bluuebunny/crossref_metadata_2025_split huggingface dataset:
Youth StepCare: A pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice.
Authors: Parker Belinda , Achilles Melinda Rose , Subotic-Kerry Mirjana , O'Dea Bridianne 
Published: December 2019

Abstract
Background: General Practitioners (GPs) are ideally placed to identify and manage emerging mental illness in young people, however, many report low levels of confidence in doing so. A web-based universal screening service delivered via a mobile tablet, Youth StepCare, was developed to assist GPs in identifying depression and anxiety symptoms in youth patients. This service also provided evidence-based treatment recommendations and fortnightly monitoring of symptoms. The current study assessed the feasibility and acceptability of delivering the Youth StepCare service in Australian general practices.
Methods: A 12-week uncontrolled trial was undertaken between August 2018 and January 2019 in two general practices in NSW, Australia. The service was offered to all youth patients aged 14-17 years who visited a participating GP during the screening period with their parent or guardian. Youth patients reported the presence of depressive and anxiety symptoms using the self-report Patient Health Questionnaire-9 and the Generalised Anxiety Disorder Questionnaire-7. New cases were defined as those who reported symptoms but were not currently seeking help from their GP, nor had sought help in the past. Feasibility and acceptability among GPs and practice staff were assessed using a battery of questionnaires.
Results: Five GPs and 6 practice staff took part. A total of 46 youth patients were approached, 28 consented, and 19 completed the screener (67.9%). Nine reported symptoms of anxiety or depression, two of which were new cases (22.2%). GPs and practice staff were satisfied with the service, reporting that there was a need for the service, and that they would use it again.
Conclusions: The Youth StepCare service appears to be a useful tool for identifying youth with unidentified symptoms of mental illness that can be easily embedded into general practice. Further research would benefit from exploring the factors affecting initial GP uptake and a larger trial is required to determine the efficacy of the service on young people’s symptom reduction.
Evaluation the effects of pycnogenol (French maritime pine bark extract) supplementation on the inflammatory biomarkers, nutritional and clinical status in traumatic brain injury patients, in Intensive Care Unit; A Randomized Clinical Trial protocol
Authors: Malekahmadi Mahsa , Moghaddam Omid Moradi , Islam Sheikh Mohammed Shariful , Tanha Kiarash , Nematy Mohsen , Pahlavani Naseh , Firouzi Safieh , Zali Mohammad Reza , Norouzy Abdolreza 
Published: December 2019

Abstract
Background: Traumatic brain injury (TBI) is one of the major health and socioeconomic problems in the world. Immune-enhancing enteral formula has been proven to significantly reduce infection rate in TBI patient. One of the ingredients that can be used in immunonutrition formulas to reduce inflammation and oxidative stress is pycnogenol.
Objective: surveying the effect of pycnogenol on the clinical, nutritional and inflammatory status of TBI patients.
Methods: This is double-blind, randomized controlled trial . Block randomization will be used. Intervention group will receive pycnogenol supplementation of 150 mg for 10 days. Control group will receive placebo for the same duration. Inflammatory status (IL-6, IL- 1β, C-reactive protein) and oxidative stress status (Malondialdehyde, total antioxidant capacity), at the base line, at the 5 th day and at the end of the study (10 th day) will be measured. Clinical and nutritional status will be assessed three times during the intervention. SOFA (sequential organ failure assessment) questionnaire for assessment of organ failure will be filled out every other day. The mortality rate will be calculated within 28 days of the start of the intervention. Weight, body mass index and body composition will be measured. All analyses will be conducted by initially assigned study arm in an intention-to-treat analysis.
Discussion: We expect that supplementation of 150 mg pycnogenol for 10 days will improve clinical and nutritional status and reduce the inflammation and oxidative stress of the TBI patients.
A detailed in silico analysis of secondary metabolite biosynthesis clusters in the genome of the broad host range plant pathogenic fungus Sclerotinia sclerotiorum
Authors: Graham-Taylor Carolyn , Kamphuis Lars G , Derbyshire Mark 
Published: December 2019

