bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient Satisfaction With Providers: Do Patient Surveys Give Enough Information to Help Providers Improve Specific Behaviors
Authors: North Frederick , Tulledge-Scheitel Sidna M. 
Published: November 2019

Background: Patient satisfaction surveys ask patients specific questions about provider behavior such as whether they were satisfied with the provider’s instructions about medications or time spent with the patient. It’s unclear how responses to these surveys can help providers focus on specific behaviors to improve. Methods: In a primary care setting, we analyzed Press Ganey patient experience survey responses. We examined the 10 questions dealing with satisfaction specific to the care provider experience. We used the “Top Box” counts (counts of most favorable responses) and Top Box% (percentage of most favorable response) for categorical and continuous measures of patient satisfaction. Results: For 12 consecutive months, 652 providers of 1014 accumulated at least 300 total responses from patients for the 10 provider-related questions. Only 8 of the 652 providers had significant differences ( P < .05) in Top Box% for the 10 questions. Correlation of responses between the questions were between 0.86 and 0.96. Analysis of variance showed that 87% of the total variation in the Top Box% of the 10 questions was between providers and only 13% within providers. Factor analysis found no independent factors within the 10 questions (ie, a one factor model was sufficient; P < .0001). Conclusion: Patient survey questions appear to ask about specific provider behaviors that contribute to patient experience. However, the responses to 10 different questions are highly correlated and may not give providers or management enough statistically significant information to focus patient experience improvement efforts for individual providers.
Association of biomass fuel smoke with respiratory symptoms among children under 5 years of age in urban areas: results from Bangladesh Urban Health Survey, 2013
Authors: Hasan Md. , Tasfina Sadia , Haque S. M. Raysul , Saif-Ur-Rahman K. M. , Khalequzzaman Md. , Bari Wasimul , Islam Syed Shariful 
Published: November 2019

Abstract
Background
Little is known regarding the effect of exposure to biomass fuel smoke inhalation on respiratory symptoms in the Bangladeshi population which is a major health hazard in most of the developing countries. This study aims to explore the association between respiratory symptoms and biomass fuel smoke exposure among children under 5 years of age.

Methods
Data were extracted from the Bangladesh Urban Health Survey conducted in 2013. A total of 10,575 mothers with at least one surviving children were selected. Respiratory symptoms among children under 5 years of age were considered as the primary outcome. Sequential multiple logistic regression models were used to observe the association between respiratory symptoms and biomass fuel smoke exposure adjusting the effect of residential factors and mother and child characteristics.

Results
Around 40% of the mothers exclusively used biomass fuel irrespective of the kitchen location and 54% of them were habituated in indoor cooking. The prevalence of respiratory symptoms of under-five children among in-house and outdoor biomass fuel users was 23.0% and 21.9%, respectively. Results of fitted multiple logistic regression models showed that the odds of having respiratory symptoms among children under 5 years of age were increased due to in-house biomass fuel use [OR = 1.18; 95% CI, 1.04–1.36] compared with the non-biomass user. An increased risk of respiratory symptoms was also significantly associated with mother’s birth complication [OR = 1.51; 95% CI, 1.36–1.67], non-government organization (NGO) membership of mothers [OR = 1.32; 95% CI, 1.16–1.51], age of the child (6–23m) [OR = 1.29; 95% CI, 1.10–1.52], and nutritional status (stunting) [OR = 1.18; 95% CI, 1.06–1.31].

Conclusion
This study found the use of in-house biomass fuel as a significant risk factor associated with respiratory symptoms of children under 5 years of age. More longitudinal studies should be designed to establish a causal relationship between HAP (household air pollution) and respiratory symptoms among children with more direct measures of HAP and clinical procedure.
Attention mechanism enhanced LSTM with residual architecture and its application for protein-protein interaction residue pairs prediction
Authors: Liu Jiale , Gong Xinqi 
Published: November 2019

Abstract
Background
Recurrent neural network(RNN) is a good way to process sequential data, but the capability of RNN to compute long sequence data is inefficient. As a variant of RNN, long short term memory(LSTM) solved the problem in some extent. Here we improved LSTM for big data application in protein-protein interaction interface residue pairs prediction based on the following two reasons. On the one hand, there are some deficiencies in LSTM, such as shallow layers, gradient explosion or vanishing, etc. With a dramatic data increasing, the imbalance between algorithm innovation and big data processing has been more serious and urgent. On the other hand, protein-protein interaction interface residue pairs prediction is an important problem in biology, but the low prediction accuracy compels us to propose new computational methods.

