bluuebunny/crossref_metadata_2025_split huggingface dataset:
Importance of internal consistency in implementation programmes. A qualitative study of focus-group interviews.
Authors: Lindholm Lars Henrik , Laitila Minna , Lassila Antero , Kampman Olli 
Published: January 2020

Abstract
Background Programmes for implementing evidence-based treatments (EBTs) reach their goals if they succeed in institutionalizing the EBTs into routine clinical practices. Resistance to change is a common response to such programmes, undermining their ultimate output. This also happened with Ostrobothnia Depression Programme (ODP) in Finland, which was targeted at several regional psychiatric teams. We conducted a process evaluation of it to ascertain how managerial and executive practices enable or inhibit implementation and how to overcome resistance.Methods We conducted focus group interviews to scrutinize the phases of preparation and practical execution of the ODP from the perspectives of management and programme executives. To gather the data, we applied the revised Socratic approach for health technology assessment and the rapid assessment process model. We analysed the data deductively according to the Normalization Process Theory.Results We identified two main critical issues: 1) The ODP comprised two simultaneously administered programmes, one for the implementation of two EBTs and the other to study their effectiveness. Tension between these two programmes was apparent right from the beginning. 2) The programme had a simplistic top-down design and, in the preparation phase, collaboration with its target groups was delayed and minimal. No formal implementation theory or framework was applied. In addition, independent internal processes in the separate teams influenced their reception of the ODP.Conclusion We recommend early collaboration between team leaders and prospective treatment providers right from the preparation phase of an EBT implementation programme. Agreement on goals and the instruments for achieving them is essential. The strategies for execution should be adjusted with respect to the prevailing implementation climates within the separate target teams. A collaborative approach may enhance the implementation climate and mitigate resistance. Applying some appropriate implementation theories and frameworks may facilitate that work.
Plasmodium falciparum genetic factors rather than the hosts' are likely to drive resistance to acts in ghana.
Authors: Hodoameda Peter , Quashie Nancy Duah , Hagan Charles Oheneba , Matrevi Sena , Abuaku Benjamin , Koram Kwadwo , Quashie Neils B 
Published: January 2020

Abstract
Background: Artemisinin-based Combination Therapy (ACT), a combination of a fast-acting artemisinin derivative and a relatively slow-acting partner drug, is used for malaria treatment in disease-endemic areas. The ACT partner drugs, currently used in Ghana are lumefantrine, amodiaquine, and piperaquine. Plasmodium falciparum isolates with reduced susceptibility to these partner drugs may affect treatment outcome. Mutations in the parasite multidrug-resistant 1 (Pfmdr1) gene is linked to reduced susceptibility to amodiaquine and lumefantrine. In addition, the potency of the partner drugs in vivo depends on the metabolism by the cytochrome P450 (CYP) enzyme in the host. Mutations in the CYP2C8 gene are linked to reduced metabolism of amodiaquine in vitro while mutations in CYP3A4 may be linked to reduced metabolism to lumefantrine in vitro. Methods: This study investigated the host and parasite genetic factors affecting the susceptibility of the malaria parasite to ACT partner drugs. Archived samples from 240 patients (120 given AL and the other half given AA) aged ≤9years participating in antimalarial drug resistance survey in sites representing the three ecological areas of Ghana were used. Polymerase chain reaction (PCR) followed by Sanger sequencing was used to determine the polymorphisms in CYP2C8, CYP3A4, and Pfmdr1 genes. Results: Of the 93 samples successfully genotyped for CYP3A4, all had wild type alleles which suggest that the hosts are good metabolizers of lumefantrine. Ninety-four samples were successfully genotyped for CYP2C8 of which 60% had wild type alleles, 35% heterozygous and 5% homozygous recessive alleles. The high percentage of wild type alleles observed also suggests that amodiaquine was metabolized efficiently by the hosts. Ninety-five samples were successfully genotyped for the Pfmdr1 gene. At codon 86, 95% were wild type (N86), 5% mutant (Y86). For codon 184, 36% were wild type (Y184) and 64% mutant (F184) while for codons 1034, 1042 and 1246, 100% (all) were wild type. The high prevalence of N86, F184, and D1246 (NFD) suggest the presence of strains of the parasites with reduced susceptibility to lumefantrine and not amodiaquine. Delayed clearance was observed in individuals with mutations in the Pfmdr1 gene and not Cytochrome 450 gene. There were both synonymous and nonsynonymous mutations observed in the Pfmdr1 at low prevalence. Conclusion: The outcome of this study indicates that parasite's genetic factors rather than the hosts' are likely to drive resistance to ACTs in Ghana.
Measuring the prevalence of 60 health conditions in older Australians in residential aged care with electronic health records: a retrospective dynamic cohort study
Authors: Lind Kimberly E. , Raban Magdalena Z. , Brett Lindsey , Jorgensen Mikaela L. , Georgiou Andrew , Westbrook Johanna I. 
Published: January 2020

