bluuebunny/crossref_metadata_2025_split huggingface dataset:
Red cell distribution width to platelet ratio (RPR) predicts liver fibrosis in patients with autoimmune hepatitis
Authors: Wang Huali , Wang Jian , Xia Juan , Yan Xiaomin , Feng Yanhong , Li Lin , Chen Jun , Liu Duxian , Ding Weimao , Yang Yongfeng , Wu Chao , Huang Rui 
Published: December 2019

Abstract
Background Accurately evaluate the stages of liver fibrosis are critical for the management of patients with autoimmune hepatitis (AIH). We evaluated the accuracy of red cell distribution width (RDW) to platelet (PLT) ratio (RPR) in predicting liver fibrosis in AIH patients.Methods One hundred and nineteen AIH patients with liver biopsy was retrospectively enrolled. Scheuer scoring system was used to stage liver fibrosis. Receiver operating characteristic curve (AUROC) was performed to evaluate the diagnostic accuracy of RPR.Results The median RPR values were 0.10, 0.10 and 0.14 for AIH patients with S2-S4, S3-S4 and S4, which were significantly higher than patients with S0-S1 (0.07, P<0.001), S0-S2 (0.08, P=0.025) and S0-S3 (0.09, P=0.014), respectively. The RPR levels were positively associated with the fibrosis stages (r=0.412, P<0.001), whereas there were no associations between liver fibrosis stages and aspartate transaminase to platelet ratio index (APRI) and fibrosis-4 score (FIB-4). The AUROCs of RPR were 0.780 (95%CI 0.696 to 0.865), 0.639 (95%CI 0.530 to 0.748) and 0.724 (95%CI 0.570 to 0.878) in diagnosing significant fibrosis (S2-S4), advanced fibrosis (S3-S4) and cirrhosis (S4) for AIH patients, respectively. The AUROCs of RPR were significantly higher than those of APRI and FIB-4 in staging liver fibrosis for AIH patients.Conclusion RPR is a simple predictor of liver fibrosis and is superior to APRI and FIB-4 in identifying liver fibrosis in AIH patients.
Beyond invasion: land use influencing bovine tuberculosis (bTB) infection as a function of ecosystem services
Authors: Dejene Sintayehu , Elbur E. van , Heitkönig Ignas M.A. , Prins Herbert H.T. , Bartholomeus H. , Boer Willem F. de 
Published: December 2019

Abstract
Background: Changes in land use and associated ecosystem change have been described as one of the causal drivers in emerging and re-emerging of infectious diseases, but there is a notable scarcity of scientific knowledge to show whether, and how, land use change plays this role. Land use change may include the invasion of non-native woody species. We studied how and to what extent Prosopis juliflora, a most powerful invasive woody species, influences the prevalence of bovine tuberculosis (bTB) in cattle in the Afar Region, Ethiopia between November 2013 and April 2016. We examined the potential underlying mechanisms by which ecological consequences of land use, such as an invading woody species, alters the risk of bTB transmission. Methods: A total of 2550 cattle from 102 herds were investigated for the presence of bTB using the comparative intradermal tuberculin test (CITT). Landsat images from 2014 were used to quantify the proportion of different land use types by applying a k-means unsupervised classification, and analyzing this within a buffer of 16km from the location of each cattle herd. A generalized linear model was used to quantify the relationship between bTB prevalence and the proportion of land use types. Then, multiple regression tree analyses were used to identify the most important land use predictor accounting for the variation in bTB prevalence. Results: A model averaging analyses identified the proportion of P. juliflora as a significant risk factor for increasing bTB prevalence in cattle (b=12.2, 95%CI=8.9-15.5, p<0.001), and multiple regression tree analysis identified the proportion of Prosopis as the most important land use predictor of bTB in cattle. Conclusions: The loss in host species evenness and the increase in cattle movement as a consequence of the loss of palatable grasses in Prosopis areas could be potential mechanisms accounting for the observed higher bTB prevalence in these areas. Given the projected spread of Prosopis, land use changes and associated changes in host community composition could affect the risk of infectious diseases, which is important for decision makers when formulating disease control strategies.
Urinary tract infection caused by enterococcus spp: risk factors and mortality.
Authors: Artero Elisa Alvarez , Campo Amaia , Garcia Inmaculada Garcia , Bravo Moises Garcia , Cores Olaia , Galindo Inmaculada , Pendones Josue , Bernus Amparo Lopez , Belhassen-Garcia Moncef , Lledias Javier Pardo 
Published: December 2019