Results
In order to surmount aforementioned problems of LSTM, we adopt the residual architecture and add attention mechanism to LSTM. In detail, we redefine the block, and add a connection from front to back in every two layers and attention mechanism to strengthen the capability of mining information. Then we use it to predict protein-protein interaction interface residue pairs, and acquire a quite good accuracy over 72%. What’s more, we compare our method with random experiments, PPiPP, standard LSTM, and some other machine learning methods. Our method shows better performance than the methods mentioned above.

Conclusion
We present an attention mechanism enhanced LSTM with residual architecture, and make deeper network without gradient vanishing or explosion to a certain extent. Then we apply it to a significant problem– protein-protein interaction interface residue pairs prediction and obtain a better accuracy than other methods. Our method provides a new approach for protein-protein interaction computation, which will be helpful for related biomedical researches.
Enhancement of de novo sequencing, assembly and annotation of the Mongolian gerbil genome with transcriptome sequencing and assembly from several different tissues
Authors: Cheng Shifeng , Fu Yuan , Zhang Yaolei , Xian Wenfei , Wang Hongli , Grothe Benedikt , Liu Xin , Xu Xun , Klug Achim , McCullagh Elizabeth A. 
Published: November 2019

AbstractBackgroundThe Mongolian gerbil (Meriones unguiculatus) has historically been used as a model organism for the auditory and visual systems, stroke/ischemia, epilepsy and aging related research since 1935 when laboratory gerbils were separated from their wild counterparts. In this study we report genome sequencing, assembly, and annotation further supported by transcriptome sequencing and assembly from 27 different tissues samples.ResultsThe genome was sequenced using Illumina HiSeq 2000 and after assembly resulted in a final genome size of 2.54 Gbp with contig and scaffold N50 values of 31.4 Kbp and 500.0 Kbp, respectively. Based on the k-mer estimated genome size of 2.48 Gbp, the assembly appears to be complete. The genome annotation was supported by transcriptome data that identified 31,769 (> 2000 bp) predicted protein-coding genes across 27 tissue samples. A BUSCO search of 3023 mammalian groups resulted in 86% of curated single copy orthologs present among predicted genes, indicating a high level of completeness of the genome.ConclusionsWe report the first de novo assembly of the Mongolian gerbil genome enhanced by assembly of transcriptome data from several tissues. Sequencing of this genome and transcriptome increases the utility of the gerbil as a model organism, opening the availability of now widely used genetic tools.
Identification and functional analysis of genetic variants in TBX5 gene promoter in patients with acute myocardial infarction
Authors: Wang Shuai , Zhang Jie , He Xiaohui , Zhang Yexin , Chen Jing , Su Qiang , Pang Shuchao , Zhang Shufang , Cui Yinghua , Yan Bo 
Published: November 2019

Abstract
Background
Coronary artery disease (CAD), including acute myocardial infarction (AMI), is a common complex disease. Although a great number of genetic loci and variants for CAD have been identified, genetic causes and underlying mechanisms remain largely unclear. Epidemiological studies have revealed that CAD incidence is strikingly higher in patients with congenital heart disease than that in normal population. T-box transcription factors play critical roles in embryonic development. In particular, TBX5 as a dosage-sensitive regulator is required for cardiac development and function. Thus, dysregulated TBX5 gene expression may be involved in CAD development.

Methods
TBX5 gene promoter was genetically and functionally analysed in large groups of AMI patients (n = 432) and ethnic-matched healthy controls (n = 448).

Results
Six novel heterozygous DNA sequence variants (DSVs) in the TBX5 gene promoter (g.4100A > G, g.4194G > A, g.4260 T > C, g.4367C > A, g.4581A > G and g.5004G > T) were found in AMI patients, but in none of controls. These DSVs significantly changed the activity of TBX5 gene promoter in cultured cells (P < 0.05). Furthermore, three of the DSVs (g.4100A > G, g.4260 T > C and g.4581A > G) evidently modified the binding sites of unknown transcription factors.

