bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analgesia in Total Knee Arthroplasty
Authors: Summers Spencer , Mohile Neil , McNamara Colin , Osman Brian , Gebhard Ralf , Hernandez Victor Hugo 
Published: January 2020

➢ Implementation of multimodal pain management regimens after total knee arthroplasty has increased patient satisfaction, decreased pain scores, and facilitated faster recovery.➢ A variety of oral and intravenous analgesics, including nonsteroidal anti-inflammatory drugs, gabapentinoids, acetaminophen, and opioids, can be employed preoperatively and postoperatively.➢ Neuraxial anesthesia, peripheral nerve blocks, and periarticular injections are effective pain modulators that should be implemented in concert with the anesthesia teams.➢ There is no consensus on the optimal multimodal pain regimen, and substantial variability exists between institutions and providers.➢ The goals of minimizing pain and improving functional recovery in the postoperative period must be considered in light of evidence-based practice as well as the risk profile of the proposed analgesic treatment.
Factors that influence the use of community assets by people with physical disabilities: results of participatory mapping in Envigado, Colombia.
Authors: Toro-Hernandez Maria Luisa , Villa-Torres Laura , Mondragón-Barrera Mónica Alejandra , Camelo-Castillo Wendy 
Published: January 2020

Abstract

Background: Disability is an evolving concept that results from the complex interaction between a person with an impairment and the context in which he/she lives. There is limited understanding on the types, access and use of community assets valuable for people with disabilities, and the role of contextual factors in Colombia. Our goal with this work was to identify the factors at the levels of the socio-ecological framework, and their interaction, that influence the use of community assets among people with physical disabilities and community stakeholders in Envigado, Colombia. Methods: Using participatory mapping, a community based participatory approach, we carried out an assessment of community assets identified by people with disabilities and rehabilitation professionals. In-depth interviews (n=32) informed the design of two participatory mapping activities, one among people with disabilities (n=5) and a second with rehabilitation professionals (n=4). Results were presented in a community forum to receive feedback on the findings. Results: Main findings indicate a chain of contextual factors that limit access and use of assets stemming from the personal (e.g. financial resources, inaccessible housing), interpersonal level (e.g. lack of a personal assistance or aid), and community levels (e.g. lack of accessible public transportation and inaccessible buildings). In most cases these barriers are heightened by system level barriers (e.g. lack of effective enforcement of the legal framework). Conclusions: Identifying these contextual factors, and their interactions, calls for stronger enforcement of the existing legal framework through articulated work between different stakeholders, so that people with disabilities can enjoy community assets.
Tuberculosis among economic migrants: A cross‐sectional study of the risk of poor treatment outcomes and impact of a treatment adherence intervention among temporary residents in an urban district in Ho Chi Minh City, Viet Nam
Authors: Vo Luan Nguyen Quang , Codlin Andrew James , Forse Rachel Jeanette , Nguyen Hoa Trung , Vu Thanh Nguyen , Truong Vinh Van , Do Giang Chau , Nguyen Lan Huu , Le Giang Truong , Caws Maxine 
Published: January 2020

