bluuebunny/crossref_metadata_2025_split huggingface dataset:
The appropriateness of DUNDRUM-3 and DUNDRUM-4 for Māori in forensic mental health services in New Zealand: participatory action research
Authors: Wharewera-Mika Julie , Cooper Erana , Wiki Nick , Prentice Kiri , Field Trudie , Cavney James , Kaire David , McKenna Brian 
Published: February 2020

Abstract
Background
The Auckland Regional Forensic Psychiatry Services (ARFPS) in New Zealand has introduced structured clinical judgment instruments developed in Ireland (DUNDRUM-3 and DUNDRUM-4) to assist staff decision-making regarding service users’ clinical pathways. In New Zealand, Māori (the indigenous people) constitute 43% of the in-patient forensic mental health population. The aim of this study was to determine the face validity of the measures for Māori.

Methods
Participatory Action Research was aligned with a kaupapa Māori (Māori-orientated) research approach, to give full recognition to Māori cultural values. Two hui (gatherings) were held with Māori clinical and cultural experts at the service. The first hui (n = 12), explored the cultural appropriateness of the measures. The second (n = 10) involved a reflection on appropriate adaptions to the measures. Discussions were digitally recorded, transcribed and thematically analysed.

Results
Although the usefulness of the measures in enhancing the overall quality of clinical decision-making was confirmed, the DUNDRUM measures were considered to be limited in their ability to fully measure Māori service user progress and recovery. Suggestions were made to develop an additional ‘pillar’ focused on cultural identity and spirituality for DUNDRUM-3; to use both service user and family ratings for the adapted DUNDRUM-3 and DUNDRUM-4 measures; and to involve cultural expertise at the point of structured clinical judgement when using the measures.

Conclusions
This is the first study to consider the face validity of the DUNDRUM-3 and DUNDRUM-4 for indigenous peoples, who are internationally over-represented in forensic mental health services. Suggested changes would require a negotiated, collaborative process between Māori cultural expertise and the original authors of the measures.
Trends in prevalence and incidence of chronic respiratory diseases from 1990 to 2017
Authors: Xie Min , Liu Xiansheng , Cao Xiaopei , Guo Mingzhou , Li Xiaochen 
Published: February 2020

Abstract
Background
Chronic respiratory diseases (CRDs) are leading causes of morbidity worldwide. However, the spatial and temporal trends in prevalence and incidence of CRDs have not been estimated.

Methods
Based on data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017, we analyzed the prevalence and incidence trends of CRDs from 1990 to 2017 according to age, sex, region and disease pattern. Furthermore, the correlations between the incidence and the World Bank income levels, sociodemographic index (SDI), and human development index (HDI) levels were analyzed to assess the factors affecting incidence.

Result
The total number of CRD cases increased by 39.5% from 1990 to 2017, nevertheless, the age-standardized prevalence rate (ASPR) and age-standardized incidence rate (ASIR) showed decreasing trends. The ASIRs of CRD, chronic obstructive pulmonary disease (COPD), pneumoconiosis, and asthma decreased, whereas the ASIR of interstitial lung disease and pulmonary sarcoidosis increased during the past 27 years. Significant differences between males and females in the incidence rates of pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis were observed. Elderly people especially suffered from CRDs, except for asthma. For COPD, the ASIR decreased from low-SDI regions to high-SDI regions. The ASIR of interstitial lung disease and pulmonary sarcoidosis in the high-SDI region was highest and have increased mostly. The ASIRs for pneumoconiosis and asthma were inversely related to the HDI.

Conclusions
In 2017, CRDs were still the leading causes of morbidity worldwide. A large proportion of the disease burden was attributed to asthma and COPD. The incidence rates of all four types of CRDs varied greatly across the world. Statistically significant correlation was found between the ASIR and SDI/HDI.
Degenerative findings in lumbar spine MRI: an inter-rater reliability study involving three raters
Authors: Doktor Klaus , Jensen Tue Secher , Christensen Henrik Wulff , Fredberg Ulrich , Kindt Morten , Boyle Eleanor , Hartvigsen Jan 
Published: February 2020

Abstract
Background
For diagnostic procedures to be clinically useful, they must be reliable. The interpretation of lumbar spine MRI scans is subject to variability and there is a lack of studies where reliability of multiple degenerative pathologies are rated simultaneously. The objective of our study was to determine the inter-rater reliability of three independent raters evaluating degenerative pathologies seen with lumbar spine MRI.