Conclusions
The DSVs identified in AMI patients may alter TBX5 gene promoter activity and change TBX5 level, contributing to AMI development as a rare risk factor.
Implementation study of a 5-component pediatric early warning system (PEWS) in an emergency department in British Columbia, Canada, to inform provincial scale up
Authors: McElroy Theresa , Swartz Erik N. , Hassani Kasra , Waibel Sina , Tuff Yasmin , Marshall Catherine , Chan Richard , Wensley David , O’Donnell Maureen 
Published: November 2019

Abstract
Background
The rapid identification of deterioration in the pediatric population is complex, particularly in the emergency department (ED). A comprehensive multi-faceted Pediatric Early Warning System (PEWS) might maximize early recognition of clinical deterioration and provide a structured process for the reassessment and escalation of care. The objective of the study was to evaluate the implementation fidelity, effectiveness, and utility of a 5-component PEWS implemented in the ED of an urban public general hospital in British Columbia, Canada, and to guide provincial scale up.

Methods
We used a before-and-after design to evaluate the implementation fidelity, effectiveness, and utility of a 5-component PEWS (pediatric assessment flowsheet, PEWS score, situational awareness, escalation aid, and communication framework). Sources of data included patient medical records, surveys of direct care staff, and key-informant interviews. Data were analyzed using mixed-methods approaches.

Results
The majority of medical records had documented PEWS scores at triage (80%) and first bedside assessment (81%), indicating that the intervention was implemented with high fidelity. The intervention was effective in increasing vital signs documentation, both at first beside assessment (84% increase) and throughout the ED stay (> 100% increase), in improving staff’s self-perceived knowledge and confidence in providing pediatric care, and self-reported communication between staff. Satisfaction levels were high with the PEWS scoring system, flowsheet, escalation aid, and to a lesser extent with the situational awareness tool and communication framework. Reasons for dissatisfaction included increased paperwork and incidence of false-positives. Overall, the majority of providers indicated that implementation of PEWS and completing a PEWS score at triage alongside the Canadian Triage and Acuity Scale (CTAS) added value to pediatric care in the ED. Results also suggest that the intervention is aligned with current practice in the ED.

Conclusion
Our study shows that high-fidelity implementation of PEWS in the ED is feasible. We also show that a multi-component PEWS can be effective in improving pediatric care and be well-accepted by staff. Results and lessons learned from this pilot study are being used to scale up implementation of PEWS in ED settings across the province of British Columbia.
Improved outcome in hip fracture patients in the aging population following co-managed care compared to conventional surgical treatment: a retrospective, dual-center cohort study
Authors: Neuerburg Carl , Förch Stefan , Gleich Johannes , Böcker Wolfgang , Gosch Markus , Kammerlander Christian , Mayr Edgar 
Published: November 2019

Abstract
Background
Hip fracture patients in the aging population frequently present with various comorbidities, whilst preservation of independency and activities of daily living can be challenging. Thus, an interdisciplinary orthogeriatric treatment of these patients has recognized a growing acceptance in the last years. As there is still limited data on the impact of this approach, the present study aimed to evaluate the long-term outcome in elderly hip fracture patients, by comparing the treatment of a hospital with integrated orthogeriatric care (OGC) with a conventional trauma care (CTC).

Methods
We conducted a retrospective, two-center, cohort study. In two maximum care hospitals all patients presenting with a hip fracture at the age of ≥ 70 years were consecutively assigned within a 1 year period and underwent follow-up examination 12 months after surgery. Patients treated in hospital site A were treated with an interdisciplinary orthogeriatric approach (co-managed care), patients treated in hospital B underwent conventional trauma care. Main outcome parameters were 1 year mortality, readmission rate, requirement of care (RC) and personal activities of daily living (ADL).

Results
A total of 436 patients were included (219 with OGC / 217 with CTC). The mean age was 83.55 (66–99) years for OGC and 83.50 (70–103) years for CTC (76.7 and 75.6% of the patients respectively were female). One year mortality rates were 22.8% (OGC) and 28.1% (CTC; p = 0.029), readmission rates were 25.7% for OGC compared to 39.7% for CTC (p = 0.014). Inconsistent data were found for activities of daily living. After 1 year, 7.8% (OGC) and 13.8% (CTC) of the patients were lost to follow-up.

