bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Affecting Participant Recruitment and Retention in Borderline Personality Disorder Research: A Feasibility Study
Authors: Woo Julia , Shahid Hamnah , Hillmer Alannah , Abdullah Alamna , Deshpande Sarah , Panesar Balpreet , Sanger Nitika , Samaan Zainab 
Published: August 2020

Abstract
Background

Previous studies have shown that stigma is a major barrier to participation in psychiatric research, and that individuals who participate in psychiatric research may differ clinically from non-participants. However, no previous study has explored research recruitment and retention challenges in the context of personality disorders.
Aim

To provide an analysis of the factors affecting participant recruitment and retention in a study of borderline personality disorder.
Methods

Adult inpatients in a tertiary psychiatric hospital were approached about participating in a cross-sectional study of borderline personality disorder. Recruitment rates, retention rates, and reasons for declining participation or withdrawing from the study were collected. Demographic characteristics were compared between participants and non-participants, and between patients who remained in the study and those who withdrew.
Results

A total of 70 participants were recruited into the study between January 2018 and February 2020. Recruitment and retention rates were 46% and 70%, respectively. Lack of interest was the most commonly cited reason for non-participation, followed by scheduling conflicts and concerns regarding mental/physical well-being. Age and sex were not predictors of study participation or retention.
Conclusions

More research is needed to explore patients’ perspectives and attitudes towards borderline personality disorder diagnosis and research; determine effects of different recruitment strategies; and identify clinical predictors of recruitment and retention in personality disorder research.
Trial registration:

The study was not registered as it did not involve the provision of a health care intervention to human participants.
The role of perforating artery pedicled neurotrophic flap in the treatment of compound tissue defect of tibia with Ilizarov technique
Authors: Zhang Yu-bo , Wu Yuan-jian , Zhang Wen-jun , Zhang Tao , Lou Tengfei , Han Pei 
Published: August 2020

Abstract
Background The aim of this research is to present our experience with the combined use of pedicled neurotrophic flap and distraction osteogenesis in management of complex lower extremity injuries with composite bone and soft tissue defects and assess the functional and cosmetic results of this method.Methods Between 2008 and 2016, soft tissue coverage with pedicled neurotrophic flap followed by distraction osteogenesis using Ilizarov external fixator was performed in 25 patients for reconstruction of segmental bone defects of lower extremity complicated by massive loss of soft tissue. There were 16 men and 9 women: their mean age was 39 years (23 to 57) at the time of surgery. The soft tissue defect after radical debridement ranged from 5 × 9 cm2 to 11 × 14 cm2, and the average size of segmental defect was 5.02 (2.5 to 7.5) cm.Results The distally based sural neurovascular flap was performed in 13 patients, and the greater saphenous neurocutaneous perforator flap in 12 patients. All flaps survived completely without complications. The bone defects were corrected by a mean lengthening of 6.74 (4.5 to 9.5) cm. The function was judged to be excellent in 12 patients and good in 13 patients. Bone results were graded as excellent in 18 patients and good in 7 patients. Complications observed in the process of the treatment included pain, pin tract infections (PTI), ankle midfoot joints stiffness, and nonunion of docking sites. All the cases achieved successful limb salvage and satisfactory function recovery without recurrence of infection.Conclusions The combined technique of a perforator artery pedicled neurotrophic flap and distraction osteogenesis should be considered to be an effective alternative approach in the salvage treatment of the massively traumatized and chronically infected lower extremity.Trial registration: This article has been retrospectively registered.
Analysis of influencing factors of incision infection in combined anterior-posterior surgery for subaxial cervical fracture dislocation
Authors: Li Shuixia , Wang Jing , Hu Jing , Hao Ding-Jun , He Baorong , Wei Dongmei , Gong Han-Lin , Li Qing-Da , Yang Jun-Song , Zhao Yuan-Ting 
Published: August 2020