Methods
Fifty-nine people, 35 patients with low back pain (LBP) or LBP and leg pain and 24 people without LBP or leg pain, received an MRI of the lumbar spine. Three raters (one radiologist and two chiropractors) evaluated the MRIs for the presence and severity of eight degenerative spinal pathologies using a standardized format: Spondylolisthesis, scoliosis, annular fissure, disc degeneration, disc contour, nerve root compromise, spinal stenosis and facet joint degeneration. Findings were identified and classified at disc level according to type and severity. Raters were instructed to evaluate all study sample persons once to assess inter-rater reliability (fully crossed design). Reliability was calculated using Gwet’s Agreement Coefficients (AC1 and AC2) and Cohen’s Kappa (κ) and Conger’s extension of Cohen’s. Gwet’s probabilistic benchmarking method to the Landis and Koch scale was used. MRI-findings achieving substantial reliability was considered acceptable.

Results
Inter-rater reliability for all raters combined, ranged from (Gwet’s AC1 or AC2): 0.64–0.99 and according to probabilistic benchmarking to the Landis and Koch scale equivalent to moderate to almost perfect reliability. Overall reliability level for individual pathologies was almost perfect reliability for spondylolisthesis, spinal stenosis, scoliosis and annular fissure, substantial for nerve root compromise and disc degeneration, and moderate for facet joint degeneration and disc contour.

Conclusion
Inter-rater reliability for 3 raters, evaluating 177 disc levels, was found to be overall acceptable for 6 out of 8 degenerative MRI-findings in the lumbar spine. Ratings of facet joint degeneration and disc contour achieved moderate reliability and was considered unacceptable.
Biomechanical efficacy of four different dual screws fixations in treatment of talus neck fracture: a three-dimensional finite element analysis
Authors: Fan Zhengrui , Ma Jianxiong , Chen Jian , Yang Baocheng , Wang Ying , Bai Haohao , Sun Lei , Wang Yan , Lu Bin , Dong Ben-chao , Tian Aixian , Ma Xinlong 
Published: February 2020

AbstractBackgroundCurrent there are different screws fixation methods used for fixation of the talar neck fracture. However, the best method of screws internal fixation is still controversial. Few relevant studies have focused on this issue, especially by finite element analysis. The purpose of this study was to explore the mechanical stability of dual screws internal fixation methods with different approaches and the best biomechanical environment of the fracture section, so as to provide reliable mechanical evidence for the selection of clinical internal fixation.MethodsThe computed tomography (CT) image of the healthy adult male ankle joint was used for three-dimensional reconstruction of the ankle model. Talus neck fracture and screws were constructed by computer-aided design (CAD). Then, 3D model of talar neck fracture which fixed with antero-posterior (AP) parallel dual screws, antero-posterior (AP) cross dual screws, postero-anterior (PA) parallel dual screws, and postero-anterior (PA) cross dual screws were simulated. Finally, under the condition of 2400N vertical load, finite element analysis (FEA) were carried out to compare the outcome of the four different internal fixation methods. The results of Von Mises stress, displacement of four groups which contain talus fracture fragments and screws internal fixations were analyzed.ResultsCompared with the other three groups, postero-anterior (PA) parallel dual screws had better results in the stress peak, stress distribution, and displacement of talus and internal fixation.ConclusionsTo sum up, the Von Mises stress of fracture section was the smallest, the stress distribution of screws were the most scattered, and the peak value was the smallest in posterior to anterior parallel double screws fixation, which was obviously better than that in the other three groups. When using screws internal fixation, the method of posterior to anterior screws fixation is better than that of anterior to posterior screws fixation, and the peak value and stress distribution of parallel double screws fixation is better than that of cross double screws fixation. Thus, for the talar neck fracture, the use of posterior to anterior parallel double screws fixation is recommended in clinical surgery.
Mechanism of increased risk of insulin resistance in aging skeletal muscle
Authors: Shou Jian , Chen Pei-Jie , Xiao Wei-Hua 
Published: February 2020