Conclusions
Interdisciplinary orthogeriatric management revealed encouraging impact on the long-term outcome of hip fracture patients in the aging population. The observed reduction of mortality, requirements of care and readmission rates to hospital clearly support the health-economic impact of an interdisciplinary orthogeriatric care on specialized wards.

Trial registration
The study was approved and registered by the bavarian medical council (BLAEK: 7/11192) and the local ethics committee of munich university (Reg. No. 234–16) and was conducted as a two-center, cohort study at a hospital with integrated orthogeriatric care and a hospital with conventional trauma care.
Changes of CD103-expressing pulmonary CD4+ and CD8+ T cells in S. japonicum infected C57BL/6 mice
Authors: Zhao Yi , Yang Quan , Jin Chenxi , Feng Yuanfa , Xie Shihao , Xie Hongyan , Qi Yanwei , Qiu Huaina , Chen Hongyuan , Tao Ailin , Mu Jianbing , Qin Wenjuan , Huang Jun 
Published: November 2019

Abstract
Background
Recent studies have shown that CD103 is an important marker for tissue-resident memory T cells (TRM) which plays an important role in anti-infection. However, the role of CD103+ TRM was not elucidated in the progress of S. japonicum infection induced disease.

Methods
6–8 weeks old C57BL/6 mice were infected by S. japonicum. Mice were sacrificed and the lungs were removed 5–6 weeks after infection. Immunofluorescent staining and Q-PCR were performed to identify the expression of CD103 molecule. Single cellular populations were made, percentages of CD103 on both CD4+ and CD8+ T lymphocytes were dynamical observed by flow cytometry (FCM). Moreover, the expression of memory T cells related molecules CD69 and CD62L, T cell function associated molecules CD107a, IFN-γ, IL-4, IL-9, and IL-10 were compared between CD103+ CD4+ and CD8+ T cells by FCM.

Results
CD103+ cells were emerged in the lung of both naive and S. japonicum infected mice. Both the percentage and the absolute numbers of pulmonary CD4+ and CD8+ cells were increased after S. japonicum infection (P < 0.05). The percentage of CD103+ cells in CD8+ T cells decreased significantly at the early stage of S. japonicum infection (P < 0.05). Increased CD69, decreased CD62L and CD107a expressions were detected on both CD4+ and CD8+ CD103+ T cells in the lungs of infected mice (P < 0.05). Compared to CD8+ CD103+ T cells, CD4+ CD103+ T cells from infected mice expressed higher level of CD69 and lower level CD62L molecules (P < 0.05). Moreover, higher percentage of IL-4+, IL-9+ and IL-10+ cells on CD4+ CD103+ pulmonary T cells was found in infected mice (P < 0.05). Significantly increased IL-4 and IL-9, and decreased IFN-γ expressing cells were detected in CD8+CD103+ cells of infected mice (P < 0.05).

Conclusions
CD103-expressing pulmonary CD4+ and CD8+ T cells play important roles in mediating S. japonicum infection induced granulomatous inflammation in the lung.
Effects of factor v Leiden polymorphism on the pathogenesis and outcomes of preeclampsia
Authors: Ababio G. K. , Adu-Bonsaffoh K. , Abindau E. , Narh G. , Tetteh D. , Botchway F. , Morvey D. , Neequaye J. , Quaye I. K. 
Published: November 2019

Abstract
Background
Factor V Leiden polymorphism is a well-recognized genetic factor in the etiology of preeclampsia. Considering that Ghana is recording high incidence of preeclampsia, we examined if factor V Leiden is a contributory factor to its development and pregnancy outcomes.

Methods
STROBE consensus checklist was adopted to recruit eighty-one (81) consenting subjects after ethical clearance. Subjects were followed up till delivery to obtain outcomes of PE. Routine blood chemistry and proteinuria were done on all samples. Factor V Leiden was characterized by polymerase chain reaction and restriction fragment length polymorphism (RFLP). The data was captured as protected health information (PHI) and analyzed with SPSS version 22.

