bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community-Based Cluster Randomized Controlled Trial: Empowering Households to Identify and Provide Appropriate Care for Low-Birthweight Newborns in Nepal
Authors: Hodgins Stephen , Rajbhandari Binamra , Joshi Deepak , Ban Bharat , Khatry Subarna , Mullany Luke 
Published: March 2020

Abstract
Background: Most newborn deaths occur among those of low birthweight (LBWt), due to prematurity &/or impaired fetal growth. Simple practices can mitigate this risk. In low-income country settings where many births occur at home, strategies are needed that empower mothers to determine if their babies are higher risk and take protective measures. Earlier studies suggest that foot-length may be a good proxy for birthweight. An earlier Nepal study found a 6.9cm cut-off performed relatively well, differentiating normal from low birthweight.Methods: Community-based, cluster-randomized controlled trial. Objective: to determine whether family-administered screening, with targeted messages improves care practices known to mitigate LBWt risks. Participants: pregnant women participating in a parent trial in rural Nepal. Women were given a 6.9cm card to assess whether the baby’s foot is small; if so, to call number on the card for advice. Follow-up visits were made over 2 weeks following the birth, assessing for: reported skin-to-skin thermal care, and care-seeking outside the home; restricting to low birthweight (using 2 cutoffs: 2,500g and 2,000g). Randomization: 17 clusters intervention, 17 control. The study also documented steps along the presumed causal chain from intervention through behavioral impact.Results: 2,022 into intervention, 2,432 into control. Intervention arm: 519 with birthweight <2,500g (vs. 663 among controls), of which 503 were available for analysis (vs. 649 among controls). No significant difference on care-seeking; for those <2,500g RR 1.13 (95%CI: 0.97-1.131). More of those in the intervention arm reported skin-to-skin thermal care than among controls; for those <2,500g RR 2.50 (95%CI: 2.01-3.1). Process measures suggest this apparent effect cannot be attributed to the intervention; the card performed poorly as a proxy for LBWt, misclassifying 84.5% of those <2,000 as normal.Conclusions: Although the trial found an apparent effect on one key behavioral outcome, this cannot be attributed to the intervention; most likely it was a result of pure chance. Other approaches are needed for identifying at-risk babies in such settings, and targeting them for appropriate care messaging.Trial registration : clinicaltrials.gov identifier: NCT02802332, registered 16 June 2016, https://clinicaltrials.gov/ct2/show/NCT02802332
Distinct clinicopathological differences between early gastric cardiac and non-cardiac carcinomas: A single-center retrospective study of 329 radical resection cases
Authors: Wang Yaohui , Li Xiu Qing , Gao Li Li , Wang Chen Xi , Zhang Yi Fen , Huang Qin 
Published: March 2020

Abstract
Background Early gastric carcinoma is heterogeneous and can be divided into early gastric cardiac carcinoma (EGCC) and early gastric non-cardiac carcinoma (EGNCC) groups. At present, differences in clinicopathology remains obscure between EGCC and EGNCC fundus-corpus and antrum-angularis-pylorus subgroups, especially between EGCC with and without esophageal invasion.Methods In this study, we studied 329 consecutive early gastric carcinoma radical gastrectomies with 70 EGCCs and 259 EGNCCs.Results Compared to the EGNCC antrum-angularis-pylorus (n=181), but not fundus-corpus (n=78), sub-group, EGCC showed significantly older age, lower prevalence of the grossly depressed pattern, better tumor differentiation, higher percentage of tubular/papillary adenocarcinoma, but lower frequency of mixed poorly cohesive carcinoma with tubular/papillary adenocarcinoma, and absence of LNM in tumors with invasion up to superficial submucosa (SM1). In contrast, pure poorly cohesive carcinoma was less frequently seen in EGCCs than in EGNCCs, but mixed poorly cohesive carcinoma with tubular/papillary adenocarcinomas was significantly more common in the EGNCC antrum-angularis-pylorus sub-group than in any other group. No significant differences were found between EGCC and EGNCC sub-groups in gender, tumor size, H. pylori infection rate, and lymphovascular/perineural invasion. EGCC with oesophageal invasion (n=22), compared to EGCC without (n=48), showed no significant differences in the H. pylori infection rate and oesophageal columnar, intestinal, or pancreatic metaplasia, except for a higher percentage of the former in size > 2 cm and tubular differentiation.Conclusions There exist distinct clinicopathologic features between EGCC and EGNCC sub-groups; EGCC was indeed of gastric origin. Further investigations with larger samples are needed to validate these findings.
Gene Expression Profiling of Inflammatory Cytokines in Esophageal Biopsies of Different Phenotypes of Gastroesophageal Reflux Disease: a cross-sectional study
Authors: Zavala-Solares Monica , Fonseca-Camarillo Gabriela , Valdovinos Miguel , Granados Julio , Grajales-Figueroa Guido , Zamora-Nava Luis , Aguilar-Olivos Nancy , Valdovinos-García Luis , Yamamoto-Furusho Jesus K. 
Published: March 2020

