bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient satisfaction and quality of life in breast reconstruction: assessment of outcomes of immediate, delayed, and nonreconstruction.
Authors: Siqueira Hianga Fayssa Fernandes , Teixeira Jorge Luiz de Almeida , Filho Reginaldo da Silva Lessa , Hora Evânia Curvelo , Brasileiro Filipe Ferreira , Borges Kênya de Souza , Brito Érika de Abreu Costa , Lima Marcela Sampaio , Marques Adriane Dórea , Moura Alex Rodrigues , Júnior Tarcizo Costa Figueiredo , de Oliveira Thiago Costa , Vasconcelos Ana Alice Santana , Lima Carlos Anselmo 
Published: February 2020

Abstract
Objectives: This study was conducted aiming to assess the quality of life and satisfaction of mastectomized women treated with and without breast reconstruction. Results: A total of 81 patients mastectomized were included, of whom 53 (65.4%) underwent breast reconstruction. Quality of life was not significantly better in the reconstruction group than the nonreconstruction group. Satisfaction with the surgically operated breast, whether reconstructed or not, was positively correlated with quality of life (p = 0.004). There was no significant difference in quality of life between women with immediate and late reconstruction. This study showed that the satisfaction of patients with the operated breast, reconstructed or not, is more important in quality of life than whether the breast was reconstructed or not. When we analyzed the quality of life of mastectomized women who were dissatisfied with their unreconstructed breasts, we observed that nonreconstruction had a negative impact on the quality of life. Keywords: Breast cancer, Mastectomy, Breast reconstruction, Quality of life
Microbiome composition differences among breeds impact feed efficiency in swine
Authors: Bergamaschi Matteo , Tiezzi Francesco , Howard Jeremy , Huang Yi Jian , Gray Kent A. , Schillebeeckx Constantino , McNulty Nathan P. , Maltecca Christian 
Published: February 2020

Abstract
Background Feed efficiency is a crucial parameter in swine production given both its economic and environmental impact. The gut microbiota plays an essential role in nutrient digestibility and is therefore likely to affect feed efficiency. This study aimed to characterize feed efficiency, production traits, and gut microbiome composition of three major breeds of domesticated swine, and to investigate a possible link between feed efficiency and gut microbiota composition. Results Average daily feed intake ( ADFI ), average daily gain ( ADG ), feed conversion ratio ( FCR ), residual feed intake ( RFI ), backfat, loin depth, and intramuscular fat of 615 pigs belonging to the Duroc ( DR ), Landrace ( LR ), and Large White ( LW ) breeds were measured. Gut microbiota composition was characterized by 16S rRNA gene sequencing. Orthogonal contrasts between paternal line (DR) and maternal lines (LR+LW) and between the two maternal lines (LR versus LW) were performed. Average daily feed intake and ADG were statistically different with DR having lower ADFI and ADG compared to LR and LW. Landrace and LW had a similar ADG and RFI, with higher ADFI and FCR for LW. Alpha diversity was higher in the fecal microbial communities of LR pigs than in those of DR and LW pigs for all time points considered. Duroc communities had significantly higher proportional representation of the Catenibacterium and Clostridium genera compared to LR and LW, while LR pigs had significantly higher proportions of Bacteroides than LW for all time points considered. We identified several amplicon sequencing variants members of certain genera including Anaerovibrio , Bacteroides , Blautia , Clostridium , Dorea , Eubacterium , Faecalibacterium , Lactobacillus, Oscillibacter , and Ruminococcus significantly associated with feed efficiency of pigs for all time points considered. Conclusions In this study we characterized differences in the composition of the fecal microbiota of three commercially relevant breeds of swine, both over time and between breeds. Correlations between different microbiome compositions and feed efficiency were established. This suggests that the microbial community may contribute in shaping host productive parameters. Moreover, our study provides important insights to understand how the intestinal microbial community might influence the host energy harvesting capacity. A deeper understanding of this process may allow us to modulate the gut microbiome for more efficient animals.
What do we know about physical activity interventions in vocational education and training? A systematic review
Authors: Grüne Eva , Popp Johanna , Carl Johannes , Pfeifer Klaus 
Published: February 2020