Abstract

Background: Tuberculosis (TB) remains a major cause of avoidable deaths. Economic migrants represent a vulnerable population due to their exposure to medical and social risk factors. These factors expose them to higher risks for TB incidence and poor treatment outcomes. Methods: This cross-sectional study evaluated WHO-defined TB treatment outcomes among economic migrants in an urban district of Ho Chi Minh City, Viet Nam. We measured the association of a patient’s government-defined residency status with treatment success and loss to follow-up categories at baseline and performed a comparative interrupted time series analysis to assess the impact of community-based adherence support on treatment outcomes. Results: Short-term, inter-province migrants experienced lower treatment success (aRR=0.95 [0.92-0.99], p=0.010) and higher loss to follow-up (aOR=1.98 [1.44-2.72], p<0.001) than permanent residents. Intra-province migrants were similarly more likely to be lost to follow-up (aOR=1.86 [1.03-3.36], p=0.041). There was evidence that patients >55 years of age (aRR=0.93 [0.89-0.96], p<0.001), relapse patients (aRR=0.89 [0.84-0.94], p<0.001), and retreatment patients (aRR=0.62 [0.52-0.75], p<0.001) had lower treatment success rates. TB/HIV co-infection was also associated with lower treatment success (aRR=0.77 [0.73-0.82], p<0.001) and higher loss to follow-up (aOR=2.18 [1.55-3.06], p<0.001). The provision of treatment adherence support increased treatment success (IRR(β 6 )=1.07 [1.00, 1.15], p=0.041) and reduced loss to follow-up (IRR(β 6 )=0.17 [0.04, 0.69], p=0.013) in the intervention districts. Loss to follow-up continued to decline throughout the post-implementation period (IRR(β 7 )=0.90 [0.83, 0.98], p=0.019). Conclusions: Economic migrants, particularly those crossing provincial borders, have higher risk of poor treatment outcomes and should be prioritized for tailored adherence support. In light of accelerating urbanization in many regions of Asia, implementation trials are needed to inform evidence-based design of strategies for this vulnerable population.
Reducing Barriers to Post-9/11 Veterans’ Use of Programs and Services as They Transition to Civilian Life
Authors: Morgan Nicole R. , Aronson Keith R. , Perkins Daniel F. , Bleser Julia A. , Davenport Katie , Vogt Dawne , Copeland Laurel A. , Finley Erin P. , Gilman Cynthia L. 
Published: January 2020

Abstract
Background - Numerous programs exist to support veterans in their transitions to civilian life. Programs are offered by a host of governmental and non-governmental stakeholders. Veterans report encountering many barriers to program participation. This was the first study to identify barrier reduction strategies offered by programs that post-9/11 veterans report using, determine which strategies veterans use and value, and to examine veteran characteristics that impact their odds of using programs that offer barrier reduction strategies. Method - This study reflects findings from the first wave of data collection of The Veterans Metrics Initiative, a longitudinal study examining the military-to-civilian reintegration of post-9/11 veterans. Veterans were asked to indicate which programs they had used. The websites of these programs were coded for the barrier reduction components. Veterans also indicated which barrier reduction components they found most helpful in meeting their reintegration goals. Results - Of 9,566 veterans who participated in Wave 1 data collection, 84% reported using a program that offered at least one barrier reduction component. Barrier reduction components included tangible supports (e.g., scholarships, cash), increased access to programs, decreased stigma, and encouraged motivation to change. Although only 4% of programs that were used by veterans focused on helping them obtain Veterans Administration benefits, nearly 60% of veterans reported that this component was helpful in reaching their goals. Access assistance to other resources and supports was also reported as a helpful barrier reduction component. For instance, approximately 20% of veterans nominated programs that offered transportation. The study also found evidence of a misalignment between the kinds of barrier reduction components veterans valued and those which programs offered. Veterans from the most junior enlisted ranks, who are at most risk, were less likely than those from other ranks to use barrier reduction components. Conclusions – Despite the evidence that barrier reduction components enhance access to programs and contribute to program sustainability, many programs used by post-9/11 veterans do not offer them. There is also a misalignment between the barrier reduction strategies veterans value and the strategies offered by programs. Veteran serving organizations should increasingly implement barrier reduction strategies that veterans value.
Evaluation of confounding in epidemiologic studies assessing alcohol consumption on the risk of ischemic heart disease
Authors: Wallach Joshua D , Serghiou Stylianos , Chu Lingzhi , Egilman Alexander C , Vasiliou Vasilis , Ross Joseph S , Ioannidis John PA 
Published: January 2020