Abstract
Background: Patients clinical phenotypes in gastroesophageal reflux disease (GERD) are classified as: Barrett's esophagus (BE), erosive esophagitis (EE) and non-erosive gastroesophageal reflux disease (NERD). The aim of this study was to characterize genes involved in the pathophysiology and immune response of GERD.Methods: This is an observational and cross-sectional study. All patients with BE, EE, NERD and the control group were subjected to a superior endoscopy (with biopsies of esophageal mucosa). The cytokine mRNA relative quantification of target genes was conducted by RT-PCR. Changes in gene expression were assessed of the genes associated with inflammation in each disease phenotype. Statistical analysis of differential gene expression was performed by using Dunn's Test for Multiple Comparisons. A p value < 0.05 was considered as significant. Results: A Total of 98 patients were included and they were divided into the following groups: Group BE 16 (16.33%), Group EE 23 (23.47%), Group NERD 42 (42.86%) and Control Group 17 (17.35%). When comparing with control group we found: patients with BE showed an increased expression of IL-8 (P<0.005) and higher levels of: IL-1β, NF-κβ, IL-10 and MMP-3, MMP-9 as well; patients with EE had higher levels of IL-1B, IL-6, IL-8 and IL-10 (P<0.005) and patients with NERD showed a differential gene expression of cytokines Th1, particularly TNF-α and IL-1B (P<0.005) and decreased gene expression of Th2 cytokines such as IL-10, IL-8 and MMP9. Conclusions: This study demonstrates the differential expression of mediators of inflammation in the esophageal mucosa of patients with the EE and BE phenotype.
Dissecting the phenotypic heterogeneity in sensory features in Autism Spectrum Disorder: a factor mixture modelling approach
Authors: Tillmann Julian , Uljarevic Mirko , Crawley Daisy , Dumas Guillaume , Loth Eva , Murphy Declan , Buitelaar Jan , Charman Tony 
Published: March 2020

Abstract
Background Heterogeneity in the phenotypic presentation of Autism Spectrum Disorder (ASD) is apparent in the profile and the severity of sensory symptoms. Here we applied Factor Mixture Modelling (FMM) to test a multidimensional factor model of sensory processing in ASD. We aimed to identify homogeneous sensory subgroups in ASD that differ intrinsically in their severity along continuous factor scores. We also investigated sensory subgroups in relation to clinical variables: sex, age, IQ, social communication symptoms, restricted and repetitive behaviours, adaptive functioning and symptoms of anxiety and Attention-Deficit/Hyperactivity Disorder. Methods 332 children and adults with ASD between the ages of 6 and 30 years with IQs varying between 40 and 148 were included. First, three different confirmatory factor models were fit to the 38 items of the Short Sensory Profile. Then, latent class models (with two-to-five subgroups) were evaluated. The best performing factor model, the 7-factor structure, was subsequently used in two FMMs that varied in the number of subgroups: a two-subgroup, seven-factor model and a three-subgroup, seven-factor model. Results The ‘three-subgroup/seven-factor’ FMM was superior to all other models based on different fit criteria. Identified subgroups differed in sensory severity from severe, moderate to low. Accounting for the potential confounding effects of age and IQ, participants in these sensory subgroups had different levels of social-communicative symptoms, restricted and repetitive behaviours, adaptive functioning skills and symptoms of inattention and anxiety. Limitations Results were derived using a single parent-report measure of sensory symptoms, the SSP, which has some notable construct limitations that constrain the generalisability of findings. Conclusion Sensory features can be best described by three homogeneous sensory subgroups that differ in sensory severity gradients along seven continuous factor scores. Identified sensory subgroups were further differentiated by the severity of core and co-occurring symptoms, and level of adaptive functioning, providing novel evidence on the associated clinical correlates of sensory subgroups. These sensory subgroups provide a platform to further interrogate the neurobiological and genetic correlates of altered sensory processing in ASD.
Identification of ATP2C1 mutations in the patients of Hailey-Hailey disease
Authors: li xiaoli , zhang dingwei , ding jiahui , li li , wang zhenghui 
Published: March 2020