Abstract
Background : The number of older Australians using aged care services is increasing, yet there is an absence of reliable data on their health. Multimorbidity in this population has not been well described. A clear picture of the health status of people using aged care is essential for informing health practice and policy to support evidence-based, equitable, high-quality care. Our objective was to describe the health status of older Australians living in residential aged care facilities (RACFs) and develop a model for monitoring health conditions using data from electronic health record systems. Methods : Using a dynamic retrospective cohort of 9436 RACF residents living in 68 RACFs in New South Wales and the Australian Capital Territory from 2014-2017, we developed an algorithm to identify residents’ conditions using: aged care funding assessments; medications administered; and clinical notes from their facility electronic health record (EHR). We generated age and sex-specific prevalence estimates for 60 health conditions. Agreement between conditions recorded in aged care funding assessments and those documented in residents’ EHRs was evaluated using Cohen’s Kappa. Cluster analysis was used to describe combinations of health conditions (multimorbidity) occurring among residents. Results : Using all data sources, 93% of residents had some form of circulatory disease, with hypertension the most common (62%). Most residents (93%) had a mental or behavioural disorder, including dementia (58%) or depression (54%). For most conditions, EHR data identified approximately twice the number of people with the condition compared to aged care funding assessments. Agreement between data sources was highest for multiple sclerosis, Huntington’s disease and dementia. The cluster analysis identified seven groups with distinct combinations of health conditions and demographic characteristics and found that the most complex cluster represented a group of residents that had on average the longest lengths of stay in residential care. Conclusions : The prevalence of many health conditions among RACF residents in Australia is underestimated in previous reports. Aged care EHR data have the potential to be used to better understand the complex health needs of this vulnerable population and can help fill the information gaps needed for population health surveillance and quality monitoring.
Arabic version of the Hayling sentence completion test: Validation and factors associated with executive functions in a sample of the Lebanese adults
Authors: Boutros Sarah , Hachem Emilio Al , Matar Joseph , Hallit Souheil , Matar Hanna 
Published: January 2020

Abstract
Background To validate the Arabic version of the Hayling Sentence Completion Test (HSCT) in healthy community-dwelling Lebanese adults, and identify factors that might affect executive functions (EF), mainly inhibitory control, in these participants. Methods Between August-December 2019, 350 participants were randomly selected. The Arabic version of the HSCT, divided into automatic and inhibition conditions, was used; in each condition, participants’ response-time and number of errors commited were recorded. Results None of the scale items was removed. For the automatic condition, response-time items converged over one factor (αCronbach=0.905) and number of errors converged over seven factors (αCronbach=0.334). For the inhibition condition, response-time converged over one factor (αCronbach=0.943) and number of errors converged over four factors (αCronbach=0.728). Using electricity as a heating method inside the house was significantly associated with a lower response-time, whereas higher problematic mobile phone use was associated with higher response-time. Using wood as a heating system inside the house and higher problematic mobile phone use were associated with higher number of errors, while using Arabian incense (bakhour) inside the house was associated with lower number of errors. Conclusion We were able to validate the HSCT Arabic version for use in the Lebanese population. Problematic mobile phone use was associated with lower executive functions in terms of reponse-time and number of errors.
Early permanent cerebrospinal fluid diversion lowers the rate of nosocomial meningitis in aneurysmal subarachnoid hemorrhage
Authors: Croci Davide Marco , Dalolio Martina , Aghlmandi Soheila , Taub Ethan , Zumofen Daniel , Guzman Raphael , Mariani Luigi , Roethlisberger Michel 
Published: January 2020

