bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-management practice, associated factors and its relationship with Health Literacy and Patient Activation among multi-morbid COPD patients from rural Nepal
Authors: Yadav Uday Narayan , Lloyd Jane , Hosseinzadeh Hassan , Baral Kedar Prasad , Bhatta Narendra , Harris Mark Fort 
Published: February 2020

Abstract
Background
Chronic Obstructive Pulmonary Disease (COPD) is a progressive and debilitating condition that affects individuals' quality of life . COPD self-management and supports provided by carers is key to the quality of life people living with COPD. Health literacy (HL) and Patient Activation (PA) are main drivers of self-management practices (SMPs). However, their contribution remains to be fully explored. This study aimed to examine the level of self-management practices, and the relationship with socio-demographic factors, HL and PA among multi-morbid COPD patients from rural Nepal.
Methods
This is a cross-sectional study conducted between July 2018 and January 2019. Patients completed a survey, including Self-management Practices questionnaire (SMPQ), five domains of the Health Literacy Questionnaire (HLQ), and Patient Activation Measure (PAM). The relationship between HL, PAM, and SMPs was examined using univariate statistics. Multivariable analysis was conducted to identify the factors associated with SMPs.
Results
A total of 238 patients responded to the study. The mean score of SMPQ was 45.31(SD=9.00). The HLQ and PAM scores were positively correlated with the total score of SMPQ. Low level of SMPs were found to be positively associated with being uneducated (β=-0.43, p=.001), having a low family income (β=-5.22, p=.002), and, negatively associated with the presence of more than one co-morbidity (β=3.58, p=0.007) after controlling for other socio-demographic variables in the multivariable analysis.
Conclusion
The overall SMPs among this sample of Nepalese with COPD were low. Our findings highlight the need to implement a self-management intervention program involving patient activation and health literacy-focused activities for COPD, creating a support system for patients from low-income families and low education.
Genome-wide indentification for genes involved in sodium dodecyl sulfate toxicity in Saccharomyces cerevisiae
Authors: Cao Chunlei , Cao Zhengfeng , Yu Peibin , Zhao Yunying 
Published: February 2020

Abstract
Background: Sodium dodecyl sulfate (SDS) is one of the most widely used anionic alkyl sulfate surfactants. Toxicological information on SDS is accumulating, however, mechanisms of SDS toxicity regulation remain poorly understood. In this study, the relationship between the SDS-sensitive mutants and their intracellular ROS levels has been investigated.
Results: Through a genome-scale screen, we have identified 108 yeast single-gene deletion mutants that are sensitive to 0.03% SDS. These genes were predominantly related to the cellular processes of metabolism, cell cycle and DNA processing, cellular transport, transport facilities and transport routes, transcription and the protein with binding function or cofactor requirement (structural or catalytic). Measurement of the intracellular ROS (reactive oxygen species) levels of these SDS-sensitive mutants showed that about 79% of SDS-sensitive mutants accumulated significantly higher intracellular ROS levels than the wild-type cells under SDS stress. Moreover, SDS could generate oxidative damage and up-regulate several antioxidant defenses genes, and some of the SDS-sensitive genes were involved in this process.
Conclusion: This study provides insight on yeast genes involved in SDS tolerance and the elevated intracellular ROS caused by SDS stress, which is a potential way to understand the detoxification mechanisms of SDS by yeast cells.
Comparison between transpancreatic sphincterotomy and needle-knife fistulotomy in difficulty biliary access, a retrospective study in Taiwan
Authors: Liang Kai-Shun , Chen Chieh-Chang , Liao Wei-Chih , Kuo Yu-ting , Tseng Liang-Wei , He Wen-Tsung , Wang Hsiu-Po 
Published: February 2020

