bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are Malaysian Type 2 Diabetes patients willing to be trained to speak to their offspring about risk of diabetes and preventive measures?
Authors: Badlishah-Sham Siti Fatimah , Ramli Anis Safura , Isa Mohamad Rodi , Mohd-Zaki Nurzakiah , Whitford David Leonard 
Published: January 2020

Abstract
Background : Offspring of diabetes patients have an absolute risk of 20-40% of developing the condition. Diabetes patients should be encouraged to speak to their offspring regarding diabetes risk and prevention strategies. The Health Belief Model conceptualises that the higher the perceived risk, the more likely an individual will modify their behaviour. The objectives of this study were to i) determine the distribution of type 2 diabetes patients regarding their willingness to accept training to speak to their offspring, ii) determine the distribution of type 2 diabetes patients regarding their willingness to accept training based on the HBM and iii) to determine the factors associated with their willingness to accept training.
Methods : This was a cross-sectional study amongst type 2 diabetes patients attending two primary care clinics in Malaysia. Sociodemographic data and knowledge of diabetes risk factors were collected. The adapted, translated and validated Diabetes Mellitus in the Offspring Questionnaire-Malay version (DMOQ-Malay) was self-administered. Statistical analysis included descriptive statistics, univariate and multiple logistic regression.
Results : A total of 425 participants were recruited. Of these, 61.6% were willing to accept training. In MLogR, six variables were found to be significantly associated with willingness to accept training. These were i) positive family history [Adj. OR 2.06 (95% CI: 1.27, 3.35)], ii) having correct knowledge that being overweight is a risk factor [Adj. OR 1.49 (95%CI: 1.01, 2.29)], iii) correctly identifying age 40 years old as a risk factor [Adj. OR 1.88 (95%CI: 1.22, 2.90)], iv) agreeing that speaking to their offspring would help them to prevent type 2 diabetes [Adj. OR 4.34 (95%: 1.07, 17.73)], v) being neutral with the statement ‘I do not have much contact with my offspring’ [Adj. OR: 0.31 (95% CI: 0.12, 0.810] and vi) being neutral with the statement ‘my offspring are not open to advice from me’ [Adj. OR: 0.63 (95% CI: 0.31, 0.84].
Conclusion : The majority of type 2 diabetes patients were willing to accept training to speak to their offspring to prevent diabetes. A training module should be designed to enhance their knowledge, attitude and skills to become family health educators.
Predicting patient outcomes in psychiatric hospitals with routine data: a machine learning approach
Authors: Wolff Jan , Gary Alexander , Jung Daniela , Normann Claus , Kaier Klaus , Binder Harald , Domschke Katharina , Klimke Ansgar , Franz Michael 
Published: January 2020

Abstract
Background: A common problem in machine learning applications is availability of data at the point of decision making. The aim of the present study was to use routine data readily available at admission to predict aspects relevant to the organization of psychiatric hospital care. A further aim was to compare the results of a machine learning approach with those obtained through a traditional method and those obtained through a naive baseline classifier.
Methods: The study included consecutively discharged patients between 1 st of January 2017 and 31 st of December 2018 from nine psychiatric hospitals in Hesse, Germany. We compared the predictive performance achieved by stochastic gradient boosting (GBM) with multiple logistic regression and a naive baseline classifier. We tested the performance of our final models on unseen patients from another calendar year and from different hospitals.
Results: The study included 45,388 inpatient episodes. The models’ performance, as measured by the area under the Receiver Operating Characteristic curve, varied strongly between the predicted outcomes, with relatively high performance in the prediction of coercive treatment (area under the curve: 0.83) and 1:1 observations (0.80) and relatively poor performance in the prediction of short length of stay (0.69) and non-response to treatment (0.65). The GBM performed slightly better than logistic regression. Both approaches were substantially better than a naive prediction based solely on basic diagnostic grouping.
Conclusion: The present study has shown that administrative routine data can be used to predict aspects relevant to the organisation of psychiatric hospital care. Future research should investigate the predictive performance that is necessary to provide effective assistance in clinical practice for the benefit of both staff and patients.
A maternal GOT1 novel variant associated with early-onset severe preeclampsia identified by whole-exome sequencing
Authors: Zhang Lin , Cao Zheng , Feng Fan , Xu Ya-Nan , LI LIN , Gao Hong 
Published: January 2020