Abstract
Background

The broad host range pathogen Sclerotinia sclerotiorum infects over 400 plant species and causes substantial yield losses in crops worldwide. Secondary metabolites are known to play important roles in the virulence of plant pathogens, but little is known about the secondary metabolite repertoire of S. sclerotiorum . In this study, we predicted secondary metabolite biosynthetic gene clusters in the genome of S. sclerotiorum and analysed their expression during infection of Brassica napus using an existing transcriptome data set. We also investigated their sequence diversity among a panel of 25 previously published S. sclerotiorum isolate genomes.Results

We identified 80 putative secondary metabolite clusters. Over half of the clusters contained at least three transcriptionally coregulated genes. Comparative genomics revealed clusters homologous to clusters in the closely related plant pathogen Botrytis cinerea for production of carotenoids, hydroxamate siderophores, DHN melanin and botcinic acid. We also identified putative phytotoxin clusters that can potentially produce the polyketide sclerin and an epipolythiodioxopiperazine. Secondary metabolite clusters were enriched in subtelomeric genomic regions, and those containing paralogues showed a particularly strong association with repeats. The positional bias we identified was borne out by intraspecific comparisons that revealed putative secondary metabolite genes suffered more presence / absence polymorphisms and exhibited a significantly higher sequence diversity than other genes.Conclusions

These data suggest that S. sclerotiorum produces numerous secondary metabolites during plant infection and that their gene clusters undergo enhanced rates of mutation, duplication and recombination in subtelomeric regions. The microevolutionary regimes leading to S. sclerotiorum secondary metabolite diversity have yet to be elucidated. Several potential phytotoxins documented in this study provide the basis for future functional analyses.
Group B Streptococcus detection in pregnant women: comparison of real-time PCR assay, culture, and the Xpert GBS rapid test
Authors: Vieira Laura , Perez Amanda Vilaverde , Machado Monique M , Kayser Michele L , Vettori Daniela V , Alegretti Ana Paula , Ferreira Charles Francisco , Vettorazzi Janete , Valério Edimárlei G 
Published: December 2019

Abstract
Background: Group B Streptococcus (GBS) is one of the most important causative agents of neonatal sepsis. As administration of prophylactic antibiotics during labor can prevent GBS infection, routine screening for this bacterium in prenatal care before the onset of labor is recommended. However, many women present in labor without having undergone such testing during antenatal care, and the turnaround time of detection methods is insufficient for results to be obtained before delivery. Methods: Vaginal and anorectal specimens were collected from 270 pregnant women. Each sample was tested by Xpert GBS, qPCR, and culture for GBS detection. Results: The overall prevalence of maternal GBS colonization was 30.7% according to Xpert GBS, 51.1% according to qPCR, and 14.3% according to cultures. Considering the qPCR method as the reference, the Xpert GBS had a sensitivity of 53% and specificity of 93%. Positive Xpert GBS results were correlated to marital status (married or cohabitating) and with prematurity as a cause of neonatal hospitalization. Positive cultures were related with ischemic–hypoxic encephalopathy requiring therapeutic hypothermia. Conclusions: Combined enrichment/qPCR and the Xpert GBS rapid test found a high prevalence of GBS colonization. The Xpert GBS technique gives faster results and could be useful for evaluating mothers who present without antenatal GBS screening results and are at risk of preterm labor, thus allowing institution of prophylactic antibiotic therapy. Keywords: Group B Streptococcus; Streptococcus agalactiae; Xpert GBS; real-time polymerase chain reaction; antenatal care
What is the advantage of rectal amputation with an initial perineal approach for primary anorectal carcinoma?
Authors: Funahashi Kimihiko , Goto Mayu , Kaneko Tomoaki , Ushigome Mitsunori , Kagami Satoru , Koda Takamaru , Nagashima Yasuo , Yoshida Kimihiko , Miura Yasuyuki 
Published: December 2019