Abstract
Background: Early permanent cerebrospinal fluid (CSF) diversion for hydrocephalus after aneurysmal subarachnoid hemorrhage (aSAH) might shorten the duration of external ventricular drainage (EVD) and thereby reduce infectious complications. The potential effect on the rate of delayed cerebral vasospasm (DCVS) and associated morbidity has not been studied to date. The objective of this study was to detect any association with EVD-associated infections (EVDAI), symptomatic DCVS, or delayed cerebral ischemia (DCI) by the time of hospital discharge. Methods: A single-center dataset of aSAH patients who received a permanent CSF diversion procedure between 2009 and 2018 was used for the evaluation. The subjects were divided into an “early group” if such a procedure was performed up to 14 days after the ictus, and a “late group” if it was performed from the 15 th day onward. The statistical analysis employed univariable and multivariable logistic regression models. Results: Among 274 consecutive aSAH patients, 39 (14.2 %) had a permanent CSF diversion procedure. While the blood clot burden was similarly distributed, patients with early permanent CSF diversion (20 out of 39, 51.2%) had higher levels of consciousness on admission. Early permanent CSF diversion was associated with a shorter duration of EVD (OR 0.73, 95%CI 0.58-0.92 per day). Higher catheter colonization to EVDAI ratio (1/7 out of 20 vs. 7/7 out of 19) and a markedly lower frequency of EVDAI (OR 0.08, 95 %CI 0.01-0.80) were detected. The prevalence (5 vs. 37) and the cumulative incidence (3 vs. 18) of EVDAI were remarkably lower in patients receiving early permanent CSF diversion. The occurrence of CSF-diversion device obstruction, the rate of symptomatic DCVS (OR 0.61, 95 %CI 0.16-2.27) or detected DCI on computed tomography (OR 0.35, 95 %CI 0.08-1.47), and the likelihood of a poor outcome at discharge did not differ between the two groups (OR 0.88, 95%CI 0.24-3.22). Conclusions: Early permanent CSF diversion in good grade aSAH patients is associated with a shorter duration of EVD, lower catheter colonization rates, and fewer infectious complications. The timing of permanent CSF diversion had no detectable effect on DCVS-related morbidity. These findings need to be confirmed in larger cohorts.
Prognostic Value of Early Intermittent Electroencephalography in Patients After Extracorporeal Cardiopulmonary Resuscitation
Authors: Kim Yong Oh , Ko Ryoung-Eun , Chung Chi Ryang , Yang Jeong Hoon , Park Taek Kyu , Cho Yang Hyun , Sung Kiick , Suh Gee Young , Ryu Jeong-Am 
Published: January 2020

Abstract

Background The aim of this study was to investigate whether intermittent electroencephalography (EEG) could be used to predict neurological prognosis of patients who underwent extracorporeal cardiopulmonary resuscitation (ECPR). Methods This was a retrospective, single center, and observational study of adult patients who were evaluated by EEG scan within 96 hours after ECPR between February 2012 and December 2018. The primary endpoint was neurological status upon discharge from the hospital assessed with Cerebral Performance Categories (CPC) scale. Results Among 69 adult cardiac arrest patients who underwent ECPR, 32 (46.4%) patients survived until discharge from the hospital. Of these 32 survivors, 17 (24.6%) patients had favorable neurological outcomes (CPC score: 1 or 2). Sedatives or analgesics were used in 41 (59.4%) patients. Malignant EEG patterns were more common in patients with poor neurological outcome than in patients with favorable neurological outcome (73.1% vs. 5.9%, p < 0.001). All patients with highly malignant EEG patterns (43.5%) had poor neurological outcome. Moderately malignant EEG patterns were reported in 8 (11.6%) patients with poor neurological outcome and one (1.4%) patient with favorable neurological outcome. Benign EEG patterns were more common in patients with favorable neurological outcome than in patients with poor neurological outcome (94.1% vs. 26.9%, p < 0.001). In multivariable analysis, malignant EEG patterns (adjusted odd ratio [OR]: 53.26, 95% confidence interval [CI]: 5.956 – 476.249) and duration of cardiopulmonary resuscitation (adjusted OR: 1.07, 95% CI: 1.011 – 1.130) were significantly associated with poor neurological outcomes in patients who underwent ECPR (Hosmer-Lemeshow Chi-squared = 7.84, df = 7, p = 0.347). Conclusions In this study, malignant EEG patterns within 96 hr after cardiac arrest were significantly associated with poor neurological outcomes in patients who underwent ECPR. Therefore, early intermittent EEG scan could be helpful for predicting neurological prognosis of post-cardiac arrest patients after ECPR.
Modeling the antimicrobial resistance of enterobacteria responsible for Urinary Tract Infections in Benin: Another way to control Antimicrobial Resistance
Authors: Victorien DOUGNON , Phenix ASSOGBA , Mohammed JIBRIL , Jean-Pierre GNIMATIN , Jerrold AGBANKPE , Hornel KOUDOKPON , Esther DEGUENON , Kafayath FABIYI , Consortium The Global Taskforce for AMR Control , Romarique MEDEGAN FAGLA Sèdami , Estelle LOKO Yêyinou Laura , Omédine KOUKOUI , Luc DJOGBENOU , Jacques DOUGNON , Honoré BANKOLE , Lamine BABA-MOUSSA 
Published: January 2020