Abstract
Purpose: Complicated urinary tract infections (UTIs) are frequently caused by Enterococcus spp. We aim to define the risk factors involved in UTIs caused by Enterococcus. Determine the overall mortality and predictive risk factors.Methods: A retrospective study was conducted. We compared the results with those of a random sample of patients with complicated UTIs infection caused by Escherichia coli.Results: We found 106 in-patients with UTIs caused by Enterococcus spp., 56 of whom had positive blood cultures. Distribution by species: 83% E. faecalis and 17% E. faecium, with a Charlson comorbidity index of 5.9±2.9. Only male sex with an OR of 2.8 (95%CI 1.2-6.4), nosocomial infection with an OR of 2.8 (95%CI 1.1-7), urinary catheter with an OR of 4.5 (95%CI 1.8-11.3), urinary cancer with an OR of 6.4 (2.1-19.4), and previous antimicrobial treatment with an OR of 4.3 (1.8-10.2) were independent predictors of Enterococcus infection. Overall, in-patient mortality was 16.5%, which was associated with a higher Sequential Organ Failure Assessment (SOFA) score (>4), severe comorbidity such as immunosuppression, malignant hemopathy and nephrostomy, or Enterococcus faecium species and its pattern or resistance to ampicillin or vancomycin (p<0.05). Appropriate empiric antibiotic therapy was not associated with a better prognosis (p >0.05).Conclusions: Enterococcus spp. is a frequent cause of complicated UTI by a profile of risk factors. High mortality secondary to a severe clinical setting and high comorbidity may be sufficient reasons for implementing empiric treatment of patients at risk, although we did not show a higher survival rate in patients with this treatment strategy.
A cross-sectional research conducted in Malatya province, Turkey: Knowledge levels and awareness about rational antibiotic use and antimicrobial resistance before and after graduation
Authors: KOSE ADEM 
Published: December 2019

Abstract
Background Irrational antibiotic use can adversely affect treatment outcomes or even lead to increased antimicrobial resistance. We aimed to determine antimicrobial prescribing habits and to evaluate the level of theoretical knowledge of rational antibiotic use and awareness about antimicrobial resistance among the senior students of medical faculty and the family physicians in Malatya province in Turkey. Methods This study was cross-sectional research and was carried out between dates of 01 February-30 April 2019, in Malatya province. Power analysis was calculated as minimum 240 participants when considering a proportion difference of 0.18 between the groups, a type I error of 0.05 and a type II error of 0.20. A total 225 senior students in Inonu University Medical Faculty (Group 1) and 230 actively-working family physicians in Malatya primary healthcare services who were found eligible (Group 2) were included in to this study. A questionnaire form was prepared including seven sections and thirty questions. All of the participants were interviewed face to face. Before the questions, the purpose of the study and the contents of the questions were explained to participants. Qualitative data were analyzed by Pearson chi-square test. A p<0.05 value was considered to be statistically significant. Results The group 1 had a tendency to apply to specialist physician when starting to themselves antibiotic treatment, they were more cautious when making antibiotic decision, and their theoretical knowledge level was better. They argued that penal sanctions could be more effective by developing strict use policies to raise awareness of resistance to antibiotics. The group 2 had higher self-confidence and it was also concluded that forgot their theoretical antibiotic knowledge over time and could not follow the novel information because of the intensity of working life. Both groups stated that post-graduation trainings could be used effectively for reducing the antibiotic resistance. Conclusion This study highlighted the need for immediate action of training and corrective actions and might create awareness to determine the difference in theoretical knowledge levels and behavior models of physicians before and after graduation and to reduce higher use rates to lower levels. Key words: Antimicrobial resistance, antibiotic, awareness, rational use
Psychosocial barriers and enablers of exclusive breastfeeding: lived experiences of mothers in low-income townships, North West Province, South Africa
Authors: Witten Chantell Beverley , Claasen Nicole , Kruger Herculina S , Coutsoudis Anna , Grobler Herman 
Published: December 2019