Abstract
Background: To explore the impact of related factors on the surgical site infection (SSI) after combined anterior-posterior surgery for subaxial cervical fracture dislocation (SCFD), and to provide a basis for formulating preventive measures.Methods: A total of 841 patients (531 males and 310 females, aged 24-68 years) with SCFD who received combined anterior-posterior surgery from January 2014 to May 2018 were retrospectively analyzed. According to whether the postoperative SSI occurred, they were divided into two groups. Demographic data, American spinal injury association (ASIA) neurological impairment scale, comorbidity, diet nursing and operating room related factors (time interval from skin preparation to operation, whether preoperative urinary catheterization was performed, whether was the consecutive operation, the total number of person in the operating room, operating room temperature, relative humidity, operational duration, and whether there was an intern nurse involved in the operation) the of patients in the two groups were analyzed by Logistic regression for the factors related to perioperative SSI. Result: SSI occurred in 44 patients with the rate of 5.2% (44/841). The results of univariate analysis showed that there were statistically significant differences between the two groups in the grade of ASIA scale, diabetes, lack of dietary care, time interval from skin preparation to operation, preoperative urinary catheterization, consecutive operation and the total number of person in the operating room (all P<0.01). Multivariable Logistic regression analysis results show that the severity of spinal cord injury (grade A OR value = 78.431, grade B OR value =24.120, grade C OR value = 5.342, P < 0.05, respectively), diabetes (OR value = 3.114, p=0.014), lack of dietary care (OR value = 2.275，p=0.023), time interval from skin preparation to operation > 6h (OR value = 2.342, p=0.022), preoperative urinary catheterization (OR value = 4.476, P <0.001) and the total number of person in the operating room > 8 (OR value = 2.921, P = 0.014) were positively correlated with perioperative SSI. Conclusion: The severity of spinal cord injury (ASIA grade A,B and C), diabetes, lack of dietary care, time interval from skin preparation to operation > 6 hours, preoperative urinary catheterization and the total number of person in the operating room > 8 are the risk factors for SSI after combined anterior-posterior surgery for SCFD.
Risk of hypertension in school-aged children with different parental risk: A longitudinal study from childhood to young adulthood
Authors: Amiri Parisa , Rezaei Marjan , Jalali-Farahani Sara , Karimi Mehrdad , Cheraghi Leila , Esbati Romina , Azizi Fereidoun 
Published: August 2020

Abstract
Background: Although previous studies have shown the relationship between different parental factors and children's blood pressure status, there is limited data on the cumulative effect of these factors. Considering parental socio-demographic, behavioral and cardio-metabolic factors, the current study aimed to distinguish parental risk clusters and their effects on the incidence of hypertension in school-age children over thirteen years.Methods: Parental characteristics of 1669 children including age, education, employment, smoking, physical activity, metabolic syndrome (MetS), hypertension (HTN), weight status and diabetes were considered to categorize parents into low and high risk clusters. Crude incidence rates (per 10,000 person-years) of HTN in children were assessed in each maternal and paternal clusters. Using Cox proportional hazard model, results on association between parental risk clusters and HTN incidence in children were reported in five different models. Results: Mean age of children was 13.96±2.89 years and 51.2% (n=854) of them were girls. MetS, HTN and weight status were the most important factors distinguishing low and high risk parental clusters respectively. Crude incidence rates (per 10,000 person-years) of HTN were 86 (95% CI: 71-106) and 38 (95% CI: 29-52), in boys and girls, respectively. Moreover, incidence rates (per 10,000 person-years) of HTN were 50 (95% CI: 40-63) and 80 (95% CI: 64-102) in maternal low and high risk clusters, respectively. The incidence rates (per 10,000 person-years) of HTN in paternal low and high risk clusters were 53 (95% CI: 41-70) and 68 (95% CI: 56-84), respectively.Conclusion: Our findings underscore the prognostic value of maternal characteristics in predicting the incidence of HTN in their offspring. The current results could be valuable in planning related programs to prevent hypertension in similar communities.
The Effect of Theory of Planned Behavior-Based Education in Adopting the Urinary Tract Infection Prevention Behavior in Pregnant Women: A randomized Controlled Trial
Authors: Moradpour Sheida , Shahnazi Hossein , Hassanzadeh Akbar 
Published: August 2020