Abstract
Background Although the health benefits of physical activity are well known, young people’s physical activity behavior often is insufficient and declines in adolescence. Numerous studies have investigated the effectiveness of physical activity promoting interventions among young people, but none has reviewed the effectiveness of physical activity interventions in the vocational education and training (VET) setting. This systematic review aims to (1) synthesize and review the available literature on physical activity promoting interventions in VET and (2) examine their effects on physical activity-related outcomes, such as physical activity level, physical fitness, physiological parameters, or psychological factors. Methods Five electronic databases were searched for studies involving adolescents aged 15 to 20 years that took place in a VET setting and evaluated the effects from an intervention, which had to comprise a physical activity component, on a physical activity-related outcome, such as PA level, physical fitness, physiological parameters, or psychological factors. The screening process and the quality assessment were conducted by two independent reviewer; data extraction was conducted by one reviewer and verified by another. Results The literature search identified 18,959 articles and 11,282 unique records. After the screening process, nine studies met the pre-defined eligibility criteria and were included in qualitative analyses. All but two studies reported significant improvements for at least one physical activity-related outcome. The interventions substantially differed in their development approaches (top-down vs. bottom-up approaches), complexity (multi- vs. single-component), and addressed behavior (multi-behavioral vs. single-behavioral). The most conspicuous finding was that bottom-up approaches tend to improve outcomes at the psychological level and top-down approaches at the physical level. Regarding the interventions’ complexity and addressed behavior, we could not reveal any conclusive results.Conclusion This systematic review highlights the varying effects of physical activity promoting interventions in VET. Nevertheless, heterogeneous effects and overall weak study quality limited our ability to draw clear conclusions about the potentially most effective intervention strategies. Therefore, future research should focus on high quality studies with long-term follow-ups to make recommendations for practical use. Trial registration: PROSPERO CRD42018109845 Keywords: Physical Activity; Health Promotion; Adolescence; Apprenticeship; Students; School; Workplace
Spectrum of Alpha Thalassemia Alleles in Kuwait
Authors: Adekile Adekunle , Sukumaran Jalaja , Thomas Diana , De Souza Thomas , Haider Mohammad 
Published: February 2020

Abstract
Background: The frequency of alpha thalassemia trait is about 40% in the Kuwaiti population, but there has been no comprehensive study of the prevalent alleles. This is a report of the patients who were referred for molecular diagnosis over a 20-year period. Methods: Blood samples from suspected cases were sent to the Hemoglobin Research Laboratory of the Department of Pediatrics, Kuwait University. A retrospective study of the molecular characterization of samples from 1994 to 2015 was carried out. The alpha globin genotypes were determined by a combination of PCR, allele-specific oligonucleotide hybridization and reverse dot-blot hybridization (Vienna Lab Strip Assay). Results: 400 samples were characterized and analyzed from individuals aged <1 month to 80 years, with a median of 6 years (~60% children and adolescents). Most (90.8%) were Kuwaiti nationals. The common genotype was homozygosity for the polyadenylation-1 mutation (αPA-1α/α PA-1α) in 33.3%, followed by heterozygosity (αα/α PA-1α) for the same mutation in 32.3%. The PA-1 was therefore the most frequent allele (0.733). The frequency of the α0, –MED was 0.19. Rare alleles that were found in very low frequencies included the α0 (--FIL) in a Filipino child, Hb Constant Spring, Hb Adana,and Hb Icaria. Conclusion: There is a wide variety of alpha thalassemia alleles among Kuwaitis, but the nondeletional PA-1 is by far the most common cause of moderate to severe HbH disease phenotype. The α0 (–MED) allele is also encountered, which has implications for pre-marital counselling especially the possibility of having babies with alpha thalassemia major (Barts hydrops fetalis).
Confirmation of the absence of local transmission and geographic assignment of imported falciparum malaria cases to China using microsatellite panel
Authors: Liu Yaobao , Tessema Sofonias K , Murphy Maxwell , Xu Sui , Schwartz Alanna , Wang Weiming , Cao Yuanyuan , Lu Feng , Tang Jianxia , Gu Yaping , Zhu Guoding , Zhou Huayun , Gao Qi , Huang Rui , Cao Jun , Greenhouse Bryan 
Published: February 2020