Abstract
Background This study wants to know the genetic cause of preeclampsia (PE) which is a leading cause of maternal and perinatal death, but the underlying molecular mechanisms that cause PE remain poorly understood. Many single nucleotide polymorphisms have been identified by genome-wide association studies and were found to be associated with PE; however, few studies have used whole-exome sequencing (WES) to identify PE mutations. Methods Five patients with severe early-onset preeclampsia (EOPE) were recruited, and WES was performed on each patient. Sanger sequencing was used to confirm the potential causative genetic mutation. Results After a stringent bioinformatics analysis, a rare mutation in the GOT1 gene, c.44C>G:p.P15R, was found in one patient. Bioinformatics analysis showed that the mutation site is highly conserved across several species and was predicted to be a pathogenic mutation according to several online mutational function prediction software packages. Further structural biology homology modeling suggested that P15R would change the electric environment of enzymatic center, and might affect the binding affinity of substrate or product. Conclusion We demonstrated for the first time that the mutation in GOT1 may be associated with EOPE, the results of this study provide researchers and clinicians with a better understanding of the molecular mechanisms that underlie maternal severe EOPE.
Integrative analysis of outer membrane vesicles proteomics and whole-cell transcriptome analysis of eravacycline induced Acinetobacter baumannii strains
Authors: Kesavan DineshKumar , Vasudevan Aparna , Wu Liang , Chen Jianguo , Su Zhaoliang , Wang Shengjun , Xu Huaxi 
Published: January 2020

Abstract
Background Acinetobacter baumannii is a multidrug-resistant (MDR) hazardous bacterium with very high antimicrobial resistance profiles. Outer membrane vesicles (OMVs ) help directly and/or indirectly towards antibiotic resistance in these organisms. The present study aims to look on the proteomic profile of OMV as well as on the bacterial transcriptome upon exposure and induction with eravacycline, a new synthetic fluorocycline. RNA sequencing analysis of whole-cell and LC-MS/MS proteomic profiling of OMV proteome abundance were done to identify the differential expression among the eravacycline-induced A. baumannii ATCC 19606 and A. baumannii clinical strain JU0126. Results The differentially expressed genes from the RNA sequencing were analysed using R package and bioinformatics software and tools. Genes encoding drug efflux and membrane transport were upregulated among the DEGs from both ATCC 19606 and JU0126 strains. As evident with the induction of eravacycline resistance, ribosomal proteins were upregulated in both the strains in the transcriptome profiles and also resistance pumps, such as MFS, RND, MATE and ABC transporters. High expression of stress and survival proteins were predominant in the OMVs proteome with ribosomal proteins, chaperons, OMPs OmpA, Omp38 upregulated in ATCC 19606 strain and ribosomal proteins, toluene tolerance protein, siderophore receptor and peptidases in the JU0126 strain. The induction of resistance to eravacycline was supported by the presence of upregulation of ribosomal proteins, resistance-conferring factors and stress proteins in both the strains of A. baumannii ATCC 19606 and JU0126, with the whole-cell gene transcriptome towards both resistance and stress genes while the OMVs proteome enriched more with survival proteins. Conclusion The induction of resistance to eravacycline in the strains were evident with the increased expression of ribosomal and transcription related genes/proteins. Apart from this resistance-conferring efflux pumps, outer membrane proteins and stress-related proteins were also an essential part of the upregulated DEGs. However, the expression profiles of OMVs proteome in the study was independent with respect to the whole-cell RNA expression profiles with low to no correlation. This indicates the possible role of OMVs to be more of back-up additional protection to the existing bacterial cell defence during the antibacterial stress.
Community and health staff perceptions on non-communicable disease management in El Salvador Health System: a qualitative study
Authors: Vidal Nicole , León-García Montserrat , Jiménez Marta , Bermúdez Keven , De Vos Pol 
Published: January 2020