Abstract
BackgroundUrinary tract infection (UTI) is a common infection in women, and it is more likely to occur during pregnancy due to mechanical and hormonal changes in pregnant women. Urinary tract infections can cause many complications for both mother and fetus. Given the roles of health behavior in the prevention of urinary tract infections and the nature of the theory of planned behavior-based education in behavioral change, the present study aimed to determine the effect of the theory of planned behavior-based education in teaching the urinary tract infection prevention behavior in pregnant women.MethodsThe present study was a randomized controlled trial in which 100 pregnant women, who visited the comprehensive health service centers of Zarinshahr City, were randomly divided into two groups, intervention and control, containing 50 individuals. The data collection tools were a urine test and a questionnaire designed based on the theory of planned behavior. Five education sessions were held based on the constructs of the theory of planned behavior. We analyzed the effect of education review and data using independent t-tests, Mann-Whitney test, chi-square test, and repeated measures ANOVA (analysis of variance) one and three months after the educational intervention.ResultsAfter implementing the educational intervention, the mean scores of knowledge and constructs of the theory of planned behavior significantly increased in the intervention group over time (P < 0.001), while the difference was not significant in the control group over time. After the educational intervention, the incidence of urinary tract infections was 4.3% in the intervention group and 21.3% in the control group.ConclusionGiven the positive effect of education based on the theory of planned behavior in changing the pregnant mothers' behavior, the theory can be used as a suitable intervention framework for implementing the educational programs to prevent urinary tract infections.Trial registrationName: Iranian Registry of Clinical Trials. Registration number: IRCT20170214032575N1. Registration date: 2019-12-12 [retrospectively registered].
Applying interpretive phenomenological analysis to library and information science research on blended librarianship: A case study
Authors: Dabengwa Israel Mbekezeli , Raju Jaya , Matingwina Thomas 
Published: August 2020

Abstract
Although interpretive phenomenological analysis (IPA) has value in library and information science (LIS), it has low uptake in Africa. Readers are guided in how to apply IPA in LIS research using an example of a blended librarianship thesis conducted in Zimbabwe. The illustration narrates how IPA was implemented within the context of phenomenology to analyse the complexity of academic librarians' views, taking into consideration social and historical environments. The methodological and theoretical approaches to using IPA in LIS and other disciplines are outlined, including a critical analysis of applying double hermeneutics and horizontalization to construct a hermeneutic interpretation. The blended librarianship thesis is compared with LIS-based IPA studies and blended librarianship research to reflect the value of IPA methods. The weaknesses of the study are discussed, including the use of quality criteria of credibility, dependability, and transferability. The guided analysis of the study encourages the use of IPA in LIS as it can solve research problems and generate new theories to inform practice, services, philosophy, theory, and institutions.
Construction and Investigation of circRNA-miRNA-mRNA ceRNA Regulatory Network in Breast Cancer
Authors: Wu Ming , Sang Meijie , Pan Shuo , Liu Fei , Sang Meixiang 
Published: August 2020

Abstract
Background: Circular RNAs (circRNAs) have drawn lots of attention in tumorigenesis and progression. However, circRNAs as crucial regulators in multitudinous biological processes have not been systematically identified in breast cancer (BC). Our research aims to explore novel circRNAs in BC and their mechanisms of action.Methods: The circRNA expression profile data, as well as RNA-sequencing data of BC, were downloaded from public database, respectively. The differentially expressed circRNAs, miRNA, and mRNA were determined via fold change filtering. The competing endogenous RNAs (ceRNAs) network were established on the foundation of the relationship between circular RNAs, miRNAs and mRNAs. GO and KEGG analysis of the overlapped genes were performed to predict the potential functions and mechanisms of circRNAs in BC. The CytoHubba was used to determine the hub genes from the PPI regulatory network. Morever, we further used Kaplan–Meier plotter to perform survival analysis of these hub genes. Real-time PCR was used to validate the expression of the circRNAs in BC tissues.Results: A total of seven differential expressed circRNAs were screened. After the predicted target miRNA and DEmiRNA were intersected, four circRNA-miRNA interactions including three circRNAs and four miRNAs were determined. Furthermore, the Venn diagram was used to intersect the predicted target genes and the downregulated differentially expressed genes, and screened 149 overlapped genes. Moreover, we constructed a PPI network, and selecting six hub genes, including DGAT2, ACSL1, ADIPOQ, LPL, LEP, PCK1. Moreover, the survival analysis results revealed that low expression of ADIPOQ, LPL, LEP were obviously correlated with poor prognosis of BC patients. The real-time PCR results demonstrated that, the levels of circ_0028899, circ_0000375, and circ_0000376 were significantly down-regulated in breast cancer tissues.Conclusions: Our study constructed and analyzed a circRNA-associated ceRNA regulatory network and discovered that circ_0028899, circ_0000375, and circ_0000376 may function as ceRNAs to serve key roles in BC.
Challenges in Basic Life Support and Automated External Defibrillator Training of Deaf People
Authors: Strnad Matej , Šalda Zdenko , Jerko Boštjan , Vrečar Vida , Lesjak Vesna Borovnik , Petrovčič Rok 
Published: August 2020