Abstract
Background: Rectal amputation (RA) remains an important surgical procedure for salvage despite advances in sphincter-preserving resection, including intersphincteric resection. The aim of this study was to compare short- and long-term outcomes of RA with an initial perineal approach to those of RA with an initial abdominal approach (conventional abdominoperineal resection (APR)) for primary anorectal cancer. Methods: We retrospectively analyzed the short- and long-term outcomes of 48 patients who underwent RA with an initial perineal approach (perineal group) and 21 patients who underwent RA with an initial abdominal approach (conventional group). Results: For the perineal group, the operation time was shorter than that for the conventional group (313 vs. 388 minutes, p = 0.027). The postoperative complication rate was similar between the two groups (43.8 vs. 47.6%, p = 0.766). Perineal wound complications (PWCs) were significantly fewer in the perineal group than in the conventional group (22.9 vs. 57.1%, p = 0.006). All 69 patients underwent complete TME, but positive CRM was significantly higher in the conventional group than in the perineal group (0 vs. 19.0%, p = 0.011). There were no significant differences in the recurrence (43.8 vs. 47.6%, p = 0.689), 5-year disease-free survival (63.7% vs. 56.7%, p = 0.665) and 5-year overall survival rates (82.5% vs. 66.2%, p = 0.323) between the two groups. Conclusion: These data suggest that RA with an initial perineal approach for selective primary anorectal carcinoma is advantageous in minimizing PWCs and positive CRMs. Further investigations on the advantages of this approach are necessary.
Knowledge regarding antibiotic use among students of three medical schools in Medellin, Colombia: A cross-sectional study
Authors: Hguita-Gutiérrez Luis Felipe , Molina Valentina , Acevedo Jenifer María , Gómez Liceth , Villamil Gustavo Eduardo Roncancio , Quiceno Judy Natalia Jiménez 
Published: December 2019

Abstract
Background The objective of the present study was to describe the knowledge regarding the antibiotic therapy of students of three medical schools in Medellín, Colombia. Methods The study population comprised medical students who were enrolled in three universities. The instrument contained questions regarding their current academic term, the university, the perceived quality of the education received on antibiotic therapy and bacterial resistance, and specific questions on upper respiratory tract infections, pneumonia, urinary tract infections, and skin and soft tissue infections. The information was analyzed by calculating frequencies and measures of dispersion and central tendency. Knowledge regarding the treatment for each type of infection was compared using the Mann–Whitney U test and the Kruskal–Wallis H test. Results We included 536 medical students, of which 43.5% students consider that the university has not sufficiently trained them to interpret antibiograms and 29.6% students consider that the quality of information received on the subject at their university ranges from regular to poor. The mean score for knowledge regarding antibiotic therapy for upper respiratory tract infections was 44.2 (9.9) on a scale from 0 to 100. The median score with regard to the treatment of pneumonia was 52.9 (14.7), that of urinary tract infection was 58.7 (14.8), and that of skin and soft tissue infections was 63.1 (19.4). The knowledge regarding antibiotic therapy for upper respiratory tract infections, pneumonia, and urinary tract infection does not improve with the academic term, the university, or perceived quality of the education received. Conclusion A large proportion of medical students perceive that the training received from the university is insufficient with regard to antibiotic use and bacterial resistance, which is consistent with the limited knowledge reflected in the selection of antibiotic treatment for respiratory, urinary tract, and skin and soft tissue infections. Overall, the situation was identical among all universities, and it did not significantly increase with the completion of an academic term.
Measles Outbreak Amplified in a Pediatric Ward: Lyantonde District, Uganda, August 2017
Authors: Biribawa Claire , Atuhairwe Joselyn Annet , Bulage Lilian , Okethwangu Denis Othuba , Kwesiga Benon , Ario Alex Riolexus , Zhu Bao-Ping 
Published: December 2019