Abstract
Background Despite national efforts to promote exclusive breastfeeding (EBF), South Africa’s EBF rate is only 32%. The aim of this study was to examine the rate of EBF discontinuation and the lived experiences of breastfeeding mothers at postnatal time points 3-14 days, 4-8 weeks, 10-14 weeks and 20-24 weeks.Methods This community-based mixed-methods study collected data within a prospective cohort study on socio-demographics, the Edinburgh Postnatal Depression Scale (EPDS) and the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) at 6-8 weeks with infant feeding data collected at 4-8, 10-14 and 20-24 weeks from 159 mothers living in low income areas. Six focus groups with 32 mothers with infants aged 6-24 weeks were conducted. Descriptive statistics was used for the quantitative data and thematic analysis for qualitative data.Results The majority of mothers were unmarried (84.9%), living with family (69.2%) and unemployed (74.2%). EBF decreased from 34% at 4-8 weeks to 9.7% at 20-24 weeks. Mixed feeding with infant formula increased from 17.0% to 50.1% and food feeding from 3.1% to 54.2%. While there were no statistically significant associations between EBF and any of the quantitative socio-demographic variables, in the qualitative data, codes associated with barriers were more than enablers. The themes were Mothers’ attributes (wellbeing, experiences and relationships) with the code mother’s stress the strongest barrier, Mother’s knowledge, attitudes and practices of breastfeeding with the code conventional medicines the strongest barrier , Family environment with the code home setting the strongest barrier, Social environment with public spaces and places a barrier and in Baby cues the code baby stomach ailments the barrier. Within these same themes mother’s positive emotions , benefits of breastfeeding , support in the home , access to information and services from health professionals and baby’s health were strong enabling factors.Conclusions Low EBF, high mixed feeding and a high EPDS score were explained by the barriers identified in the qualitative data. The data suggests that mothers from low-income households would be better supported through interventions that address food insecurity; family relationships and those that build confidence in mothers and resilience in confronting difficult and hostile breastfeeding environments.
Allo-HSCT compared with immunosuppressive therapy for acquired aplastic anemia: Is superiority a one-sided understanding?
Authors: Zhu Yangmin , Gao Qingyan , Hu Jing , Guan Dongrui , Liu Xu , Zhang Fengkui 
Published: December 2019

Abstract
Background: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) and immunosuppressive therapy (IST) are two major competing treatment strategies for acquired aplastic anemia (AA). Whether allo-HSCT is superior to IST as a front-line treatment for patients with AA has been a subject of debate. To comprehensively compare the efﬁcacy and safety of allo-HSCT with IST as a front-line treatment for patients with AA. Methods: We searched the Medline, Embase, and Cochrane Registry of Controlled Trials databases from January 2000 to March 2019. Studies comparing allo-HSCT with IST as a first-line therapy for patients with AA were included. Results: Fifteen studies including a total of 5336 patients were included in the meta-analysis. The pooled hazard ratio (HR) for overall survival (OS) was 0.4 (95% CI 0.074–0.733, P = 0.016, I2 = 58.8%) and the pooled HR for failure-free survival (FFS) was 1.962 (95% CI 1.43–2.493, P = 0.000, I2 = 0%). The pooled relative risk (RR) for overall response rate (ORR) was 1.691 (95% CI 1.433–1.996, P = 0.000, I2 = 11.6%). Conclusion: Although survival was significantly longer among AA patients undergoing first-line allo-HSCT compared to those undergoing first-line IST, the selection of initial treatment for patients with newly diagnosed AA still requires comprehensive evaluation of donor availability, patient age, expected quality of life, risk of disease relapse or clonal evolution after IST, and potential use of adjunctive eltrombopag.
Medical Costs of Alpha-1 Antitrypsin Deficiency-Associated COPD in the United States
Authors: Sieluk Jan , Slejko Julia F , Silverman Henry , Perfetto Eleanor , Mullins C. Daniel 
Published: December 2019

