%)
limited to a single area of the body (most commonly to the lower limbs). Pain duration
was reported to be >6 months previous to study enrollment by 57 subjects (59.4% of
those reporting pain). The patients with and without pain differed significantly in terms
of age at study inclusion (with the median age of 45.3 years in the pain group vs. 39.6
years in the no pain group; p=0.0002); median duration of specialist care (10.8 years
vs. 4.9 years, respectively; p=0.0008), median nadir CD4+ cell counts (168 cells/mcL
vs. 253 cells/mcL), median duration of ART (8.5 years vs. 3.4 years; p=0.0046), viral
rebound after complete suppression (5.1% vs. 38.3%; p=0.018), as well as previous
treatment with zidovudine (44.6% vs. 30.5%; p=0.063) and ‘D’ drugs (33.9% vs. 11%;
p=0.0004).
Conclusions. The prevalence of chronic pain in the studied population of HIV-positive
Polish patients was high in comparison with other HIV-positive and HIV-negative
patient populations. The most prominent risk factor for chronic pain in the study group
was age, which poses an important clinical and epidemiological problem due to the
aging of the HIV-positive population.
Two-dimensional speckle tracking echocardiography in goats: repeatability, variability, and validation of the technique using an exercise test and an experimentally induced acute ischemic cardiomyopathy.
Authors: Leroux Aurelia A , Moonen Marie , Farnir Frédéric , Deleuze Stefan , Sandersen Charlotte , Amory Hélène 
Published: January 2020

Abstract
Background: Two-dimensional speckle tracking (2DST) technique has been validated in numerous animal species, but neither studies of repeatability nor measurements after exercise or in animals with cardiac disease have been reported in goats. Goats are an attractive candidate for animal models in human cardiology because they are easy to handle and have a body and heart size comparable to that of humans. Therefore, the aim of this study was to validate this technique in goats for further clinical and experimental applications in this species.
Methods: This study was divided into several steps. First, a standardized echocardiographic protocol was performed and 5 cineloops of a right parasternal short-axis view at papillary muscles level were recorded three times at one-day intervals in ten healthy adult unsedated Saanen goats to test repeatability and variability of 2DST measurements. Then, the same measurements were performed immediately before and after a standardized exercise on treadmill in seven of the goats, and at 24h after induction of an experimental ischemic cardiomyopathy in five of the goats, to test the reliability of the technique to assess physiological and pathological changes. Average and regional measurements of radial and circumferential strain and strain rate, radial displacement, rotation and rotation rate were obtained. Comparisons were performed using two-way ANOVA (p<0.05).
Results: Caprine 2DST average measurements have demonstrated a good repeatability with a low to moderate variability for all measurements except for the diastolic peaks of the circumferential strain rate, radial strain rate and rotation rate. Segmental 2DST measurements were less repeatable than average measurements. Time effect of two-way ANOVA was significant for anteroseptal segment diastolic peaks measurements, rotation and rotation rate measurements. Overall variability of segmental measurements was moderate or high. Segmental and average peak values obtained after exercise and after myocardial ischemia were significantly different than curves obtained at baseline.
Conclusions: The results of this study are consistent with those previously described in other animal species and humans. 2DST echocardiography is a valid technique to evaluate physiological and pathological changes in myocardial function in goats, despite the technical limitations observed in this species.
Identification of bacterial pathogens in cultured fish with a custom peptide database constructed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS)
Authors: Piamsomboon Patharapol , Jaresitthikunchai Janthima , Hung Tran Quang , Roytrakul Sittiruk , Wongtavatchai Janenuj 
Published: January 2020