AbstractAs age increases, the risk of developing type 2 diabetes increases, which is associated with senile skeletal muscle dysfunction. During skeletal muscle aging, mitochondrial dysfunction, intramyocellular lipid accumulation, increased inflammation, oxidative stress, modified activity of insulin sensitivity regulatory enzymes, endoplasmic reticulum stress, decreased autophagy, sarcopenia and over-activated renin-angiotensin system may occur. These changes can impair skeletal muscle insulin sensitivity and increase the risk of insulin resistance and type 2 diabetes during skeletal muscle aging. This review of the mechanism of the increased risk of insulin resistance during skeletal muscle aging will provide a more comprehensive explanation for the increased incidence of type 2 diabetes in elderly individuals, and will also provide a more comprehensive perspective for the prevention and treatment of type 2 diabetes in elderly populations.
Accumulation of DNA methylation alterations in paediatric glioma stem cells following fractionated dose irradiation
Authors: Danielsson Anna , Barreau Kristell , Kling Teresia , Tisell Magnus , Carén Helena 
Published: February 2020

Abstract
Background
Radiation is an important therapeutic tool. However, radiotherapy has the potential to promote co-evolution of genetic and epigenetic changes that can drive tumour heterogeneity, formation of radioresistant cells and tumour relapse. There is a clinical need for a better understanding of DNA methylation alterations that may follow radiotherapy to be able to prevent the development of radiation-resistant cells.

Methods
We examined radiation-induced changes in DNA methylation profiles of paediatric glioma stem cells (GSCs) in vitro. Five GSC cultures were irradiated in vitro with repeated doses of 2 or 4 Gy. Radiation was given in 3 or 15 fractions. DNA methylation profiling using Illumina DNA methylation arrays was performed at 14 days post-radiation. The cellular characteristics were studied in parallel.

Results
Few fractions of radiation did not result in significant accumulation of DNA methylation alterations. However, extended dose fractionations changed DNA methylation profiles and induced thousands of differentially methylated positions, specifically in enhancer regions, sites involved in alternative splicing and in repetitive regions. Radiation induced dose-dependent morphological and proliferative alterations of the cells as a consequence of the radiation exposure.

Conclusions
DNA methylation alterations of sites with regulatory functions in proliferation and differentiation were identified, which may reflect cellular response to radiation stress through epigenetic reprogramming and differentiation cues.
Methylation silencing of TGF-β receptor type II is involved in malignant transformation of esophageal squamous cell carcinoma
Authors: Ma Yarui , He Siyuan , Gao Aiai , Zhang Ying , Zhu Qing , Wang Pei , Yang Beibei , Yin Huihui , Li Yifei , Song Jinge , Yue Pinli , Li Mo , Zhang Dandan , Liu Yun , Wang Xiaobing , Guo Mingzhou , Jiao Yuchen 
Published: February 2020

Abstract
Background
Although massive studies have been conducted to investigate the mechanisms of esophageal squamous cell carcinoma (ESCC) carcinogenesis, the understanding of molecular alterations during the malignant transformation of epithelial dysplasia is still lacking, especially regarding epigenetic changes.

Results
To better characterize the methylation changes during the malignant transformation of epithelial dysplasia, a whole-genome bisulfite sequencing analysis was performed on a series of tumor, dysplastic, and non-neoplastic epithelial tissue samples from esophageal squamous cell carcinoma (ESCC) patients. Promoter hypermethylation in TGF-β receptor type II (TGFBR2), an important mediator of TGF-β signaling, was identified. Further, we evaluated the methylation and expression of TGFBR2 in tumor samples through The Cancer Genome Atlas multiplatform data as well as immunohistochemistry. Moreover, treatment of ESCC cell lines with5-Aza-2′-deoxycytidine, a DNA methyltransferase inhibitor, reactivated the expression of TGFBR2. The lentiviral mediating the overexpression of TGFBR2 inhibited the proliferation of ESCC cell line by inducing cell cycle G2/M arrest. Furthermore, the overexpression of TGFBR2 inhibited the tumor growth obviously in vivo.