Abstract
Background: Infectious diseases are serious public health issue both in developing countries and industrialized nations. In developing countries, they are the main cause of high mortality rates. In the second group, existing resistance strains to antibiotics is developing and growing at an alarming rate. The purpose of this study was to produce data of national interest to implement sustainable control program against the spread of antimicrobial resistance strains in Benin. Methods: One hundred and ninety (190) urine samples were collected in selected hospitals in Benin from patients with urinary tract infection. After getting the informed consent from the patients, samples collections were performed under aseptic conditions and cultured for further analysis in the laboratory. The resistance profile of the bacterial strains was established. The search for beta-lactamase production by the isolates was performed using the synergy test for amoxicillin/clavulanic acid and cephalosporins. Mathematical modeling for predicting the development of resistance of the strains by the year 2024 was carried out employing the compartmental deterministic models. Results: Two hundred and thirty (230) strains were identified from the urine samples. Male individuals were the most affected by urinary tract infections. Individuals between the ages of 21-30 were predominantly infected. E. coli was the most isolated species (32.43%) in the urine samples, followed by K. pneumoniae (26.85%) and E. cloacae (25.92%). The susceptibility testing of isolates showed a high resistance to amoxicillin (91.82%). Whereas the lowest resistance was to imipenem (2%). The beta-lactamase was produced by 24.03% of the strains. Escherichia coli (32.43%) was the most productive of broad spectrum beta-lactamase, followed by K. pneumoniae (31.03%). The mathematical modeling revealed a rampant rise in resistance development of the strains to the tested antibiotics. Conclusions: These results provide important data for developing new preventive strategies against the evolution of bacterial resistance to antibiotics. It therefore, further deserves a constructive advocacy so that more actions are taken against the rampant spread of antimicrobial resistance strains in our health facilities as well as in the communities.
Prevalence of cardiac lesions in cases of bovine clostridial myositis
Authors: Newkirk Kim , Culligan Caitlin M. , Okafor Chika C. , Uzal Francisco A. 
Published: January 2020

Abstract
ObjectiveThe aim of this retrospective study was to determine the prevalence of cardiac lesions in cases of clostridial myositis. Clostridial myositis (blackleg) is a common cause of death in cattle and is caused by the bacterium Clostridium chauvoei. The characteristic lesions include hemorrhage, necrosis, edema, and emphysema within skeletal muscle and, less commonly, the heart.ResultsOf the 37 cases of blackleg identified, 26 animals (70.3%) had cardiac lesions, including 4 (10.8%) which had only cardiac involvement without skeletal muscle lesions. Cardiac lesions were characterized as necrotizing myocarditis (n=21), fibrinous to fibrinosuppurative pericarditis, epicarditis, or endocarditis (n=24), or both (n=19). These data demonstrate that, in cases of bovine clostridial myositis, cardiac lesions are common, while heart involvement in the absence of skeletal muscle lesions is uncommon.
Identified metabolic related genes to construct a prognostic model of Breast cancer patients
Authors: Ma Yu-Yuan , Wang Han , Qi Jie , Zhu Jie , Huang Yue-Qing , Ding Zhi-liang , Wang Wen-jie 
Published: January 2020