Abstract
Background: The majority of infectious diseases of cultured fish is caused by bacteria. Rapid identification of bacterial pathogens is necessary for immediate management. The present study developed a custom Main Spectra Profile (MSP) database and validate the method using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) for rapid identification of fish bacterial pathogens. Streptococcus agalactiae, Streptococcus iniae, Aeromonas hydrophila, Aeromonas veronii, and Edwardsiella tarda obtained from diseased fish were used as representative bacterial pathogens in this study. Bacterial peptides were extracted to create a Main Spectra Profile (MSP), and the MSPs of each bacterial species was added into the MALDI Biotyper database. Fifteen additional isolates of each bacterial species were tested to validate the utilized technique.
Results: The MSPs of all field isolates were clearly distinguishable, and the MSPs of the same species were clustered together. The identification methodology was validated with 75 bacterial isolates. The reliability and specificity of the method were determined with MALDI Biotyper log score values and matching results with 16s rDNA sequencing. The species identification using the public MALDI Biotyper library (Bruker MALDI Biotyper) showed unreliable results (log score <2.000) with 42.67% matching result with the reference method. In contrast, accurate identification was obtained when using the custom-made database, giving log score > 2.115, and a 100% matching result.
Conclusion: This study demonstrates an effective identification of fish bacterial pathogens when a complete custom-made MSP database is applied. Further applications require a broad, well-established database to accommodate prudent identification of many fish bacterial pathogens by MALDI-TOF MS.
Women's Experiences of Rectovaginal Fistula: An Ethno- Religious Experience
Authors: Nezhad Fatemeh Touhidi , Jalali Rostam , Karimi Fozieh 
Published: January 2020

Abstract
Background: Obstetric fistulas are one of the most tragic injuries that occur after difficult, prolonged childbirth without timely intervention. These fistulas cause discomfort to patients and result in emotional, social, and even physical suffering. The aim of the present study was to explore the experiences of women with rectovaginal fistula in Kamyaran city, in Kurdestan province, west of Iran. Methods: In a phenomenological study, 16 patients, healthcare personnel and patients' families were investigated. Purposive sampling was performed and Study participants were interviewed in-depth semi-structured interviews. All interviews were audio-recorded, transcribed verbatim (word by word) and analyzed by Colaizzi's method. In order to determine the validity of the study, Lincoln and Guba’s criteria, which include credibility, dependability, transferability, and confirmability, were considered. Results: Five general themes and ten sub-themes emerged after investigating interviews. Themes include religious harassment the sub-theme of being defiled), fail (subthemes of loss and negative attitudes, disrupted sex (the subtheme of sexual dissatisfaction), consequence (three subthemes of sleep disturbance, mental crisis, and isolation), and ultimately panic (three subthemes of humiliation, secrecy, and fear). Conclusion: The rectovaginal fistula is a complex and multifaceted problem with social, individual, familial, religious, and ethnic-environmental dimensions, so there is no simple solution to interact with this problem and there is a need to find a solution, considering the dimensions of the problem and plan for help these patients cope with their disease, and take steps to fully treat it.
Prediction of patients with a tumor proportion score &gt;50% who do not respond to first-line monotherapy with pembrolizumab
Authors: Morita Mitsunori , Tamiya Motohiro , Fujimoto Daichi , Tamiya Akihiro , Suzuki Hidekazu , Hirano Katsuya , Fukuda Yasushi , Yokoyama Toshihide , Kominami Ryota , Kanazu Masaki , Uchida Junji , Hara Satoshi , Yamashita Shuji , Tomioka Hiromi 
Published: January 2020

Abstract
Background: Pembrolizumab is effective as first-line therapy against advanced non-small cell lung cancer (NSCLC) in patients with programmed death ligand-1 (PD-L1) expression levels ≥50%. However, it is not effective in all patients, and the factors predicting responses among this population remain unknown. Methods: We retrospectively analyzed patients with NSCLC and a PD-L1 tumor proportion score (TPS) >50%, who received first-line monotherapy with pembrolizumab from February 1, 2017 to April 30, 2018. The study included 11 hospitals, which participated in the Hanshin Oncology clinical Problem Evaluation group (HOPE). We analyzed the differences between responders and non-responders in terms of age, sex, performance status score, degree of progression, histological type, smoking history, expression of PD-L1, use of steroids prior to treatment, metastasis site, and laboratory data. Results: A total of 205 patients were included in this study. Of those, 108 patients exhibiting complete or partial response were defined as responders. Those exhibiting progressive disease (N=52) were defined as non-responders. In the univariate analysis, Eastern Cooperative Oncology Group performance status score ≥2 (p=0.0832), stage IV disease or recurrence (p=0.0487), PD-L1 TPS 50–89% (p=0.0657), use of steroids prior to the administration of pembrolizumab (p=0.0243), malignant pleural effusion (p=0.0032), and baseline C-reactive protein (CRP) levels >1.0 mg/dL (p=0.0390) were significantly associated with non-response to treatment. In the multivariate analysis, use of steroids prior to the administration of pembrolizumab (odds ratio [OR]: 5.86; 95% confidence interval [CI]: 1.32–31.8; p=0.0200), malignant pleural effusion (OR: 2.68; 95% CI: 1.15–6.35; p=0.0228), and baseline CRP >1.0 mg/dL (OR: 2.17; 95% CI: 1.03–4.68; p=0.0402) were significantly associated with non-response to treatment. Conclusion: In real-world patients with NSCLC and a PD-L1 TPS ≥50%, use of steroids prior to treatment, malignant pleural effusion, and baseline CRP levels >1.0mg/dL reduced the response of first-line monotherapy with pembrolizumab.
Treatment of Distal Clavicle Fractures using a Scorpion Plate and Influence of Timing on Surgical Outcomes: A Retrospective Cohort Study of 105 Cases
Authors: Furuhata Ryogo , Takahashi Masaaki , Hayashi Teppei , Inagawa Miyu , Kono Aki , Matsumura Noboru , Kamata Yusaku , Arino Hiroshi , Morioka Hideo 
Published: January 2020