Conclusions
The characterization of methylation silencing of TGFBR2 in ESCC will enable us to further explore whether this epigenetic change could be considered as a predictor of malignant transformation in esophageal epithelial dysplasia and whether use of a TGFBR2 agonist may lead to a new therapeutic strategy in patients with ESCC.
Replication study of susceptibility variants associated with allergic rhinitis and allergy in Han Chinese
Authors: Gao Yunbo , Li Jingyun , Zhang Yuan , Zhang Luo 
Published: February 2020

Abstract
Background
Allergic rhinitis (AR) is believed to be a complex genetic disease. The last decade has been marked by the publication of more than 20 genome-wide association studies (GWASs) of AR and associated allergic phenotypes and allergic diseases, which have shown allergic diseases and traits to share a large number of genetic susceptibility loci. The aim of present study was therefore to investigate the highly replicated allergy related genes and variants as candidates for AR in Han Chinese subjects.

Methods
A total of 762 AR patients and 760 control subjects were recruited, and a total of 58 susceptible variants previously reported to be associated with allergic traits were choose for replication.

Results
Logistic regression analyses revealed that in the co-dominant-effect model as assessed by the AIC, compared with wild-type carriers, significant AR risk were associated with rs9865818 in LPP (P = 0.029, OR = 1.469 for GG vs. AA); rs6554809 in DNAH5 (P = 0.000, OR = 1.597 for TC vs. CC); rs1438673 in WDR36-CAMK4 loci (P = 0.037, OR = 1.396 for CC vs.TT), rs7775228 in HLA region (P = 0.000, OR = 1.589 for TC vs.TT), rs7203459 in CLEC16A (P = 0.025, OR = 0.731 for TC vs. TT).

Conclusion
We replicated Han Chinese AR-specific susceptibility loci in LPP, DNAH5, HLA, CLEC16A and WDR36-CAMK4. Further understanding the molecular mechanisms underlying these associations may provide new insights into the etiology of allergic disease.
Risk factors for fecal carriage of drug-resistant Escherichia coli: a systematic review and meta-analysis
Authors: Hu Yuan , Matsui Yusuke , W. Riley Lee 
Published: February 2020

Abstract
Background
Antimicrobial resistance is a serious public health problem. Fecal carriage of drug-resistant bacteria has been suggested as an important source of antimicrobial resistant genes (ARGs). We aimed to identify risk factors associated with fecal carriage of drug-resistant commensal Escherichia coli among healthy adult population.

Methods
We conducted a systematic review and meta-analysis following the PRISMA guideline. We identified observational studies published from 2014 to 2019 through PubMed, Embase, and Web of Science. Studies were eligible if they investigated and reported risk factors and accompanying measure of associations for fecal carriage of drug-resistant E. coli for healthy population aged 18-65. Data on risk factors assessed in three or more studies were extracted.

Results
Fifteen of 395 studies involving 11480 healthy individuals were included. The pooled prevalence of drug-resistant Enterobacteriaceae was 14% (95% confidence interval [CI] 8-23%). Antimicrobial use within the 12 months prior to stool culture (odds ratio [OR] 1.84 [95%CI 1.35-2.51]), diarrhea symptoms (OR 1.56 [95%CI 1.09-2.25]), travel to India (OR 4.15 [95%CI 2.54-6.78]), and vegetarian diet (OR 1.60 [95%CI 1.00(1.0043)-2.56(2.5587)]) were associated with increased risk of fecal carriage of drug-resistant E. coli. Among travellers, antimicrobial use (OR 2.81 [95%CI 1.47-5.36]), diarrhea symptoms (OR 1.65 [95%CI 1.02-2.68]), travel to India (OR 3.80 [95%CI 2.23-6.47]), and vegetarian diet (OR 1.92 [95%CI 1.13-3.26]) were associated with increased risk. Among general adult population, antimicrobial use (OR 1.51 [95%CI 1.17-1.94]), diarrhea symptoms (OR 1.53 [95%CI 1.27-1.84]), and travel to Southeast Asia (OR 1.67 [95%CI 1.02-2.73]) were associated with the increased risk of drug-resistant E. coli carriage.