Abstract

Non-communicable Diseases (NCDs) are the leading cause of global mortality and disability, with a rising burden in low- and middle-income countries. Their multifactorial aetiology, and their requirement of long-term care, imply the need for comprehensive approaches. From 2009, the Ministry of Health (MoH) in El Salvador has developed a national public health system based on comprehensive primary health care. This study aims to describe the different stakeholders’ perceptions about the management of NCDs along the pathways of care in this health system. During three fieldwork periods in 2018, three complementary qualitative data collection methods were deployed and conducted in high prevalence of NCDs settings within El Salvador. First, we used illness narrative methodology to document the life histories of people living with a chronic disease and being treated in second and third level health facilities. Second, through social mapping, we analysed support-resources that NCD patients used throughout the process of their illness within the same settings. Third, semi-structured interviews were conducted in the same locations, with both chronic patients and health personnel working at different levels of the primary health care setting. Participants were recruited through purposive and snowball sampling, and a deductive approach was implemented for coding during the analysis phase. After grouping codes into potential themes, a thematic framework was elaborated through a reflexive approach and triangulation of the data. This innovative approach of combining three well-defined qualitative analysis frameworks identified key implications for the implementation of a comprehensive approach to NCDs management in resource-poor settings. The following dimensions are identified: 1) social risk factors and barriers to care; 2) patient pathways to NCDs care; 3) resources available identified through social connections mapping; 4) trust in social connections; 5) community health promotion and prevention of NCDs management. The Salvadoran public health system has been able to strengthen its comprehensive approach to NCDs, combining a clinical approach – including long term follow-up – with a preventive community-based strategy. The structural collaboration between the health system and the (self)organized community has been key to identify failings, discuss tensions and work out adapted solutions.
Informal caregivers’ views on the quality of healthcare services provided to older patients aged 80 or more in the hospital and 30 days after discharge
Authors: Lilleheie Ingvild , Debesay Jonas , Bye Asta , Bergland Astrid 
Published: January 2020

Abstract

Background:In the European Union (EU), informal caregivers provide 60% of all care. Informal caregiving ranges from assistance with daily activities and provision of direct care to helping care recipients to navigate within complex healthcare and social services systems. While recent caregiver surveys document the impact of informal caregivers, systematic reviews show that they have unmet needs. Because of the political desire to reduce the length of hospital stays, older patients are discharged from the hospital ‘quicker and sicker’ than before. The transition between different levels of the healthcare system and the period after hospital discharge is critical for elderly patients.Caregivers’ perspectives on the quality of older patients’ care journeys between levels of the healthcare system may provide valuable information for healthcare providers and policymakers. This study aims to explore older patient’s informal caregivers’ views on healthcare quality in the hospital and in the first 30 days after hospitalisation.Method:We conducted semi-structured individual interviews with 12 participants to explore and describe informal caregivers’ subjective experiences of providing care to older relatives. The interviews were then transcribed and analysed thematically.Results:The analysis yielded the overarching theme ‘Informal caregivers – a health service alliance – quality contributor’, which was divided into four main themes: ‘Fast in, fast out’, ‘Scant information’, ‘Disclaimer of responsibility’ and ‘A struggle to secure professional care’. The healthcare system seemed to pay little attention to ensuring mutual understandings between those involved in discharge, treatment and coordination. The participants experienced that the healthcare providers’ main focus was on the patients’ diseases, although the health services are supposed to view patients holistically.Conclusion:Based on the information given by informal caregivers, health services must take into account each person’s needs and preferences. To deliver quality healthcare, better coordination between inter-professional care teams and the persons they serve is necessary. Health professionals must strengthen the involvement of caregivers in transitions between care and healthcare. Future work should evaluate targeted strategies for formal caregivers to cooperate, support and empower family members as informal caregivers.
Patients perspective of m-health adoption factors in the developing world.&nbsp;Development of a Proposed framework
Authors: Addotey-Delove Michael Nii-Addotey , Scott Richard E. , Mars Maurice 
Published: January 2020