Abstract
Background Plate fixation is an established method for treating unstable distal clavicle fractures. However, the appropriate timing of surgery for acute distal clavicle fractures remains unclear. The present study aimed to evaluate the clinical outcomes of osteosynthesis using a Scorpion plate and to assess the influence of surgery timing on the surgical outcomes for acute unstable distal clavicle fractures. Methods We retrospectively reviewed 105 patients who underwent fixation for acute unstable distal clavicle fractures (Neer type II and V) using the Scorpion plate between 2008 and 2018. Patients were divided into early (45 patients) and delayed (60 patients) treatment groups based on the timing of the surgical intervention (within or after seven days). The outcomes were postoperative complications (nonunion, peri-implant fracture, plate loosening, plate-related pain, and stiffness). We evaluated the outcomes from X-ray radiographs and clinical notes. Results Among the 105 patients, nonunion, plate loosening, plate-related pain, and stiffness were observed in six patients (5.7%), four patients (3.8%), seven patients (6.7%), and one patient (1.0%), respectively. The nonunion rate was significantly higher in the delayed treatment group than that in the early treatment group (P=0.036). Although the difference was not significant, plate loosening and stiffness were only observed in the delayed treatment group. Conclusion Our results demonstrated that osteosynthesis using Scorpion plates achieved satisfactory surgical outcomes for unstable distal clavicle fractures . In addition, this study suggested that performing surgery within six days after injury is recommended to reduce postoperative complications .
The Development of a Return to Work Intervention Programme for Stroke Survivor (SReTWIP): A Delphi Survey
Authors: Olaoye Olumide Ayoola , Soeker Shaheed Moghammad , Rhoda Anthea 
Published: January 2020

Abstract
Background: Even though clearly defined pathways for vocational re-entry are well recognized for conditions such as mental health, musculoskeletal dysfunction (MSD) and traumatic brain injury (TBI), none has been identified for stroke. There has been a lack of consensus regarding such clear pathways to vocational re-entry and the essential contents of return to work (RTW) interventions for stroke survivors. As part of a larger study aimed to design a RTW programme for stroke survivors, this study describes the concluding process through which Stroke Return to Work Intervention Programme (SReTWIP) was developed.Methods: Experts in the field of neurorehabilitation and vocational rehabilitation (VR) from 6 countries participated in this 3-round Delphi survey via e-mail. Concept mapping was used to triangulate findings from the Delphi with previous phases of the larger study. Content thematic analysis was conducted on qualitative data while descriptive statistic was used to analyze quantitative data.Results: Fifteen experts with a mean age and mean duration of practice of 44.73±9.48 years and 18.26±8.71 years respectively participated in this study. The developed RTW programme (SReTWIP) is a 12 week programme that consisted of four interconnected phases of intervention viz: an assessment phase, clinic-based work and non-work specific intervention phase, a work test placement phase and a client full participation in worker role phase. The experts agreed on a set of implementation strategies that included the use of interdisciplinary team, the tailoring of intervention to meet stroke survivor’s need, as well as the use of case management approach.Conclusion: The SReTWIP is the first step in developing a VR pathway that can ultimately enhance the RTW rates and quick resumption of the worker role of stroke survivors. The stroke survivor can move along the different phases of the SReTWIP after achieving competency in a preceding phase. Future work will include a feasibility study with other key stakeholders involved in RTW such as employers, informal caregivers and stroke survivors before its implementation.
Factors associated with high-risk low-level viremia leading to virologic failure: 16-year retrospective study of a Chinese antiretroviral therapy cohort
Authors: Zhang Tong , Ding Haibo , An Minghui , Wang Xiaonan , Tian Wen , Zhao Bin , Author) Xiaoxu Han(New Corresponding 
Published: January 2020