Abstract
Background: More and more evidence confirms that there are many metabolic disorders in the tumor. The occurrence and development of breast cancer (BC) is closely related to metabolism. Methods: A metabolic related genes table was obtained by the Kyoto Encyclopedia of Genes and Genomes (KEGG) related metabolic pathway. The edgeR package was used to identify differentially expressed genes (DEGs) of The Cancer Genome Atlas (TCGA) breast cancer. We established a prognostic model by univariate Cox regression analysis and lasso-penalized Cox regression. The validation prognostic model was built through the Group on Earth Observations (GEO) database. Use the nomogram and Receiver Operating Characteristic (ROC) curve to verify the accuracy of models. Result: We identified 178 DEGs and 14 prognostic-related genes to construct a prognostic model. In the TCGA prognostic model and the GEO validation prognostic model, patients were divided into high riskscore group and low riskscore group, the high riskscore group had worse prognosis.Conclusion: We constructed a prognostic model of metabolic related genes and verified the feasibility and accuracy of the model. It is hoped that the model can provide a basis and biomarker for breast cancer related metabolic therapy and prognosis.
Transarterial chemoembolization combined with apatinib for treatment of advanced hepatocellular carcinoma: analysis of survival and prognostic factors
Authors: Liu Ziyi , Kan Xuefeng , Zhang Lijie , Makamure Joyman , Li Qing , Zhao Dan , Zhou Guofeng , Feng Gansheng , Zheng Chuansheng , Liang Bin 
Published: January 2020

Abstract
Backgroud: To evaluate the overall survival (OS) after transarterial chemoembolization (TACE) combined with apatinib in patients with advanced hepatocellular carcinoma (HCC), and to identify the factors affecting patient survival. Methods: Fifty-one patients with HCC who received TACE combined with apatinib in our hospital from June 2015 to May 2017 were enrolled and followed up until May 2019. The OS and progression-free survival (PFS) were calculated using the Kaplan-Meier method. Log-rank test and Cox regression model were used to determine the factors affecting the patients’ OS. Results: The median OS and PFS of the patients were 15 months and 10 months, respectively. The 1-, 2-, and 3-year survival rates were 62.7%, 23.5%, and 1.8%, respectively. Univariate survival analysis showed that patients with Child-Pugh A (P = 0.008), severe reduction rate of proper hepatic artery (P = 0.013), hand-foot syndrome (P = 0.006), secondary hypertension (P = 0.042), AFP< 400 ug/L (P = 0.076), and without ascites (P = 0.013) had a better OS. Multivariate analysis showed that hand-foot syndrome (P = 0.004), secondary hypertension (P = 0.034), and reduction rate of proper hepatic artery (P = 0.028) were independent predictors of better OS. Conclusions: TACE combined with apatinib is a promising treatment for advanced HCC. Hand-foot syndrome, secondary hypertension, and the reduction rate of proper hepatic artery were associated with a better OS.
METTL14 and miR-1247 are associated with poor outcomes in Triple-Negative Breast Cancer
Authors: Hu Junbo , Hou Mingyue , Chen Bo , Wu Huan , Cai You , Wang Qin , Gao Xia , Lu Yanju , Pang Pei , Li Li , Tang Na 
Published: January 2020

Abstract
BackgroundTriple-negative breast cancer (TNBC) doesn’t have targets for therapy, and accounts for 15% of all breast cancers. m6A modification has been reported to play important role in the progression of various cancers. However, the expression and function of the m6A methyltransferase METTL14 in TNBC are unclear. MethodsThe count data of miRNA and mRNA of breast cancer patients with both tumor tissues and matched nomal tissues were downloaded from the TCGA data portal. The expression of METTL14 was determined by immunohistochemistry and western blot. The expression of has-miR-1247 was determined by qRT-PCR.The Cox regression analysis was executed for the expression levels of METTL14 and DEmiRNAs .The Kaplan-Meier survival analysis were performed to establish the correlation between the expression level and survival of BC patients .ResultsWe discovered that METTL14 was significantly downregulated in TNBC tissues, and low expression of METTL14 is correlated with worse differentiation ,higher ki67 proliferation and poorer survival suggesting its potential as an independent prognostic biomarker for TNBC. We also found the positive correlation between the expression levels of METTL14 and has-miR-1247. Moreover, has-miR-1247 was significantly downregulated in TNBC tissues, and lead to poorer survival.ConclusionOur data suggested that METTL14 and miR-1247 could be valuable diagnostic tools, prognostic biomarkers, and therapeutic targets for TNBC.