Abstract
Patient perceptions and experiences of mobile health (m-health) systems have been recognised as an important element to consider in the adoption of m-health based technologies. Though much research supports this, published studies that focus on m-health use by patients appear to highlight these issues in an isolated rather than holistic manner. Consequently, there is no encompassing framework that serves as a guide for effective implementation and maximum adoption of m-health from the perspective of patients in the developing world. This review documents patient adoption issues, and uses these to develop a framework of patient adoption issues for m-health in the developing world.
A structured literature search was conducted using PubMed and Scopus. For PubMed a consolidated search string combined ‘MESH’ terms and ‘All Fields’ terms for selected keywords. For Scopus an equally consolidated search string was used. The searches were restricted to articles in English during the period January 2000 - December2019 and relevant to the developing world. Duplicate articles were removed. Titles and abstracts were screened by all authors for inclusion, and those studies that met the inclusion criteria were selected for full-text review. Review and data abstraction was performed by two authors.
Fifty-four (54) articles reported factors that impact patient adoption. Review and data abstraction identified specific factors, initially classified under 22 categories, that promote or impede m-health adoption in the developing world. Continued iterative review and discussion reduced these to 7 primary categories, with 21 sub-categories.
The review showed: great inconsistency in the approach and tools used in published studies; multiple factors impact patient adoption of m-health in the developing world; the specific factors vary from setting to setting and by recency of findings. Successful adoption of m-health by patients in the developing world critically depends on addressing the factors identified in the proposed framework, and assessing them prior to implementation of m-health initiatives in any specific setting. The framework will serve to: increase the consistency of patient adoption studies, form the basis for informed policy decisions by stakeholders, and provide the foundation for greater success of future m-health implementations for patients in the developing world.
Identifying predictive patients’ characteristics in case of High Flow Nasal Cannula failure when used for post-extubation failure
Authors: Terstappen Afra L.E. , Haas Lenneke E.M. , Seumeren Esther S.E. van , Balzereit Anja , Endeman Henrik 
Published: January 2020

Abstract
Background: High Flow Nasal Cannula (HFNC) is a relatively new but broadly used type of oxygen therapy. Hence, not much is known about HFNC in the setting of post-extubation failure. Aim of this study is to identify patients’ characteristics that predict failure of HFNC when used for post-extubation failure.
Methods: This retrospective, observational study was conducted in a Dutch ICU. Between 2008 and 2014 all subjects aged 18 and older who started with HFNC due to respiratory failure within 2 to 72 hours after extubation were included. Primary outcome was patient characteristics predicting failure of HFNC. Failure was defined as reintubation or death following HFNC. Success was defined as the opportunity to stop HFNC after a non-specified time. Secondary outcome was the difference in length of stay (LOS) and mortality between the success and failure group.
Results: A total of 246 subjects were included; in 135 (55%) cases HFNC failed. The success and failure group were comparable in terms of age, primary diagnosis and duration of mechanical ventilation prior to extubation. HFNC was started median 14 (min-max: 2-71) after extubation. Significant differences were found for breathing frequency (success: 21 (9-45)/min vs failure: 24(7-45)/min, p=0.009) and the presence of acute kidney injury (51% vs. 79%, p=0.003). There was a non-significant difference in pH pH (7.42(7.27-7.56) vs. 7.41 (7.13-7.58), p=0.08) After logistic breathing frequency (p=0.02) and pH (p=0.01) remained independent predictors of HFNC failure. LOS at the ICU after starting HFNC differed (success: median 131, min-max: 12-1432 hours vs. failure: 250 (23-4726) hours p<0.001. ICU and hospital mortality were not significantly different between groups.
Conclusion: In more than half of the patients HFNC failed when used for post-extubation failure. Breathing frequency and pH were predictors of HFNC failure.
Hidden analyses: A review of current reporting practice and recommendations for more transparent reporting of initial data analyses
Authors: Huebner Marianne , Vach Werner , Cessie Saskia le , Schmidt Carsten Oliver , Lusa Lara 
Published: January 2020