Abstract
Background Selective deep biliary cannulation is the first and the most important step before further biliary therapy. Transpancreatic sphincterotomy(TPS), and needle knife fistulotomy(NKF) were commonly used in patients with difficult cannulation, but few studies compare the outcome between TPS and NKF. Aims To investigate the success rate and complications of NKF and TPS in patients with difficult biliary access. Methods A total of 78 patients who met the criteria of difficult cannulation in the National Taiwan University hospital from October 2015 to October 2017 were retrospectively reviewed. Their baseline demographics, success rate of biliary cannulation, and the rate of adverse events were assessed. Results 31 patients and 47 patients underwent TPS and NKF for difficult biliary access, respectively. The characteristics of the 2 groups were similar, but patients in TPS group had more frequent pancreatic duct cannulation. Bile duct cannulation was successful in 23 patients (74.2 %) in the TPS group and 39 (83.0%) in the NKF group (P=0.34). There was no difference between the TPS and NKF in the rate of adverse events, including post-ERCP pancreatitis (PEP) (16.1% vs. 6.4%, p = 0.17), and hemorrhage (3.2% vs. 8.5%, p = 0.35). No perforation occurred. Conclusions Both TPS and NKF have good biliary access rate in patient with difficult cannulation. TPS has acceptable successful rate and similar complication rate, compared with NKF.
Fluoroquinolone resistance and mutational profile of gyrA gene in pulmonary MDR tuberculosis patients
Authors: Kabir Saba , Tahir Zarfishan , Mukhtar Nadia , Sohail Muhammad , Saqalein Muhammad , Rehman Abdul 
Published: February 2020

Abstract
Background
Flouroquinolones (FQs) are the potential drugs that inhibit DNA synthesis and used in the treatment of MDR-TB and anti-TB short term regimens. In recent year’s high proportion of flouroquinolone (FQs) resistance in Mycobacterium tuberculosis isolates has been observed. The development of FQs resistance among multidrug resistant TB (Pre-XDR TB) negatively impact patient treatment outcome and is a serious threat to control TB.
Methods
A total of 562 samples were included in the study from patients with pulmonary TB which had been on anti-tuberculosis therapy. MTBDRsl assay was performed for molecular detection of mutations. Sequence analysis was performed for characterization and mutational profiling of FQ resistant isolates.
Results

FQs resistance was observed in 104 (18.5%) samples and most of them were previously treated and treatment failure cases. A total of 102 isolates had mutations in gyrA gene while gyrB gene mutations were observed in only two isolates. Mutational analysis showed that the mutations mostly alter protein at codon 94 (D94G) (represents the replacement of aspartic acid with glycine) and 90 (A90V) (substitution of alanine with valine). In MDR and treatment failure cases, the FQs-R was most commonly associated with D94G mutation. Whereas, a high proportion of A90V mutation was observed in MTB isolates which were newly diagnosed.
Conclusion
The findings suggest that the genotypic studies for FQs resistance should be carried out at the time of initial diagnosis, before starting treatment, to rule out all type of mutations for its potential use in treatment to control the resistance.
neoANT-HILL: an integrated tool for identification of potential neoantigens
Authors: Coelho Ana Carolina , Fonseca Andre , Martins Danilo , Lins Paulo , Cunha Lucas da , de Souza Sandro 
Published: February 2020

Abstract
Background

Cancer neoantigens have attracted great interest in immunotherapy due to their capacity to elicit antitumoral responses. These molecules arise from somatic mutations in cancer cells, resulting in alterations on the original protein. Neoantigens identification remains a challenging task due largely to a high rate of false-positives.

Results

We have developed an efficient and automated pipeline for the identification of potential neoantigens. neoANT-HILL integrates several immunogenomic analyses to improve neoantigen detection from Next Generation Sequence (NGS) data. The pipeline has been compiled in a pre-built Docker image such that minimal computational background is required for download and setup. NeoANT-HILL was applied in the The Cancer Genome Atlas (TCGA) melanoma dataset and found several putative neoantigens including ones derived from the recurrent RAC1:P29S and SERPINB3:E250K mutations. neoANT-HILL was also used to identify potential neoantigens in RNA-Seq data with a high sensitivity and specificity.

Conclusion

neoANT-HILL is a user-friendly tool with a graphical interface that performs neoantigens prediction efficiently. neoANT-HILL is able to process multiple samples, provides several binding predictors, enables quantification of tumor-infiltrating immune cells and considers RNA-Seq data for identifying potential neoantigens. The software is available on github at https://github.com/neoanthill/neoANT-HILL .
The Disruptive bEhavior manageMEnt ANd prevention in hospitalized patients using a behaviORal intervention team (DEMEANOR) study protocol: a pragmatic, cluster, crossover trial.
Authors: Morrison Jay , Hasselblad Michele , Kleinpell Ruth , Buie Reagan , Ariosto Deborah , Hardiman Erin , Osborn Stephen W , Lindsell Christopher J 
Published: February 2020

Abstract
Background

Disruptive behavior in hospitalized patients has become a priority area of safety concern for clinical staff, as well as having consequences for patient management and hospital course. Proactive screening and intervention of patients with behavioral co-morbidities has been reported to reduce disruptive behavior in some settings, but has not been studied in a rigorous way.