Conclusions
The findings indicate that dietary habit as well as past antimicrobial use and travel to high-risk country are associated with the risk of fecal carriage of drug-resistant commensal E. coli.
Economic evaluation of AbobotulinumtoxinA vs OnabotulinumtoxinA in real-life clinical management of cervical dystonia
Authors: Misra V. P. , Danchenko N. , Maisonobe P. , Lundkvist J. , Hunger M. 
Published: February 2020

Abstract
Background
Botulinum neurotoxins type A (BoNT-As) are commonly used treatments for cervical dystonia (CD). Clinical trials have demonstrated the benefits of them in these patients, but data from real-life clinical practice as well as comparative data on the cost and outcome of different BoNT-A formulations are limited. The aim of this study was to compare abobotulinumtoxinA (aboBoNT-A) and onabotulinumtoxinA (onaBoNT-A) on their clinical outcomes and drug costs in real-life clinical practice.

Methods
This analysis included 356 adult patients with idiopathic CD treated with aboBoNT-A (n = 253) or onaBoNT-A (n = 103) from 38 centres across Europe and Australia (NCT00833196). The clinical outcome measures were treatment responses, changes in TWSTRS scores and changes in health utility scores from baseline to study visit 2 and 3. Health utility score was mapped from the TWSTRS total scale, using a previous publication. Costs included drug cost for France.

Results
The aboBoNT-A treated group had 2.06 (95% CI: 1.15 to 3.69) times higher odds of achieving treatment response than the onaBoNT-A treated group. The adjusted mean change in TWSTRS total score from baseline to visit 3 were − 6.42 (95% CI: − 7.52 to − 5.33) for aboBoNT-A and − 3.94 (95% CI: − 5.68 to − 2.2) for onaBoNT-A, with a difference of − 2.48 (95% CI: − 4.57 to − 0.39). The corresponding difference in the adjusted mean change for health utility score was 0.008 (95% CI: 0.001 to 0.014). Mean treatment costs for aboBoNT-A and onaBoNT-A were 314.1 (95% CI: 299.1 to 329.0) and 346.6 (95% CI: 322.9 to 370.4) Euros, respectively.

Conclusions
This comparative analysis indicated that treatment with aboBoNT-A may be less costly and lead to improved clinical outcomes when compared with onaBoNT-A, from a French healthcare system perspective. Additional comparative clinical data from larger patient cohorts, as well as more information about cost consequences of an improvement in clinical outcome would be of value to further confirm the findings.
Intensive support for adults with intellectual disability and behaviours that challenge: a survey of provision and service typologies in England
Authors: Hassiotis Angela , Walsh Amy , Budgett Jessica , Harrison Isobel , Jones Rebecca , Morant Nicola , Courtenay Ken , Crossey Elisabeth Victoria , Hall Ian , Romeo Renee , Taggart Laurence George , Langdon Peter E. , Ratti Victoria , Kirchner Vincent , Lloyd-Evans Brynmor 
Published: February 2020

Background
Approximately 18% of adults with intellectual disabilities living in the community display behaviours that challenge. Intensive support teams (ISTs) have been recommended to provide high-quality responsive care aimed at avoiding unnecessary admissions and reducing lengthy in-patient stays.

Aims
To identify and describe the geographical distribution and characteristics of ISTs, and to develop a typology of IST service models in England.

Method
We undertook a national cross-sectional survey of 73 ISTs. A hierarchical cluster analysis was performed based on six prespecified grouping factors (mode of referrals, size of case-load, use of outcome measures, staff composition, hours of operation and setting of service). A simplified form of thematic analysis was used to explore free-text responses.

Results
Cluster analysis identified two models of IST provision: (a) independent and (b) enhanced provision based around a community intellectual disability service. ISTs aspire to adopt person-centred care, mostly use the framework of positive behaviour support for behaviour that challenges, and report concerns about organisational and wider context issues.

Conclusions
This is the first study to examine the delivery of intensive support to people with intellectual disability and behaviour that challenges. A two-cluster model of ISTs was found to have statistical validity and clinical utility. The clinical heterogeneity indicates that further evaluation of these service models is needed to establish their clinical and cost-effectiveness.