Abstract
Background There are limited data on economic aspects of the genetic variant of chronic obstructive pulmonary disease (COPD) in the context of the more prevalent form of COPD. The objective of this study was to isolate the healthcare resource utilization and economic burden attributable to the presence of a genetic factor among COPD patients with and without Alpha-1 Antitrypsin Deficiency (AATD), twelve months before and after their initial COPD diagnosis.Results The study population consisted of 8,881 patients (953 cases matched with 7,928 controls). The AATD-associated COPD cohort had higher expenditures and use of OV and OTH services, as well as OV, OP, ER, RX, and OTH before and after the index date, respectively. Adjusted total cost ratios for AATD-associated COPD patients as compared to controls were 2.04 [95% CI: 1.60 – 2.59] and 1.98 [95% CI: 1.55 – 2.52] while the incremental cost difference totaled $6,861 [95% CI: $3,025 - $10,698] and $5,772 [95% CI: $1,940 - $9,604] per patient before and after the index date, respectively.Conclusions Twelve months before and after their initial COPD diagnosis, patients with AATD incur higher healthcare utilization costs that are double the cost of similar COPD patients without AATD. This study also suggests that increased costs of AATD-associated COPD are not solely attributable to augmentation therapy use. Future studies should further explore the relationship between augmentation therapy, healthcare resource use, and other AATD-associated COPD expenditures.
An Investigation of the Prevalence of Giardia agilis in Anuran Amphibians Reveals Special Parasitic Adaptations of this Giardia Species
Authors: Lyu Zhangxia , Cheng Jiaoni , Shao Jingru , Ye Qingqing , Bai Huixian , Wang Jiangxin , Wen Jianfan 
Published: December 2019

Abstract
Background: Giardia agilis is a Giardia species with a very narrow and elongated body distinct from others. It was first reported in 1882, and was detected in several species of anuran amphibians. Although there were some studies about its morphology, no investigations about its prevalence have ever been reported to date.Methods: We detected G. agilis in frogs and tadpoles from some areas of China based on its distinct morphology. Statistical analysis was performed using mid-P exact probability tests and differences were considered significant when p-values ≤0.05 were obtained.Results: We investigated the prevalence of G. agilis in 25 anuran amphibian species and found that 195 of the 463 (42.1%) samples were detected to be positive. Our molecular phylogenetic analysis indicated all the detected G. agilis were from the same species. The 195 positive frog samples were from 9 frog species, which are distributed scatteredly in four families that are not closely related rather than just restricted to a narrow lineage. The statistical prevalence among adults of different frog species showed no significant difference, and so did among tadpoles, but the prevalence in the tadpoles is significantly higher than in their adults. More interestingly, although the prevalence in Kaloula verrucosa from the same area showed no significant differences between its tadpoles without legs and the ones with two legs, but is significantly higher in these two developmental stages than in the four-legged stage, which is still much higher than in the adults. Moreover, all the positive samples were found to be from the areas with relatively high altitude (more than 870 meters).Conclusions: G. agilis is probably able to infect all anuran amphibians without species-bias. The turning point of prevalence in the period of front leg development might be related with the development of immune system of the hosts. That G. agilis tends to infect easily the frogs living in high altitude areas means that it has adapted to the dramatic temperature change in the poikilothermal animal hosts. Therefore, G. agilis has evolved some special successful parasitism strategies for parastizing the poikilothermal hosts with metamorphosis development -- anuran amphibians.
The first report on the occurrence of Dirofilaria species in stray dogs in Siddharthnagar, Lumbini, Nepal
Authors: Rimal Subash , Adhikari Anil , Acharya Rabin , Singh Dinesh Kumar , Joshi Naresh Prasad , Shrestha Birendra , Kaphle Krishna , El-Dakhly Khaled Mohamed 
Published: December 2019