Abstract
Background: Among different investigators studying the same exposures and outcomes, there may be a lack of consensus about potential confounders that should be considered as matching, adjustment, or stratification variables in observational studies. Concerns have been raised that confounding factors may affect the results obtained for the alcohol-ischemic heart disease relationship, as well as their consistency and reproducibility across different studies. Therefore, we assessed how confounders are defined, operationalized, and discussed across individual studies evaluating alcohol and ischemic heart disease risk. Methods: For observational studies included in a recent alcohol-ischemic heart disease meta-analysis, we identified all variables adjusted, matched, or stratified for in the largest reported multivariate model (i.e. potential confounders). We recorded how the variables were measured and grouped them into higher-level confounder domains. Abstracts and Discussion sections were then assessed to determine whether authors considered confounding when interpreting their study findings. Results: 85 of 87 (97.7%) studies reported multivariate analyses for an alcohol-ischemic heart disease relationship. The most common higher-level confounder domains included were smoking (79, 92.9%), age (74, 87.1%), and BMI, height, and/or weight (57, 67.1%). However, no two models adjusted, matched, or stratified for the same higher-level confounder domains. Most (74/87, 85.1%) articles mentioned or alluded to “confounding” in their Abstract or Discussion sections, but only one stated that their main findings were likely to be affected by residual confounding. There were five (5/87, 5.7%) authors that explicitly asked for caution when interpreting results. Conclusion: There is large variation in the confounders considered across observational studies evaluating alcohol and ischemic heart disease risk and almost all studies spuriously ignore or eventually dismiss confounding in their conclusions. Given that study results and interpretations may be affected by the mix of potential confounders included within multivariate models, efforts are necessary to standardize approaches for selecting and accounting for confounders in observational studies.
Pattern of nucleotide variants of TP53 and their correlation with the expression of p53 and its downstream proteins in a Sri Lankan cohort of breast and colorectal cancer patients
Authors: Manoharan Vahinipriya , Karunanayake Eric Hamilton , Tennekoon Kamani Hemamala , De Silva Sumadee , Imthikab Ahamed Ilyas Ahamed , De Silva Kanishka , Angunawela Preethika , Vishwakula Sameera , Lunec John 
Published: January 2020

Abstract

Background
Breast cancer (BC) is known to be the most common malignancy in females whereas colorectal cancer (CRC) incidence also higher in both genders in Sri Lanka. TP53 is an important tumour suppressor gene and its somatic mutations are reported in approximately 27% of BC and 43% of CRC cases. Analysis of TP53 gene variants not only provides clues for the aetiology of the tumour formation, but also has an impact on treatment efficacy. The current study was conducted to investigate the pattern of TP53 variants in patients with BC and CRC from Sri Lanka.

Methods

30 patients with BC, 21 patients with CRC and an equal number of healthy controls were screened for mutational status of TP53 by polymerase chain reaction (PCR) followed by direct sequencing. In addition, a subset of these samples were analysed for the protein expression of p53 and comparison made with the mutational status of TP53 . We also analysed the protein expression of p21 and MDM2 as potential indicators of p53 functional status and compared it with the protein expression of p53. Additionally, hotspot codons of the KRAS, BRAF and PIK3CA genes were also analysed in a subset of CRC patients.

Results

Twenty seven sequence variants, including several novel variants in the TP53 gene were found. Nine BC and seven CRC tumour samples carried pathogenic TP53 variants. Pathogenic point missense variants were associated with strong and diffuse positive staining for p53 by immunohistochemistry (IHC), whereas, wild type TP53 showed complete absence of positive IHC staining or rare positive cells, regardless of the type of cancer. There was no direct correlation between p21 or MDM2 expression and p53 expression in either BCs or CRCs. Four of the CRC patients had pathogenic hotspot variants in KRAS ; three of them were on codon 12 and one was on codon 61.

Conclusion

The prevalence of pathogenic somatic TP53 variants was 31% and 33.33% in the studied BC and CRC cohorts respectively. All of them were located in exons 5 – 8 and the pathogenic missense variants were associated with strong immuno-positive staining for p53.
Costs analysis of Staged Versus Simultaneous Bilateral Total Knee and Hip Arthroplasty: a university affiliated hospital survey of 1579 Chinese patients
Authors: Hou Ji-Fei , Hu Chuan , Zhang Yun , Liu Yan-Zheng , Zhang Chi , Li Jing , Wang Yue , Li Cheng-Cheng 
Published: January 2020