Abstract
Background: Familial benign chronic pemphigus (OMIM 169600), also known as Hailey-Hailey disease (HHD), is a clinically rare bullous Dermatosis. However the mechanism has not been clarified. Objective: To detect novel mutations in exons of ATP2C1 gene in HHD patients; to explore the mechnism of HHD pathogenesis by examining the expression profile of hSPCA1, Mir-203, p63, Notch1 and HKⅡ proteins in the skin lesions of HHD patients. Methods: Genomic DNA was extracted from peripheral blood of HHD patients. All exons of ATP2C1 gene in HHD patients were amplified by PCR and the products were purified and sequenced. All related signaling proteins of interest were stained by using skin lesion tissues from HHD patients and Mir-203 levels were also determined. Results: In this study, one synonymous mutation c.G2598A (in exon 26), one nonsense mutation c.C635A and two missense mutations c.C1286A (p.A429D) and c. A1931G (p. D644G) were identified. The nonsense mutation changed codon UCG to stop codon UAG, causing a premature polypeptide chain of the functional region A. The two missense mutations were located in the region P (phosphorylation region) and the Mn binding site of hSPCA1. The calcium pump was not no longer functional due to impaired protein structures. The level of hSPCA1 was significantly decreased in HHD patients compared to the normal human controls, accompanied by an increase of Mir-203 level and a decrease of p63 and HKⅡ levels. Conclusion: In HHD patients, these factors may be involved in the signaling pathways of HHD pathogenesis. In addition, Notch1, which was negatively regulated p63, is downregulated. Our data showed that both p63 and Mir-203 may have significant regulatory effects on Notch1 in the skin.
Experiences of participation in bereavement groups from significant others’ perspectives
Authors: Näppä Ulla , Randström Kerstin Björkman 
Published: March 2020

Abstract
Background When death ends a life, the impact of caring for person who suffered a period of illness or disease continues for significant others who are left to grieve. They should be offered support to avoid complicated grief. This can be provided in different ways and individually or in groups. This study aims to describe significant others’ experiences of participation in bereavement groups. Methods Ten bereavement groups that each met five times offered support for the significant others of deceased loved ones who had been cared for by a palliative-care team. After the five meetings, the grieving members completed written comments about the role of the groups; they also commented one year after participating. Comments were analyzed qualitatively using the theory of a good death according to the 6S’s: self-image, self-determination, social relationships, symptom control, synthesis and summation, and surrender. Results Bereavement groups were found to be a source for alleviating grief for some significant others, but not all experienced relief. Moreover, grief was found to persist during participation. Another finding involved the impact of the role of the palliative home-care team on bereavement support. To evaluate the experience of participating in a bereavement group, the use the 6S’s as a model was a strength of the analysis. Bereavement groups could enhance the self and offer relief from grief. Participation was described as social relationships that offered a sense of coherence and understanding in grief. The effects of participation were more meaningful close to the loss and could lose efficacy over time. Bereavement support provided before a loved one’s death was seen as valuable. Conclusion Overall, the bereavement groups eased the grief of significant others close to the death of their loved one. However, moving forward, several of the significant others were not sure that their participation eased their grief. To identify persons who may remain in a state of complicated grief, a routine of planned contacts with the bereaved should begin before death and be followed up later than six months after the death of a loved one.
Corticosteroid Treatment Guided by Peripheral Blood Mononuclear Cell Counts in Cerebral Amyloid Angiopathy-related Inflammation: A Case Report
Authors: Li Ya , Liu ChunTing , Guo ShiPeng , Zhang AnNi , Wu XuLing , He Dian 
Published: March 2020