Abstract
Background: Measles is a highly infectious viral disease. In August 2017, Lyantonde District, Uganda reported a measles outbreak to Uganda Ministry of Health. We investigated to assess the outbreak scope, factors facilitating transmission, and recommend control measures.
Methods: We defined a probable case as sudden onset of fever and generalized rash in a resident of Lyantonde, Lwengo, or Rakai Districts from 1 June-30 September 2017, plus ≥1 of the following: coryza, conjunctivitis, or cough. A confirmed case was a probable case with serum positivity of measles-specific IgM. We conducted a neighborhood- and age-matched case-control study to identified exposure factors, and used conditional logistic regression to analyze the data. We estimated vaccine effectiveness and vaccination coverage.
Findings: We identified 81 cases (75 probable, 6 confirmed); 4 patients (4.9%) died. In the case-control study, 47% of case-patients and 2.3% of controls were hospitalized at Lyantonde Hospital pediatric department for non-measles conditions 7-21 days before case-patient’s onset (ORadj=34, 95%CI: 5.1-225). Estimated vaccine effectiveness was 95% (95%CI: 75-99%) and vaccination coverage was 76% (95%CI: 68-82%). During the outbreak, an “isolation” ward was established inside the pediatric ward. Measles and non-measles patients were mixed in regular pediatric wards.
Conclusion:This outbreak was amplified by nosocomial transmission and facilitated by low vaccination coverage. We recommended moving the isolation ward outside of the building, supplemental vaccination, and vaccinating pediatric patients during measles outbreaks.
Small RNA-seq analysis of extracellular vesicles from porcine uterine flushing fluids during peri-implantation
Authors: Hua Renwu , Wang Yueying , Lian Weisi , Li Wenchao , Xi Yu , Xue Songyi , Kang Tingting , Lei Minggang 
Published: December 2019

Abstract
Background: The extracellular vesicles (EVs) of uterine flushing fluids (UFs) mediate intrauterine communication between conceptus and uterus in pigs. The small RNAs of UFs-EVs are widely recognized as important factors that influence embryonic implantation in humans, mice, cattle and sheep. Therefore, it can be hypothesized that small RNAs of UFs-EVs are essential for implantation in pigs.
Results: Cup-shaped EVs of porcine UFs were isolated and characterized, and then PKH67 stained extracellular vesicles were taken up by endometrial epithelial cells and porcine trophectoderm cells in a time-dependent manner. The expression of small RNAs in these EVs on days 10 (D10), 13 (D13) and 18 (D18) of pregnancy was comprehensively profiled through sequencing. From nine libraries, a total of 152 known microRNAs (miRNAs), 43 novel miRNAs and 6248 known Piwi-interacting RNAs (piRNAs) and 110 novel piRNAs were identified. Hierarchical cluster analysis and principal component analysis suggested that the expression profiles of small RNAs in D13 group were different from those in D10 and D18 groups. Bioinformatics analysis showed that the miRNAs differentially expressed in the comparisons between D10 and D13, D13 and D18, and D10 and D18 groups were involved in important processes and pathways related to immunization, proliferation, angiogenesis, apoptosis and development, which play important roles in embryonic implantation.
Conclusions: Our results reveal that EVs from porcine UFs contain various small RNAs with potentially vital effects on implantation. This research also provides resources for studies of miRNAs and piRNAs in the cross-talk between embryo and endometrium.
Factors Associated with Salmonella Infection in Patients with Gastrointestinal Complaints Seeking Health Care at Regional Hospital in Southern Highland of Tanzania
Authors: Ngogo Fadhili Ashery , Joachim Agricola , Abade Ahmed M , Rumisha Susan F , Mizinduko Mucho M , Majigo Mtebe Venance 
Published: December 2019