Abstract
Background: Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are required for many patients. No recent studies that concentrate on the costs for each of the payment items both for TKA and THA when comparing simultaneous bilateral procedures with staged arthroplasty. This study aimed to evaluate the medical costs, length of stay(LOS), blood transfusion, and in-hospital complications in patients undergoing simultaneous TKA or THA and staged TKA or THA. Methods: A retrospective cohort study was conducted by analyzing 1,579 patients from a single institution. All patients who underwent primary bilateral TKA or THA from 2013 to 2018 were divided into three groups: TKA,THA and all patients. Then, we grouping simultaneous bilateral groups and staged bilateral groups in these three groups respectively. Finally, these two sub-groups(simultaneous bilateral groups and staged bilateral groups) were compared between the three groups(TKA, THA, and pooled groups). Results: All categories of medical costs, except for materials fees which were higher in the simultaneous bilateral THA and pooled groups but with no statistical significance, were lower in the simultaneous TKA, THA and pooled simultaneous groups. The total average medical costs in simultaneous and staged bilateral TKA groups were $15,535.621and $16,747.192, p <0.001), respectively; THA groups were $15,046.210 and $16,126.808, ( p =0.003), respectively; pooled groups were $16,506.971and $15,467.561, ( p <0.001), respectively. All costs were presented in the United States dollar. The highest and lowest costs were materials fees and nursing care fees. No significant differences were found for five common co- morbidities and postoperative complications between the two sub-groups in three groups. The simultaneous groups had a shorter LOS, a higher incidence of blood transfusion than staged groups whether it is TKA groups or THA or pooled groups. Conclusions: These results indicate that simultaneous bilateral TKA and THA with a shorter LOS is more economical than staged bilateral TKA and THA. Counts of complications were not affected by the choice for staged or simultaneous bilateral total arthroplasty. But blood transfusion was more prevalent in the simultaneous groups both for TKA and THA.
Isoniazid causes heart looping disorder in zebrafish embryos by the induction of oxidative stress
Authors: Ni Jie , Wang Hongye , Xiyi Wei , Shen Kangjie , Sha Yeqin , Dong Yuxiang , Shu Yimei , Wan Xiaojie , Chen Jingwen , Wang Fang , Yihai Liu 
Published: January 2020

Abstract
Background: The cardiotoxicity of isoniazid on zebrafish embryos and its underlying mechanism is unclear. Methods: Here, we exposed zebrafish embryos at 4 hours post-fertilization to different levels of isoniazid and recorded the morphology and number of malformed and dead embryos under the microscope. Results: The high concentration of isoniazid group showed more malformed and dead embryos than the low concentration of isoniazid group and control group. The morphology of the heart and its alteration were visualized using transgenic zebrafish (cmlc2: GFP) and confirmed by in situ hybridization. The negative effects of isoniazid on the developing heart were characterized by lower heart rate and more heart looping disorders. Mechanistically, PCR showed decreased expression of heart-specific transcription factors when exposed to isoniazid. Oxidative stress was induced by isoniazid in cardiomyocytes, mediated by decreased activities of catalase and superoxide dismutase, which were rescued by scavengers of reactive oxygen species. Conclusion: In conclusion, this study demonstrated that isoniazid led to heart looping disturbance by the downregulation of cardiac-specific transcription factors and induction of cardiomyocyte apoptosis.
Community-level socioeconomic inequality in the incidence of ischemic heart disease: a nationwide cohort study
Authors: Gwon Jun Gyo , Choi Jimi , Han Young Jin 
Published: January 2020

Abstract
Background
The purpose of this study was to confirm that inequalities in community-level social economic status (SES) do actually impact the incidence of ischemic heart disease (IHD) using the Korean population-based cohort study of the National Health Insurance Service–National Sample Cohort (NHIS-NSC) database.
Methods
This study used the NHIS-NSC database, a population-based cohort database established by the NHIS in South Korea. Community-level SES was classified into three categories, i.e. low, moderate, and high, according to the rank. The outcome measure of interest was IHD, which was defined according to the International Classification of Disease, 10th Revision (ICD-10) codes.
Results
In the low community-level SES group, the incidence of IHD was 3.56 per 1,000 person years (cumulative incidence rate, 1.78%), and in the high community level SES group, it was 3.13 per 1,000 person years (cumulative incidence rate, 1.57%). Multivariate analysis showed that the incidence of IHD was higher in the low community-level SES group (p=0.029). The log-rank test showed that the cumulative incidence of IHD was higher in the low community level SES group than the high community-level SES group (adjusted hazard ratio, 1.16; 95% CI, 1.01-1.32)
Conclusions
People living in areas with low community-level SES show an increased incidence of IHD. Therefore, intervention in active, health-risk behavior corrections at the local level will be required to reduce the incidence of IHD.
The Oxidoreductase DsbA1 negatively influences 2,4-diacetylphloroglucinol biosynthesis by interfering the function of Gcd in Pseudomonas fluorescens 2P24
Authors: Zhang Bo , Zhao Hui , Wu Xiaogang , Zhang Li-Qun 
Published: January 2020