Abstract
BackgroundBasic life support (BLS) with the use of an automated external defibrillator (AED) is a fundamental link to a successful chain of survival of patients with cardiac arrest. However, the BLS protocol is not tailored for deaf people who encounter many challenges during BLS training. MethodsAfter an ergonomic analysis and modifications of the BLS and AED protocol, a practical course was conducted. A pre-course BLS and AED knowledge was tested with a questionnaire. After the course, each participant practically solved a cardiac arrest scenario on a manikin and qualitative and quantitative data on BLS and AED performance were collected with a modified Cardiff test and the QCPR mobile application. Results of the knowledge test and performance were presented with frequencies and correlations between pre- and post-course BLS and AED knowledge and performance were analyzed and presented with Spearman’s rho. Results51 deaf volunteers from seven Slovenian societies for deaf people participated in the study. Results on the pre-course knowledge test were poor (3.5 points out of 10). BLS performance according to the modified Cardiff test post-course was also poor: 52.9 % of the participants used a safe approach, 58.8 % checked responsiveness and 51.0 % sent a text message to the rescue service. Only 43.1 % of them opened the airway and 49.0% checked initial breathing. 80.4% of the deaf rescuers performed chest compressions on the lower half of the sternum but only 52.9 % of them compressed with adequate depth. According to the QCPR application the best performance was achieved with the compression score of 61.1 % and flow fraction 74.9%.ConclusionsThis study shows that a more comprehensive and assidiuous approach is needed for effective BLS and AED training courses for deaf people.
Formula-fed and Clostridioides difficile infected neonatal piglets carry a highly diverse and abundant set of antimicrobial resistance genes
Authors: Pieper Robert , Dadi Temesgen , Grzeskowiak Lukasz , Pieper Laura , Siegmund Britta , Vahjen Wilfried , Schwarz Stefan , Heinsen Femke , Franke Andre , Reinert Knut , Zentek Jürgen 
Published: August 2020

Abstract
Background Clostridioides difficile infection (CDI) is an increasing zoonotic health threat and has also been documented as a cause of enteritis outbreaks in neonatal pigs. Furthermore, CDI in neonatal piglets cause changes in microbial gut colonization. We hypothesized that an imbalanced microbial colonization in piglets with CDI could be associated with an altered abundance of antimicrobial resistance genes.Results We analyzed fecal metagenomic data of lactating sows (S), their piglets during suckling (SP), the same piglets two weeks after weaning (WP), 5-day old artificially reared and formula-fed siblings (FP) and FP infected with C. difficile (FP-CD) for microbiota composition and antimicrobial resistance gene abundance. FP and FP-CD piglets had an immature-type microbiota and increased abundance of antimicrobial resistance genes. A co-occurrence of genes encoding for resistance against aminoglycosides (e.g. aph(3”)-lb, aph(6)-ld, ant(2”)-la), β-lactams (blaCTX−M, blaTEM), fluoroquinolones (pat(A) macrolides (mph(A)), sulfonamides (sul1, sul2), polypeptides (e.g. pmrB, pmrC, arnA, bac(A)) and tetracyclines (e.g. tet(A-D),) was observed. A strong association between Escherichia, Streptococcus, Shigella, Enterococcus and Fusobacterium taxa with the expansion of the resistome in FP and FP-CD piglets were found.Conclusion Increased abundance of antimicrobial resistance genes in formula feeding and concomitant CDI may be associated with therapeutic resistance later in life and warrant further studies.
The Direct Economic Disease Burden of Healthcare-associated Infections (HAIS) and Antimicrobial Resistance (AMR): A Preliminary Study in a Teaching Hospital of Nepal
Authors: Liu Xinliang , Shrestha Rajeev , Koju Pramesh , Maharjan Bedana , Shah Poonam , Thapa Pramila , Li Hao 
Published: August 2020