Abstract
Background: Low level viremia (LLV) often occurs during antiretroviral therapy (ART) against HIV-1. However, whether LLV increases the risk of virologic failure (VF) is controversial because of the non-uniform definitions of LLV and VF. Methods: A long-term first line regimen ART cohort from 2002–2018 from Shenyang, northeast China, was retrospectively studied. All participants were followed up every 3 to 6 months to evaluate the treatment effect. The high-risk LLV subgroups leading to VF (with strict standards) were explored with Cox proportional hazards model and linear mixed-effect model. The association factors of high-risk LLV were further explored using multivariate logistic regression analyses. Results: A total of 2155 HIV-1 infected participants were included; of these, 38.7% showed LLV. Both high level LLV (HLLV) and any other level LLV coupled with high level blip (HLB) showed higher risk of VF (hazards ratios, HRHLLV=5.93, and HRHLB=2.84, p<0.05 respectively). Moreover, HR increased with prolonged duration of LLV. Independent factors associated with high-risk LLV included the zenith baseline viral load (VL) above 6 log copies/ml (aOR=3.49, p=0.002), nadir baseline CD4+T cell counts below 200 cells/mm3 (aOR=1.78, p=0.011), Manchu (aOR=2.03, p=0.003), ART over 60 months (aOR=1.81, p=0.004), AZT+3TC+NVP (aOR=2.26, p<0.001) or DDI-based regimen (aOR=9.96, p=0.002), and subtype B’ infection (aOR=8.22, p=0.001). Conclusions: In case of VF with strict standards, high-risk LLV leading to VF includes VL above 400 copies/ml, occurring at least once. Serious laboratory indicators or advanced stage of infection, long term ART and subtype B’ infection might also predict the occurrence of high-risk LLV.
Transcriptome analysis of postharvest blueberries (Vaccinium corymbosum‘Duke’) in response to cold stress
Authors: Zhang Fan , Ji ShuJuan , Wei BaoDong , Cheng Shunchang , Hao Jia , Wang YaJuan , Wang SiYao , Zhou Qian 
Published: January 2020

Abstract
Background: Blueberry ( Vaccinium spp. ) is a small berry with high economic value. Although cold storage can extend the storage time of blueberry to more than 60 days, it leads to chilling injury (CI) displayed as pedicle pits; and the samples of 0°C-30 days was the critical point of CI. However, little is known about the mechanism and the molecular basis response to cold stress in blueberry have not been explained definitely. Methods: To comprehensively reveal the CI mechanisms in response to cold stress, we performed high-throughput RNA Seq analysis to investigate the gene regulation network in 0d (control) and 30d chilled blueberry. At the same time, the pitting and decay rate, electrolyte leakage (EL), malondialdehyde (MDA) proline content and GSH content were also measured. Results: Two cDNA libraries from 0d (control) and 30d chilled samples were constructed and sequenced, generating a total of 35,060 unigenes with an N50 length of 1,348bp. Of these, 1852 were differentially expressed, with 1,167 upregulated and 685 downregulated. Forty-five cold-induced transcription factor (TF) families containing 1,023 TFs were identified. The DEGs indicated in biological processes such as stress responses; cell wall metabolism; abscisic acid, gibberellin, membrane lipid, energy metabolism, cellular components, and molecular functions were significantly responsed to cold storage. The transcriptional level of 40 DEGs were verified by qRT-PCR. Conclusions: The postharvest cold storage leads serious CI in blueberry, which substantially decreases the quality, storability and consumer acceptance. The MDA content, proline content, EL increased and the GSH content decreased in this chilled process. The biological processes such as stress responses, hormone metabolic processes were significantly affected by CI. Overall, the results obtained here are valuable for preventing CI under cold storage and could help to perfect the lack of the genetic information of non-model plant species.