Abstract
Background: Cerebral amyloid angiopathy-related inflammation (CAA-I), a rare variant of cerebral amyloid angiopathy, is one of treatable causes of rapidly progressive dementia. CAA-I usually occurs in the elderly and corticosteroids are most often used for treatment. Thus it is more necessary to develop an individualized dosing regimen to maximize efficacy yet minimize adverse effects of corticosteroids. We report a CAA-I patient successfully treated by corticosteroid therapy guided by dynamic monitoring of peripheral blood mononuclear cell (PBMC) count. Case presentation: A 68-year-old female presented with subacute step-wise cognitive decline. Medical history and current examination revealed multiple risk factors for cerebral amyloid angiopathy, including apolipoprotein E ε4/ε4 genotype, hyperhomocysteinemia, hypertension, and chronic renal failure, while brain susceptibility-weighted magnetic resonance imaging revealed diffuse lobar microbleeds associated with extensive lesions disturbed throughout cerebral grey and white matter on T1- and T2-weighted MRI. The CD19+ B-cell fraction of PBMCs was markedly elevated, as were inflammatory markers such as erythrocyte sedimentation rate and C-reactive protein. Cerebrospinal fluid total protein and T-tau levels were also elevated, while Aβ42 was low and P-tau levels were normal. Corticosteroid treatment guided by dynamic CD19+ B-cell number monitoring reversed these inflammatory signs, imaging manifestations, and acute cognitive decline. Conclusions: Corticosteroid treatment individualized by dynamic monitoring of PBMC CD19+ B-cell fraction may provide for maximum therapeutic efficacy with minimal adverse effects in patients with CAA-I.
Knowledge, attitudes, and practices of primary health care physicians regarding the pre-travel counselling of patients with type 2 diabetes in Riyadh, Saudi Arabia
Authors: Alduraibi Rabia , Almigbal Turky H , Alrasheed Abdullah A , Batais Mohammed Ali 
Published: March 2020

Abstract
Background Travel has become an integral part of Saudi life. People with diabetes face many challenges while travelling that can have detrimental effects on glycaemic control. However, no previous studies have investigated pre-travel counselling in Saudi Arabia. This study aims to assess the knowledge, attitudes and practices of primary health care (PHC) physicians regarding pre-travel counselling for patients with type 2 diabetes. Methods This cross-sectional study was conducted in PHC centres under the Ministry of Health in Riyadh, Saudi Arabia, during the period 2018-2019. A cluster multistage random sampling technique was used to recruit physicians. The data were collected through a self-administered questionnaire. Results Three hundred and eighty-five primary health care physicians were recruited. This study showed that more than half (57.9%) of PHC physicians had poor knowledge scores. Additionally, the following characteristics were significantly associated with poor knowledge: being younger in age, being male, being Saudi, being a general practitioner, and having limited (0-5 years) experience. A total of 183 (47.5%) subjects showed disagreement attitudes towards the importance of pre-travel counselling among patients with diabetes. Furthermore, these disagreement attitudes were significantly associated with being older and having more years of experience. The majority (62.6%) of the physicians had poor practice scores. Poor practices were detected among physicians who were younger, male, and Saudi and who had a general practitioner specialty and degree. Conclusions It could be concluded that a gap was detected in the knowledge and practices of primary health care physicians regarding pre-travel counselling for people with type 2 diabetes. Therefore, it is necessary to create easily accessible travel medicine education programmes for Saudi PHC prosviders to improve the management of travellers with diabetes.
Compositional and functional characterisation of biomass-degrading microbial communities in guts of plant fibre- and soil-feeding higher termites
Authors: Marynowska Martyna , Goux Xavier , Sillam-Dusses David , Rouland-Lefevre Corinne , Halder Rashi , Wilmes Paul , Gawron Piotr , Roisin Yves , Delfosse Philippe , Calusinska Magdalena 
Published: March 2020