Abstract
Background Current methods to classify local and imported malaria infections depends primarily on patients travel history, which can have limited accuracy. Genotyping has been investigated as a complementary approach to track the spread of malaria and identify the origin of imported infections.Methods An extended panel of 26 microsatellites (16 new microsatellites) for Plasmodium falciparum was evaluated in 602 imported infections from 26 sub-Saharan African countries to the Jiangsu province of People's Republic of China. The potential of the 26 microsatellite markers to assign imported parasites to their geographic origin was assessed using a Bayesian method with MCMC (Markov Chain Monte Carlo) as implemented in the program Smoothed and Continuous Assignments (SCAT) with a modification to incorporate haploid genotype data.Results The newly designed microsatellites were polymorphic and are not in linkage disequilibrium with the existing microsatellites, supporting previous findings of high rate of recombination in sub-Saharan Africa. Consistent with epidemiology inferred from patients travel history, we found no evidence for local transmission; nearly all genetically related infections were identified in people who traveled to the same country near the same time. The smoothing assignment method assigned imported cases to their likely geographic origin with an accuracy (Angola: 59%; Nigeria: 51%; Equatorial Guinea: 40%) higher than would be achieved at random, reaching statistical significance for Angola and Equatorial Guinea.Conclusions Routine genotyping is valuable for malaria case classification and program evaluation in an elimination setting. Method for assigning geographic origin of mammals based on genetic data were adapted for malaria and showed potential for identification of the origin of imported infections.
Genetic polymorphism of Plasmodium falciparum circumsporozoite protein (PfCSP) and mismatches against RTS, S/AS01 malaria vaccine observed on Bioko Island, Equatorial Guinea and globally
Authors: Huang Hui-Ying , Liang Xue-Yan , Lin Li-Yun , Chen Jiang-Tao , Ehapo Carlos Salas , Eyi Urbano Monsuy , Li Jian , Jiang Ting-Ting , Zheng Yu-Zhong , Zha Guang-Cai , Xie Dong-De , He Jin-Quan , Chen Wei-Zhong , Liu Xiang-Zhi , Mo Huan-Tong , Chen Xin-Yao , Lin Min 
Published: February 2020

Abstract
Backgroud RTS, S/AS01 is a Plasmodium falciparum circumsporozoite protein ( PfCSP ) based anti-malaria vaccine, but various genetic polymorphisms of PfCSP among global P. falciparum population could lead to mismatch against the PfCSP - based vaccine and reduce vaccine efficacy. This study aimed to investigate the genetic polymorphisms and natural selection of PfCSP in Bioko as well as global P. falciparum population. Methods From January 2011 to December 2018, 148 blood samples were collected from P. falciparum infected Bioko patients and 96 monoclonal sequences of them were successfully acquired and analyzed with 2200 global PfCSP sequences mined from MalariaGEN Pf3k Database and NCBI. Results In Bioko, the N-terminus of PfCSP showed limited genetic variations and the numbers of repetitive sequences (NANP/NVDP) were mainly found as 40 (35%) and 41 (34%) in central region. Most polymorphic characters were found in Th2R/Th3R region, where natural selection (p>0.05) and recombination occurred. The overall pattern of Bioko PfCSP gene had no obvious deviation from African mainland PfCSP (Fst=0.00878, p<0.05). The comparative analysis of Bioko and global PfCSP displayed the various mutation patterns and obvious geographic differentiation among populations from four continents (p<0.05). The global PfCSP C-terminal sequences were clustered into 138 different haplotypes (H_1 to H_138). Only 3.35% of sequences matched 3D7 vaccine strain haplotype (H_1). Conclusions The genetic polymorphism phenomena of PfCSP were found universal. The overall vaccine efficacy might be influenced by the low proportion of vaccine-matched isolates in global parasites population. Genetic polymorphism and geographical characteristics should be considered for future improvement of RTS, S/AS01.
Malaria in children and women of childbearing age: prevalence and knowledge in the province of Nyanga, Gabon
Authors: IMBOUMY-LIMOUKOU Roméo Karl , MAGHENDJI-NZONDO Sydney , SIR-ONDO-ENGUIER Pater Noster , TEGOMO Nathalie Pernelle TSAFACK , OKOUGA Alain Prince , ONDEME Augustin MOUINGA , NOLNA Sylvie KWEDY , LEKANA-DOUKI Jean Bernard 
Published: February 2020