Abstract
Background Salmonellosis remains an important public health problem globally. The disease is among the leading causes of morbidity and mortality in developing countries that experience poor hygiene and lack of access to clean and safe water. There was an increase in reported cases of Salmonellosis in the Njombe region Southern Highland of Tanzania between 2015 and 2016, based on clinical diagnosis. Nevertheless, little is known about the factors contributing to the transmission of this disease in the region. This study was conducted to determine the prevalence, antimicrobial susceptibility, and factors associated with Salmonella infection among patients who report gastrointestinal complaints. Methods A cross-sectional study was conducted from December 2017 to February 2018 among patients with gastrointestinal complaints at Kibena Regional Hospital. Stool samples were submitted for culture on Xylose Lysine Deoxycholate Agar, intended for isolation of Salmonella spp. Identification was based on conventional biochemical tests and serotyping to differentiate typhoid and non-typhoid Salmonella. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method. Multivariable logistic regression analysis was performed to examine the factors independently associated with Salmonella infection after adjustment for other explanatory variables. Results The prevalence of Salmonella infection among participants with gastrointestinal complaints was 16.5% (95% CI: 12.7-21.1). All isolates were sensitive to ceftriaxone and ciprofloxacin, whereas 27.8% and 100% were resistant to co-trimoxazole and ampicillin respectively. The odd of Salmonella infection was fourfold higher among participants with formal employment (AOR 3.8, 95% CI, 1.53-9.40). Use of water from wells/rivers (AOR 2.2, 95% CI, 1.07-4.45), drinking untreated water (AOR 2.6, 95% CI, 1.21-5.48) and often eating at a restaurant (AOR 3.4, 95% CI, 1.28-8.93) had increased odds of Salmonella infection. Likewise, having abdominal pain (AOR 8.5, 95% CI, 1.81-39.78) and diarrhea (AOR 2.3, 95% CI, 1.12-4.68) were independent symptoms that predict Salmonella infection. Conclusion There is a high prevalence of Salmonella infection among people who report gastrointestinal complaints and it is clinically predicated by diarhoea and abdominal pain. Employed participants and those eating at restaurant and drinking unsafe water had higher risk of infection. Salmonella spp causing gastroenteritis has developed resistance to commonly used antibiotics.
Perceived Barriers to Early Diagnosis of Breast Cancer in South and South Western Ethiopia: a qualitative study
Authors: Getachew Sefonias , Tesfaw Aragaw , Kaba Mirgissa , Wienke Andreas , Taylor Lesley , Kantelhardt Eva J. , Addissie Adamu 
Published: December 2019

Abstract
Background Early diagnosis is a key determinant of breast cancer prognosis and survival. More than half of breast cancer cases are diagnosed at an advanced stage in Ethiopia, and the barriers to early diagnosis in this country are not well understood. We aimed to identify the perceived barriers to early diagnosis of breast cancer from the perspective of patients and health care providers in south and southwestern Ethiopia. Methods A qualitative study was conducted from March to April 2018 using in-depth interviews of breast cancer patients and breast cancer health care providers from six public hospitals located in urban and rural areas of south and southwestern Ethiopia. All participants proved verbal consent before participating. A thematic analysis was performed using Open Code 4.02. Results Twelve breast cancer patients and thirteen health care providers were included in the study. Patient and health-system related barriers to early diagnosis of breast cancer were identified. Patient-related barriers were lack of knowledge and awareness of breast cancer, belief in traditional medicine and religious practices for treatment, and lack of social and financial support to seek care at a medical facility. Health-system related barriers were misdiagnosis of breast cancer, long distance to referral facilities, high cost of diagnostic services, long waiting time for diagnostic tests, and lack of screening and diagnostic tests in local facilities. Conclusions Early diagnosis of breast cancer is affected by multiple barriers in south and southwestern Ethiopia. Awareness campaigns and education about the disease, prevention, and early detection are needed to increase early diagnosis of breast cancer. Opportunities exist to improve early diagnosis and timely treatment in rural areas.
Identification of Dissociation Factors in Pancreatic Cancer using a Mass Spectrometry-Based Proteomic Approach
Authors: Liu Peng , Kong Lingming , Liang Keke , Wu Yunhao , Jin Haoyi , Song Bing , Tan Xiaodong 
Published: December 2019

Abstract
Pancreatic cancer is a highly malignant tumor of the digestive system. This secretome of pancreatic cancer is key to its progression and metastasis. In this study, different protein pretreatment methods were used to analyze the secretome, furthermore to identify dissociation factors in pancreatic cancer. Pancreatic cancer cells were cultured in serum-containing or serum-free medium, and the corresponding supernatants were extracted as samples. Subsequently, the above samples were separated by size exclusion chromatography (SEC), and peptide segments were identified by LC-MS/MS. The final results were identified via the hamster secreted protein database and a public database. Although the number of identified proteins in the serum-free medium group was high, the real secretion of proteins in pancreatic cancer cells was changed. There were six significant secreted proteins in the serum-containing medium group. Survival analysis via the TCGA database suggested that patients with higher expression levels of YWHAG showed a worse overall survival rate than those with lower YWHAG expression. YWHAG could be used as a prognostic indicator for pancreatic cancer. Finally, the results in the serum-containing medium group were more similar to the real secretome of pancreatic cancer cells, and the results might be used to identify biomarkers in liquid biopsy.