Abstract
The polyketide antibiotic 2,4-diacetylphloroglucinol (2,4-DAPG), produced by Pseudomonas fluorescens 2P24, is positively regulated by the GacS-GacA two-component system. Here we reported on the characterization of DsbA1 (disulfide oxidoreductase) as novel regulator of biocontrol activity in P. fluorescens . Our data showed that mutation of dsbA1 caused the accumulation of 2,4-DAPG in a GacA-independent manner. Further analysis indicated that DsbA1 interacts with membrane-bound glucose dehydrogenase Gcd, which positively regulates the production of 2,4-DAPG. Mutation of cysteine (C)-235, C275, and C578 of Gcd, significantly reduced the interaction with DsbA1, enhanced the activity of Gcd and increased 2,4-DAPG production. Taken together, our results suggest that DsbA1 regulates the 2,4-DAPG concentration via fine-tuning the function of Gcd in P. fluorescens 2P24.
The S68G polymorphism is a compensatory mutation associated with the drug resistance mutation K65R in CRF01_AE strains
Authors: Li Shengjia , Ouyang Jinming , Zhao Bin , An Minghui , Wang Lin , Ding Haibo , Zhang Min , Author) Xiaoxu Han(New Corresponding 
Published: January 2020

Abstract
Background The rate of S68G mutation in human immunodeficiency virus type 1 (HIV-1) reverse transcriptase has increased and is closely related to the K65R mutation among CRF01_AE-infected patients who failed treatment. We aimed to explore the temporal association of S68G and K65R mutations and disclose the role of the former on susceptibility to nucleotide/nucleoside reverse transcriptase inhibitor (NRTI) and viral replication with the K65R double mutations among CRF01_AE-infected patients who failed treatment. Methods The occurrence of S68G and K65R mutations was evaluated among HIV-1 of various subtypes in the global HIV Drug Resistance Database. The temporal association of S68G and K65R mutations was analyzed through next-generation sequencing in four CRF01_AE-infected patients who failed treatment with tenofovir/lamivudine/efavirenz. The impact of the S68G mutation on susceptibility to NRTI and replication fitness was analyzed using pseudovirus phenotypic resistance assays and growth competition assays, respectively. Results The frequency of the S68G mutation increased by 1.4–9.7% in almost all HIV subtypes and circulating recombinant forms in treatment-experienced patients, except subtype F. The S68G mutation often occurred in conjunction with the K65R mutation among RTI-treated patients, with frequencies ranging 21.1%–61.7% in various subtypes. Next-generation sequencing revealed that the S68G mutation occurred following the K65R mutation in three of the four CRF01_AE-infected patients. In these three patients, there was no significant change detected in the half maximal inhibitory concentration for zidovudine, tenofovir, or lamivudine between the K65R and K65R/S68G mutations, as demonstrated by the phenotypic resistance assays. Virus stocks of the K65R and K65R/S68G mutations were mixed with 4:6, 1:1, and 9:1 and cultured for 13 days, the K65R/S68G mutants outgrew those of the K65R mutants irrespective of the input ratio. Conclusions S68G may be a natural polymorphism and compensatory mutation of K65R selected by NRTIs in the CRF01_AE strain of HIV-1. This mutation does not affect susceptibility to NRTI; however, it improves the replication fitness of K65R mutants. This study deciphers the role of the S68G mutation in the HIV reverse transcriptase of the CRF01_AE strain and provides new evidence for the interpretation of drug-resistant mutations in non-B subtypes of HIV-1.