Abstract
Background: There is little information on the social perception of malaria and the use of preventative measures in Gabon, especially in rural areas. Adequate knowledge of malaria prevention and control can help in reducing the burden of malaria among vulnerable groups, particularly pregnant women and children aged under 5 years old living in malaria endemic settings. This study was designed to assess the prevalence of malaria and the knowledge and attitude towards this disease in households in the Nyanga Province. Methods: A cross-sectional study was conducted to assess malaria knowledge, prevention practices and prevalence of the infection in five departments of the Nyanga Province. Malaria infection was confirmed using rapid diagnostic tests. A questionnaire was administered randomly to 535 households during a two weeks period in March 2018. Overall, the respondents’ socio-demographic characteristics, knowledge on malaria, malaria prevention practices and malaria prevalence were evaluated and compared across the five departments. Results: Data was collected on 1,307 participants were included in this study, 631 women of childbearing age (including 61 pregnant women) and 676 children. Practically the entire (97.7%) interviewed population had already heard about malaria and attributed the cause of malaria to a mosquito bite (95.7%). This survey revealed that the bed net coverage rate was 73.3%. The study observed an average malaria parasite prevalence of 13.9%. All departments of Nyanga province had significant level of malaria infection except for the Mayumba department where no plasmodial infection was found. The overall prevalence of the plasmodial infection was significantly higher in children and pregnant women compared to adults in the cities of Tchibanga and Moabi. Conclusion: Malaria is highly prevalent in the province of Nyanga. Our findings show that children under five and pregnant women are more vulnerable to malaria in this area of the country. This study reveals that respondents have a high knowledge of mode of transmission, malaria symptoms and preventive measures. Despite this high level of knowledge of the disease and its preventive measures, the incidence of malaria remains relatively high in this rural community highlighting the need for continuous strategic interventions particularly health awareness and educational programs
CO2 Cholangiography Reduce Cholangitis Risk in Patients with Bismuth Type IV Hilar Biliary Obstruction during ERCP
Authors: zhang wenhui , Ding Peng peng , liu lei , wang yanling , lai wenhui , han jingjing , han jun , li hanwei 
Published: February 2020

Abstract
Backgrounds: Endoscopic palliation in hilar obstruction requires endoscopic retrograde cholangiopancreatography (ERCP), whereas cholangitis could be induced by contrast injection. Post ERCP cholangitis risk is particularly high in Bismuth type IV hilar obstruction, and the risk is further increased if the contrast could not be drained. The aim of this study is to evaluate the cholangitis risks associated with contrast agent, air and CO 2 injection in type IV hilar lesions.
Methods : The authors retrospectively evaluated the utility of contrast, air and CO 2 cholangiography in consecutive 70 patients with type IV hilar obstruction. The patients were divided into 3 groups based on the agent used: A) contrast (n=22), B) air (n=18), and C) CO 2 (n=30). Prior to ERCP, MRCP was obtained in all patients to guide endoscopic intervention.
Results : At baseline, there was no significant difference in patient’s age, gender, symptoms, liver function tests between different groups ( p ＞0.05). The complication rates in group B and C were significantly lower than that in group A (27.8% and 26.7% versus 63.6%, p ＜0.05). Except cholangitis risk ( p ＜0.05), no significant difference was found in post ERCP pancreatitis and bleeding risks (both p ＞0.05) between the 3 groups. After ERCP, the mean hospital stay duration was shorter in group B and C compared with group A ( p ＜0.05). However, the difference of one month mortality between 3 groups was not significant ( p ＞0.05). There was no significant difference between group B and C in primary end points.
Conclusions : CO 2 cholangiography based ERCP is safer and should be utilized to reduce the risk of post-ERCP cholangitis in typer IV hilar obstruction.
A method to audit and score implementation of knowledge translation (KT) interventions in large health regions – an observational pilot study using rectal cancer surgery in Ontario
Authors: Simunovic Marko , Fahim Christine , Coates Angela , Urbach David , Earle Craig , Grubac Vanja , Brouwers Melissa , O'Brien Mary Ann , Baxter Nancy 
Published: February 2020