Abstract
Backround: Dirofilaria species are important zoonotic filarioid nematodes transmitted by mosquitoes causing a heartworm disease in canines worldwide. Map of the distribution pattern of dirofilariois in Nepalese context is lacking. Methodology: A study was done to access the occurrence of dirofilarioids among stray dogs population in Siddharthanagar, sub-metropolitan city of Lumbini, Nepal. A total of 150 blood specimens were examined using direct microscopy, buffy coat centrifugation and modified Knott's method. Haematobiochemical parameters including packed cell volume (PCV), alanine aminotransferase (SGPT), aspartate aminotransferase (SGOT), alkaline phosphate (ALP), creatinine, blood urea nitrogen (BUN), urea and total protein were evaluated. Furhter, the clinical performance, comprising the body temperature and respiratory rate, were also assessed. Results: The dirofilariod is recognized as Dirofilaria immitis . Overall prevalence of dirofilariosis was reported to be 19.33% (29/150). Meanwhile, microfilariae were noticed to be 16.0, 16.0 and 19.33 % using the direct blood smear microscopy, buffy coat and modified Knott technique, respectively. The infection rate was significantly ( P <0.05) higher in aged dogs with high respiratory rates. The response of sex was non-significant. Among haematobiochemical parameters, only SGPT and SGOT were significantly ( P <0.05) elevated. The body temperature was not altered.Conclusion: Coinciding with the existence of stray dog communities and the recent zoonotic appearance of such filarioids, further investigations including molecular approaches, are urgently needed to accurately differentiate both dirofilarioids and other filarioid nematodes in both pets and humans.
Histone demethylase KDM4C is required for ovarian cancer stem cell maintenance
Authors: Chen Guoqing , Ye Ping , Zeng Fa , Zhu Xiongshan , Chen Lu , Huang Yan , Xu Ling , Xie Xiaoying 
Published: December 2019

Abstract
Ovarian cancer is a highly deadly disease, which is often diagnosed at a late stage with metastases. However, most ovarian cancers relapse after surgery combined with platinum based chemotherapy. Cancer stem cells (CSCs) are stem-like cells that possess high tumorigenic capability and display higher resistant capability against current therapies. However, our knowledge of ovarian CSCs and their molecular mechanism remain sparse. In current study, we found that KDM4C, a histone demethylase, was required for ovarian cancer stem cells (CSCs) maintenance. Depletion of KDM4C significantly reduced the CSCs population and sphere formation in vitro. Moreover, we found that KDM4C can regulate the expression of stem cell factor OCT-4 via binding to its promoter. These data indicate that KDM4C is relevant for ovarian CSCs maintenance and underscore its importance as a potential therapeutic target.
Patient-reported outcomes following primary total hip arthroplasty in Crowe type Ⅲ or Ⅳ developmental dysplasia are comparable to those in Crowe type Ⅰ: a case-control study of 96 hips
Authors: Ueoka Ken , Kabata Tamon , Kajino Yoshitomo , Inoue Daisuke , Ohmori Takaaki , Ueno Takuro , Yoshitani Junya , Yamamuro Yuki , Tsuchiya Hiroyuki 
Published: December 2019

Abstract
Background: A few previous studies have investigated patient satisfaction following total hip arthroplasty (THA) according to the degree of pelvic deformity. This study compared patient-reported outcomes following primary THA for Crowe types Ⅲ, Ⅳ, and I dysplasia.Methods: Questionnaires were sent to patients who underwent primary THA for Crowe type III and IV dysplasia to evaluate postoperative satisfaction. Twenty-three patients were enrolled in the high hip dislocation group (H group), while the control group had 46 patients with Crowe type I dysplasia. To investigate the influence of femoral shortening osteotomy, the H group was divided according to whether or not femoral shortening osteotomy was performed. Ten patients underwent THA with femoral shortening osteotomy (FO group), while 12 patients underwent THA without femoral shortening osteotomy (N-FO group). Clinical evaluations were performed using the Japanese Orthopaedic Association (JOA) scores, 36-item short-form survey (SF-36), visual analogue scale (VAS), and questionnaires. Results: Postoperative leg length discrepancy (LLD) was significantly greater in the H group than in the control group. The H and control groups were not significantly different in terms of the pre- and postoperative JOA scores and SF-36. In the H group, VAS score at the final follow-up was significantly higher, and significantly more patients felt that postoperative rehabilitation was serious, expressing that they underwent THA for LLD correction. In addition, VAS scores in the FO group were higher than those in the N-FO group.Conclusion: The postoperative VAS score was higher in Crowe type Ⅲ and Ⅳ dysplasia than in Crowe type I dysplasia, but there were no significant differences in the postoperative satisfaction, JOA score, and SF-36. These findings can help determine the need for THA in patients with Crowe type Ⅲ and Ⅳ dysplasia and can preoperatively predict the THA outcomes.