Abstract
Background: Healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) have been becoming the public and global health issues. The purpose of this study is to estimate the direct economic burden attributable to HAIs and AMR.Methods: This study applied propensity score matching (PSM) methodology to conduct a prospective case-control study of direct disease burden attributable to HAIs and AMR 16th December, 2017 to 16th April, 2018 in a teaching hospital in Nepal. Clinical information was retrieved from Hospital Health Information and electronic medical record systems, as well as the microbiology lab system. The finance system was used to determine the health expenditure and length of hospitalization of HAIs, HAIs-AMR and Non-HAIs patients. STATA 12.0 was used to conduct descriptive analysis, (bivariate) χ2 test, paired/independent T test, PSM (B=0.25a, nearest neighbour 1:1 matching, General Boosted Model, GBM). The statistically significant level was set at P < 0.05.Results: HAIs patients and HAIs-AMR patients had statistically significant higher expenditures and longer length of hospital days than Non-HAI inpatients during the study period (P<0.05). The additional average total medical expenditure, medicines expenditure, out-of-pocket expenditure and length of hospitalization per patient caused by HAIs were 17,224.93 Rupees, 11,947.49 Rupees, 15,776.57 Rupees and 7 days, respectively. In the meantime, the extra total medical expenditure, medicines expenditure, out-of-pocket expenditure and length of hospitalization attributable to HAIs-AMR were 39,879.63 Rupees, 21,173.63 Rupees, 38,770.87 Rupees and 9 days, respectively. Moreover, the percentage of out-of-pocket expenditure accounting for total medical expenditure of HAIs Group was 94.24% while it was 96.75% of HAIs-AMR Group.Conclusions: It was the first time to apply the research framework of the previous study in China to estimate the direct economic burden caused by HAIs and AMR in a teaching hospital of Nepal. HAIs and AMR have substantially led to excess direct economic burden for patients and their family due to the low Gross Domestic Product (GDP) and low health expenditure in Nepal. This calls for active collaboration with developed countries to reduce the threat caused by HAIs and AMR to prevent the transnational communication.
Laparoscopic Transgastric Necrosectomy in Treatment of Walled-off Pancreatic Necrosis with Sinistral Portal Hypertension: A Single-Center Retrospectively Study
Authors: Cao Feng , Zheng Zhi , Li Ang , Wang Xiaohui , Gao Chongchong , Li Jia , Li Fei 
Published: August 2020

Abstract
Background: Laparoscopic transgastric necrosectomy (LTGN) has been used in treatment of walled-off pancreatic necrosis (WON) for more than a decade. However, the safety and effectiveness of LTGN for WON with sinistral portal hypertension was still unclear. Methods: WON patients with sinistral portal hypertension treated in our department between Jan. 2011 and Dec. 2018 were included and retrospective analyzed in this study. Patients were divided into two groups according to different surgical approaches, LTNG or laparoscopic assisted trans-lesser sac necrosectomy (LATLSN). Perioperative and long-term outcomes were compared between two groups. Results: 312 cases diagnosed with WON were screened and 53 were finally included in this study. Of the included patients, 21 and 32 cases were received LTGN and LATLSN, respectively. LTGN was associated with significantly lower morbidity than LATLSN (19.0% vs 46.9%, p=0.04) and similar sever complication (Clavien-Dindo≥Ⅲ) rate (12.5% vs 19.0%, p=0.70). LTGN did not increase the rate of postoperative hemorrhage (9.5% vs 6.3%, p=1.00) and mortality (9.5% vs 9.4%, p=1.00). After 39(11-108) months follow-up, the recurrence rate of WON and long-term complications were also comparable between groups. Conclusions: From current data, LTGN was safe and effective in treatment of WON patients with sinistral portal hypertension in terms of short- and long-term outcomes.