Abstract
Background: Across Ontario, since the year 2006 various knowledge translation (KT) interventions designed to improve the quality of rectal cancer surgery have been implemented by the provincial cancer agency or by individual researchers. Ontario is divided administratively into 14 health regions. We piloted a method to audit and score for each region of the province KT interventions implemented to improve the quality of rectal cancer surgery. Methods: We interviewed stakeholders to audit KT interventions used in respective regions over years 2006 to 2014. Results were summarized into narrative and visual forms. KT experts reviewed these data and then, for each region, scored KT intervention implementation using a 20-item KT Signature Assessment Tool. Scores could range from 20-100 with higher scores commensurate with greater KT intervention implementation. Results: There were thirty interviews. KT experts produced scores for each region that were bimodally distributed, with an average score for 2 regions of 78 (range 73-83) and for 12 regions of 30.5 (range 22-38). Conclusion: Our methods efficiently identified two groups with similar KT Signature scores. Two regions had relatively high scores reflecting numerous KT interventions and the use of sustained iterative approaches in addition to those encouraged by the provincial cancer agency, while 12 regions had relatively low scores reflecting minimal activities. These groupings will be used for future comparative quantitative analyses to help determine if higher KT signature scores correlate with improved measures for region-level quality of rectal cancer surgery.
The deleterious effect of the HLA-C1/KIR2DL3 receptor-ligand combination on Chinese HIV Patients
Authors: Sun Jianjun , SHEN Jia-yin , ZHANG Feng-di , ZHANG Ren-fang , LIU Li , SHEN Yin-zhong , WANG Jiang-rong , QI Tang-kai , WANG Zhen-yan , TANG Yang , SONG Wei , CHEN Jun , GUAN Li-qian , SUN Mei-yan , ZHANG Shu-ye , LU Hong-zhou 
Published: February 2020

Abstract
Background Among Chinese HIV-infected patients we assessed the impact of different KIR-HLA combinations on the viral set point levels, CD4/CD8 ratios and plasma soluble CD14, all of which are risk factors for the prognosis of HIV patients. Methods Peripheral blood samples were collected from newly diagnosed HIV-infected patients who were treatment naive, and processed according to the study design. Participants were selected according to the inclusive criteria and their clinical data and other demographic information were recorded. The genomic DNA of the host was extracted from the whole blood samples, and the KIR genotyping was performed by sequence specific primer amplification (PCR-SSP); the HLA genotyping was performed by sequence analysis (PCR-SBT); and the HLA-KIR genotyping and combination information were obtained. Results In China, the distribution of KIR genotypes in HIV patients was similar to that of KIR genotypes in people without HIV infection; the baseline HIV level in patients with HLA-C1+/KIR2DL3+ background was significantly higher than that of HLA-C1+/KIR2DL3-(4.34 log10 copies/ml v.s 3.72 log10 copies/ml, P=0.02); the baseline CD4/CD8 ratio of HLA-C1+/KIR2DL3+ was significantly lower than that of HLA-C1+/KIR2DL3-(0.33 v.s 0.56, P=0.02). The plasma soluble CD14 level at baseline was significantly lower in HLA-C1+/KIR2DL3- infected persons than that of HLA-C1+/KIR2DL3+ (P=0.03). Conclusions NK cells may affect the viral set point and host immune status in HIV-infected patients through the combination of KIR molecules and their corresponding ligand HLA, thus affecting the prognosis of HIV infection.
Are Preinjury Anticoagulant and Antiplatelet Medications a Pitfall in the Bleeding Tendencies of Elderly Trauma Patients in Intensive Care?
Authors: Kim Se Heon , Sul Young Hoon , Lee Jin Young , Ye Jin Bong , Lee Jin Suk , Kim Hong Rye , Yoon Soo Young , Kim Joong Suck 
Published: February 2020

Abstract
Purpose: The elderly are more likely to be on anticoagulant or antiplatelet medications, which increase bleeding. We aimed to determine the effect of preinjury anticoagulant or antiplatelet medications on required blood transfusions and the trauma outcomes of elderly patients.Methods: We retrospectively reviewed the medical records of all elderly trauma patients admitted to Chungbuk National University Hospital from January 2016 to June 2019. We compared the required number of blood transfusion units, complications, and mortality rate between those on anticoagulant or antiplatelet medications and those that were not, using the chi-squared test, independent t-test, liner regression analysis, and logistic regression analysis.Results: Out of 466 patients, 142 were on anticoagulant or antiplatelet medications while 324 were not. There was a significant statistical difference in the unit amount of red blood cells transfused within 4 hours of arriving at the hospital between the medicated and non-medicated groups (0.89 vs 1.43 units, respectively, p = 0.02); however, multivariate analysis showed no statistical difference (p = 0.28). The medication group showed a higher rate of complications compared to the non-medicated group (47.9% vs. 29.6%, respectively, p = 0.001), bleeding (17.6% vs 2.8%, respectively, p = 0.001), and pneumonia (24.4% vs 14.2%, respectively, p =0.01). There was no statistical difference in the mortality rate (16.9% vs. 22.2%, respectively, p = 0.21). Conclusion: Preinjury anticoagulant or antiplatelet medications in elderly trauma patients increased bleeding and complications such as pneumonia but did not affect transfusion requirement, or mortality rate.