Abstract
Background In the data pipeline from the data collection process to the planned statistical analyses, initial data analysis (IDA) typically takes place between the end of the data collection and do not touch the research questions. A systematic process for IDA and clear reporting of the findings would help to understand the potential shortcomings of a dataset, such as missing values, or subgroups with small sample sizes, or shortcomings in the collection process, and to evaluate the impact of these shortcomings on the research results. A clear reporting of findings is also relevant when making datasets available to other researchers. Initial data analyses can provide valuable insights into the suitability of a data set for a future research study. Our aim was to describe the current practice of reporting of initial data analyses in observational studies in five highly ranked medical journals with focus on data cleaning, screening, and reporting of findings which led to a potential change in the analysis plan. Methods This review was carried out using systematic search strategies with eligibility criteria for articles to be reviewed. A total of 25 papers about observational studies were selected from five medical journals. Each paper was reviewed by two reviewers and IDA statements were further discussed by all authors. The consensus was reported. Results IDA statements were reported in the methods, results, discussion, and supplement of papers. Ten out of 25 papers (40%) included a statement about data cleaning. Data screening statements were included in all articles, and 18 (72%) indicated the methods used to describe them. Item missingness was reported in 11 papers (44%), unit missingness in 15 papers (60%). Eleven papers (44%) mentioned some changes in the analysis plan. Reported changes referred to missing data treatment, unexpected values, population heterogeneity and aspects related to variable distributions or data properties. Conclusion Reporting of initial data analyses were sparse, and statements on IDA were located throughout the research articles. There is a lack of systematic reporting of IDA. We conclude the article with recommendations on how to overcome shortcomings in the current practice of IDA reporting in observational studies.
The Bifunctional Enzyme, GenB4, Catalyzes the Last Step of Gentamicin 3’,4’-Di-Deoxygenation via Reduction and Transamination Activities
Authors: Chen Xiao tang , Zhang Hui , Zhou Shaotong , Bi Mingjun , Qi Shizhou , Gao Huiyuan , Ni Xianpu , Xia Huanzhang 
Published: January 2020

Abstract
Background: New semi-synthetic aminoglycoside antibiotics generally use chemical modifications to avoid inactivity from pathogens. One of the most used modifications is 3’,4’-di-deoxygenation, which imitates the structure of gentamicin. However, the mechanism of di-deoxygenation has not been clearly elucidated.
Results: Here, we report that the bifunctional enzyme, GenB4, catalyzes the last step of gentamicin 3’,4’-di-deoxygenation via reduction and transamination activities. Following disruption of gen B4 in wild-type M. echinospora , its products accumulated in 6’-deamino-6’-oxoverdamicin ( 1 ), verdamicin C2a ( 2 ), and its epimer, verdamicin C2 ( 3 ). Following disruption of gen B4 in M. echinospora △ gen K, its products accumulated in sisomicin ( 4 ) and 6’-N-methylsisomicin ( 5 , G-52). Following in vitro catalytic reactions, GenB4 transformed sisomicin ( 4 ) to gentamicin C1a ( 9 ) and transformed verdamicin C2a ( 2 ) and its epimer, verdamicin C2 ( 3 ), to gentamicin C2a ( 11 ) and gentamicin C2 ( 12 ), respectively.
Conclusion: This finding indicated that in addition to its transamination activity, GenB4 exhibits specific 4’,5’ double-bond reducing activity and is responsible for the last step of gentamicin 3’,4’-di-deoxygenation. Taken together, we propose three new intermediates that may refine and supplement the specific biosynthetic pathway of gentamicin C components and lay the foundation for the complete elucidation of di-deoxygenation mechanisms.