Abstract
Background: Termites are among the most successful insect lineages on the globe and are responsible for providing numerous ecosystem services. They mainly feed on wood and other plant material at different stages of humification. Lignocellulose is often a principal component of such plant diet and termites largely rely on their symbiotic microbiota and associated enzymes to decompose their food efficiently. While lower termites and their gut flagellates were given larger scientific attention in the past, the gut lignocellulolytic bacteria of higher termites remain less explored. Therefore, in this study, we investigated the structure and function of gut prokaryotic microbiomes from 11 higher termite genera representative of Syntermitinae, Apicotermitinae, Termitidae and Nasutitermitinae subfamilies, broadly grouped into plant fibre- and soil-feeding termite categories. Results: Despite the different compositional structures of the studied termite gut microbiomes, reflecting well the diet and host lineage, we observed a surprisingly high functional congruency between gut metatranscriptomes from both feeding groups. The abundance of transcripts encoding for carbohydrate active enzymes as well as expression and diversity profiles of assigned glycoside hydrolase families were also similar between plant fibre- and soil-feeding termites. Yet, dietary imprints highlighted subtle metabolic differences specific to each feeding category. Roughly 0.18 % of de novo re-constructed gene transcripts were shared between the different termite gut microbiomes, making each termite gut a unique reservoir of genes encoding for potentially industrially applicable enzymes, e.g. relevant to biomass degradation. Taken together, we demonstrated the functional equivalence in microbial populations across different termite hosts. Conclusions: Our results provide valuable insight into the bacterial component of the termite gut system and significantly expand the inventory of termite prokaryotic genes participating in the deconstruction of plant biomass.
HbA1c and Blood Pressure Levels in Type 2 Diabetes: How Many Patients are on Target?
Authors: de Farias Camila Bergonsi , Zelmanovitz Themis , Coelli Sabrina , Satler Fabíola , Duarte Camila Kümmel , Brondani Letícia , Silveiro Sandra Pinho 
Published: March 2020

Abstract
Background: Achieving HbA1c and blood pressure targets is an important strategy for preventing chronic vascular complications in diabetes. The aim of this paper was to determine the proportion of type 2 diabetes patients who meet the recommended HbA1c and arterial blood pressure targets and the determinants of failure to do so.Methods: A cross-sectional study was conducted in an outpatient endocrine clinic at a university hospital. HbA1c was measured with a certified HPLC method, with a goal of 7%, except for patients with advanced chronic complications where 8% was the goal. Blood pressure was measured with a validated device after a 5-minute rest, and the overall expected target was 140/90 mmHg. Results: A total of 602 type 2 diabetes patients were analyzed: 62% were female, 14% self-reported as black, the mean age was 63±11 years, the mean diabetes duration was 17±9 years, and the median (IQR) HbA1c was 8.0% (7.0-9.5%). Macrovascular disease was present in 198 (33%) patients, diabetic retinopathy in 283 (47%), peripheral neuropathy in 258 (43%) and diabetes kidney disease in 337 (56%). Regarding metabolic control, 403 (67%) patients were not at the adjusted target HbA1c level, and the main determinants of poor glycemic control were female gender, black skin color, younger age, and insulin use. Regarding blood pressure, 348 (58%) patients were not at the recommended targets, and a more advanced age was the main associated factor. Conclusions: Since more than half of Brazilian type 2 diabetes outpatients do not meet the recommended HbA1c and blood pressure target values, there is a major call to overcome therapeutic inertia and treat to target each individual patient. Female, black and younger individuals seem to be associated with a worse glycemic profile.