Methods

The D isruptive b E havior manage ME nt AN d prevention in hospitalized patients using a behavi OR al intervention team (DEMEANOR) study is a pragmatic, cluster, cross-over trial being conducted. Each month, the behavioral intervention team, comprised of a psychiatric-mental health advanced practice nurse and a clinical social worker, with psychiatrist consultation as needed, rotates between an adult medicine unit and a mixed cardiac unit at Vanderbilt University Medical Center in Nashville, TN. The team proactively screens patients upon admission utilizing a protocol which includes a comprehensive chart review, and if indicated, a brief interview, seeking to identify those patients who possess risk factors indicative of either a potential psychological barrier to their own clinical progress or a potential risk for exhibiting disruptive, aggressive or self-injurious behavior during their hospitalization. Once identified, the team provides interventions aimed at mitigating these risks, educates and supports the patient care teams (nurses, physicians and others), and assists non-psychiatric staff in the management of patients who require behavioral health care. Patients who are both admitted to and discharged from either unit are included in the study. Anticipated enrollment is approximately 1790 patients. The two primary outcomes are i) a composite of objective measures related to the patients’ disruptive, threatening or acting out behaviors, and ii) staff self-reported comfort with and confidence in their ability to manage patients exhibiting disruptive, threatening or acting out behavior. Secondary outcomes include patient length of stay, patient attendant (sitter) use, and the unit nursing staff retention.

Discussion

This ongoing trial will provide evidence on the real-world effectiveness of a proactive behavioral intervention to prevent disruptive, threatening or acting out events in adult hospitalized patients.
Comparative physiological and biochemical mechanisms of salt tolerance in five contrasting highland quinoa cultivars
Authors: Cai Zhiquan , Gao Qi 
Published: February 2020

Abstract
Background: Chenopodium quinoa Willd., a halophytic crop, shows great variability among different genotypesin response to salt. To investigate the salinitytolerance mechanisms, five contrasting quinoa cultivars belonging to highland ecotype were compared for their seed germination (under 0, 100 and 400 mM NaCl) and seedling’s responses under five salinity levels (0, 100, 200, 300 and 400 mM NaCl). Results: Substantial variations were found in plant size (biomass) and overall salinity tolerance (plant biomass in salt treatment as % of control) among the different quinoa cultivars. Plant salinity tolerance was negatively associated with plant size, especially at lower salinity levels (<300 mM NaCl), but salt tolerance between seed germination and seedling growth is was not closely correlated. Except for shoot/root ratio, all measured plant traits responded to salt in a genotype-specific way. Salt stress resulted in decreased plant height, leaf area, root length, and root/shoot ratio in each cultivar. With increasing salinity levels, leaf superoxide dismutase (SOD) activity and lipid peroxidation generally increased, but catalase (CAT) and peroxidase (POD) activities showed non-linear patterns. Organic solutes (soluble sugar, proline and protein) accumulated in leaves, whereas inorganic ion (Na + and K + )increased but K + /Na + decreased in both leaves and roots. Across different salinity levels and cultivars, without close relationships with antioxidant enzyme activities (SOD, POD, or CAT), salinity tolerance was significantly negatively correlated with leaf organic solute and malondialdehyde contents in leaves and inorganic ion contents in leaves or roots ( not except for root K + content), but positively correlated with K + /Na + ratio in leaves or roots. Conclusion: Our results establish indicate ed that leaf osmoregulation, K + retention, Na + exclusion, and ion homeostasis are the main physiological mechanisms conferring salinity tolerance of these cultivars, rather than the regulations of leaf antioxidative ability.As an index of salinity tolerance, K + /Na + ratio in leaves or roots can be used for the selective breeding of highland quinoa cultivars.
Comparison of amyloid PET measured in Centiloid units with neuropathological findings in Alzheimer’s Disease
Authors: Amadoru Sanka , Doré Vincent , McLean Catriona A , Hinton Fairlie , Shepherd Claire E , Halliday Glenda M , Leyton Cristian E , Yates Paul A , Hodges John R , Masters Colin L , Villemagne Victor L , Rowe Christopher C 
Published: February 2020

Abstract
Background: The Centiloid scale was developed to standardise the results of beta-amyloid (Aβ) PET. We aimed to determine the Centiloid unit (CL) thresholds for CERAD sparse and moderate density neuritic plaques, Alzheimer’s disease neuropathologic change (ADNC) score of intermediate or high probability of Alzheimer’s Disease (AD), final clinicopathological diagnosis of AD and expert visual read of a positive Aβ PET scan. Methods: Aβ PET results in CL for 49 subjects were compared with post-mortem findings, visual read, and final clinicopathological diagnosis. The Youden Index was used to determine the optimal CL thresholds from receiver operator characteristic (ROC) curves. Results: A threshold of 20.1 CL (21.3 CL when corrected for time to death, AUC 0.97) yielded highest accuracy in detecting moderate or frequent plaque density while <10 CL was optimal for excluding neuritic plaque. The threshold for ADNC intermediate or high likelihood AD was 49.4 CL (AUC 0.98). Those cases with a final clinicopathological diagnosis of AD yielded a median CL result of 87.7 (IQR ±42.2) with 94% > 45 CL. Positive visual read agreed highly with results >26 CL. Conclusions: Centiloid values <10 accurately reflected the absence of any neuritic plaque, >20 CL indicated the presence of at least moderate plaque density but approximately 50 CL or more best confirmed both neuropathological and clinicopathological diagnosis of Alzheimer’s disease.
Increase of vancomycin-resistant Enterococcus faecium strain type ST117 CT71 at Charité - Universitätsmedizin Berlin, 2008 to 2018
Authors: Weber Anna , Maechler Friederike , Schwab Frank , Gastmeier Petra , Kola Axel 
Published: February 2020

Abstract
Background: In addition to an overall rise in vancomycin-resistant Enterococcus faecium (VREfm), an increase in certain strain types marked by sequence type (ST) and cluster type (CT) has been reported in Germany over the past few years. Outbreak analyses at Charité - Universitätsmedizin Berlin revealed the frequent occurrence of VREfm ST117 CT71 isolates in 2017 and 2018. To investigate whether ST117 CT71 have emerged in recent years or whether these strains have been circulating for a longer time, we retrospectively analyzed non-outbreak strains that occurred between 2008 and 2018 to identify frequent STs and CTs.Methods: In total, 120 VREfm isolates obtained from clinical and surveillance cultures from the years 2008, 2013, 2015, and 2018 were analyzed. Thirty isolates per year comprising the first 7 - 8 non-outbreak isolates of each quarter of the respective year were sequenced using whole genome sequencing. MLST and cgMLST were determined as well as resistance genes and virulence factors. Risk factors for VREfm ST117 were analyzed in a multivariable analysis with patient characteristics as possible confounders. Results: The percentage of VREfm of type ST117 increased from 17% in 2008 to 57% in 2018 (p=0.012). In 2008, vanA genotype accounted for 80% of all ST117 isolates compared to 6% in 2018. VanB CT71 first appeared in 2018 and predominated over all other ST117 at 43% (p<0.0001). The set of resistance genes (msrC, efmA, erm(B), dfrG, aac(6')-Ii, gyrA, parC and pbp5) and virulence factors (acm, esp, hylEfm, ecbA and sgrA) in CT71 was also found in other ST117 non-CT71 strains, mainly in CT36. The study population did not differ among the different calendar years analyzed in terms of age, gender, length of stay, or ward type (each p>0.2).Conclusion: This study revealed an increase in ST117 strains from 2008 to 2018, accompanied by a shift toward CT71 strains with the vanB genotype in 2018. We did not detect resistance or virulence traits in CT71 that could confer survival advantage compared to other CTs among ST117 strains. To date, it is not clear why ST117 and in particular strain type ST117 CT71 predominates over other strains.
Comparison of Instrumental Activities of Daily Living assessment by face-to-face or telephone interviews: A randomized, crossover study
Authors: Dauphinot Virginie , Boublay Nawèle , Moutet Claire , Achi Sarah , Bathsavanis Anthony , Krolak-Salmon Pierre 
Published: February 2020

Abstract
Background

The functional autonomy assessment is essential to manage patients with a neurodegenerative disease, but its evaluation is not always possible during consultation. To optimize ambulatory autonomy assessment, we compared the Lawton Instrumental Activities of Daily Living (IADL) questionnaire collected by telephone and face-to-face interviews.

Methods

A randomized, crossover study was carried-out among patients attending a memory clinic (MC). The IADL questionnaire was collected for patients during telephone and face-to-face interviews between nurses and patients’caregivers. The agreement between the two methods was measured using the proportion of participants giving the same response, Cohen’s Kappa, intraclass correlation (ICC) coefficient, and Bland and Altman method. The associations between patient characteristics, events occurring between the two assessments, and agreement were assessed.

Results

Among the 292 patients (means±SD age 81.5±7, MMSE 19.6±6, 39.7% with major neurocognitive disorders) analyzed, the proportion of agreement between the two modes was 89.4% for the total IADL score. Weighted Kappa coefficent was 0.66 and ICC score was 0.91 for total IADL score. The mean difference between the IADL score by telephone or face-to-face was 0.32. Overall, 96.9% of measures lay within the 95% limits of agreement. The occurrence of fall was less likely associated with the probability to lie within the 95% limits of agreement (OR=0.07[0.02-0.27]).

Conclusion

The administration of IADL by telephone with the caregiver appears to be an acceptable method of assessment for MC patients compared to face-to-face interview. The events such as falls which could occur in a time close to the evaluation should be reported.
Tight blood pressure control versus standard blood pressure control on the incidence of myocardial infarction and stroke: An observational retrospective cohort study
Authors: Park Bumsoo , Budzynska Katarzyna , Almasri Nada , Islam Sumaiya , Alyas Fanar , Carolan Rachel L. , Abraham Benjamin E. , Castro-Camero Pamela A. , Shreve Maria E. , Rees Della A. , Lamerato Lois 
Published: February 2020

Abstract
Background: The 2017 American College of Cardiology and American Heart Association guideline defined hypertension as blood pressure (BP) ≥ 130/80 mmHg compared to the traditional definition of ≥ 140/90 mmHg. This change raised much controversy. We conducted this study to evaluate incidences of myocardial infarction (MI) and stroke comparing tight (TBPC) and standard BP control (SBPC). Methods: The data were collected and analyzed in 2018. We retrospectively identified hypertensive patients for 1 year at our institution who were classified by BP rate across 3 years into 2 groups of TBPC (< 130 mmHg) and SBPC (130-139 mmHg). We compared the incidence of new MI and stroke between the 2 groups across a 2-year follow-up. Multivariate analysis was done to identify independent risk factors. Results: Of 5640 study patients, the TBPC group showed significantly less incidence of stroke compared to the SBPC group. No differences were found in MI incidence between the 2 groups. Multivariate analysis showed that increased age independently increased the incidence of both MI and stroke, and TBPC independently decreased the incidence of stroke but not of MI. Conclusions: Our observational study suggests that TBPC may be beneficial in less stroke incidence compared to SBPC but it didn’t seem to affect the incidence of MI. Our study is limited by its retrospective design with potential confounders.
Exploring optimal examination to detect occult anastomotic leakage after rectal resection in patients with diverting stoma
Authors: Kitaguchi Daichi , Enomoto Tsuyoshi , Ohara Yusuke , Owada Yohei , Hisakura Katsuji , Akashi Yoshimasa , Takahashi Kazuhiro , Ogawa Koichi , Shimomura Osamu , Oda Tatsuya 
Published: February 2020

Abstract
Background When considering “early stoma closure”, both standardized inclusion/exclusion criteria and standardized methods to assess anastomosis are necessary to reduce the risk of occult anastomotic leakage (AL). However, in the immediate postoperative period, neither have the incidence and risk factors of occult AL in patients with diverting stoma (DS) been clarified nor have methods to assess anastomosis been standardized. The aim of this study was to elucidate the incidence and risk factors of occult AL in patients who had undergone rectal resection with DS and to evaluate the significance of computed tomography (CT) following water-soluble contrast enema (CE) to detect occult anastomotic leakage. Methods This was a single institutional prospective observational study of patients who had undergone rectal resection with the selective use of DS between May and October 2019. Fifteen patients had undergone CE and CT to assess for AL on postoperative day (POD) 7, and CT was performed just after CE. Univariate analysis was performed to assess the relationship between preoperative variables and the incidence of occult AL on POD 7 Results The incidence of occult AL on postoperative day 7 was 6 of 15 (40%). Hand-sewn anastomosis, compared with stapled anastomosis, was a significant risk factor. Five more cases with occult AL that could not be detected with CE could be detected on CT following CE; CE alone had a 33% false-negative radiological result rate. Conclusions Hand-sewn anastomosis appeared to be a risk factor for occult AL, and CE alone had a high false-negative radiological result rate. When considering the introduction of early stoma closure, stapled anastomosis and CT following CE could be an appropriate inclusion criterion and preoperative examination, respectively.