Results
Overall allelic frequencies found in FVL exon 10 were 0.67 and 0.33 for G and A alleles respectively. The FVL mutation was more in PE and hypertensive patients. Increased white blood cells, increased uric acid and a three – fold increment of AST / ALT ratio was observed in PE cases when stratified by FVL exons (exon 8 and 10). Significant differences were also observed between FVL and age, systolic blood pressure (SBP), diastolic blood pressure (DBP), liver enzymes, white blood cells (wbc), hemoglobin levels.

Conclusion
FVL mutation allele frequency was 0.33, a first report. The mutation was associated with increased uric acid, liver enzymes and blood cell indices suggestive of acute inflammation.
Impact of prior stroke on major clinical outcome in chronic kidney disease: the Salford kidney cohort study
Authors: Tollitt James , Odudu Aghogho , Flanagan Emma , Chinnadurai Rajkumar , Smith Craig , Kalra Philip A. 
Published: November 2019

Abstract
Background
Chronic kidney disease (CKD) is an independent risk factor for stroke in the general population. The impact of prior stroke on major clinical outcomes in CKD populations is poorly characterised.

Methods
The Salford Kidney Study is a UK prospective cohort of more than 3000 patients recruited since 2002 and followed until March 2018. Multivariable Cox regression examined associations of stroke at two time points; cohort inception, and at dialysis initiation, with risks of death, non-fatal cardiovascular events (NFCVE) and end stage renal disease (ESRD).

Results
277 (9.1%) of 3060 patients suffered a prior stroke and this was associated with mortality, ESRD and future NFCVE after cardiovascular risk factor adjustments. Median survival for prior stroke patients was 40 months vs 77 months in patients without a stroke. Prior stroke was independently associated with mortality (HR 1.20 95%CI 1.0–1.43, p = 0.05). Of 579 patients who reached ESRD and commenced dialysis, a prior stroke (N = 48) was independently associated with mortality. Median survival for the prior stroke group was 29 months compared with 50 months for the non-stroke group. Only 70 and 75% of patients who had suffered an ischaemic stroke were prescribed antiplatelets or statins respectively.

Conclusions
A diagnosis of stroke is strongly and independently associated with several adverse clinical outcomes for patients with CKD. Prior stroke profoundly alters cardiovascular risk in CKD patients. Greater attention to primary and secondary preventive strategies is warranted which may improve these outcomes.
Calcium-sensing receptor gene (CASR) polymorphisms and CASR transcript level concerning dyslipidemia in hemodialysis patients: a cross-sectional study
Authors: Grzegorzewska Alicja E. , Frycz Bartosz A. , Świderska Monika , Niepolski Leszek , Mostowska Adrianna , Jagodziński Paweł P. 
Published: November 2019

AbstractBackgroundThere is scarce data onCASRassociations with dyslipidemia. We investigated in hemodialysis (HD) patients whetherCASRsingle nucleotide polymorphisms (SNPs) rs7652589 and rs1801725 have associations with dyslipidemia and show epistatic interactions with SNPs of the energy homeostasis-associated gene (ENHO), retinoid X receptor α gene (RXRA), and liver X receptor α gene (LXRA).MethodsThe study included 1208 HD subjects. For diagnosis of dyslipidemia, both K/DOQI criteria and atherogenic index ≥3.8 were used.CASRrs1801725 was genotyped by TaqMan SNP Genotyping Assay, other SNPs – by high-resolution melting curve analysis or polymerase chain reaction-restriction fragment length polymorphism, as appropriate. Relative transcript levels ofCASR,ENHO,RXRA, andLXRAwere measured in peripheral blood mononuclear cells. The occurrence of dyslipidemic phenotypes concerning tested polymorphisms was compared using models of inheritance. Haplotypes were estimated using the Haploview 4.2 software. Epistatic interactions between tested SNPs were analyzed using the logistic regression and epistasis option in the PLINK software.ResultsRs7652589 indicated a greater probability of atherogenic dyslipidemia in the dominant inheritance model (OR 1.4, 95%CI 1.0–2.0,P = 0.026), principally because of increased triglyceride (TG) levels. The rs1801725 variant allele was associated with a decreased probability of dyslipidemia characterized by non-HDL-cholesterol ≥130 mg/dL and TG ≥200 mg/dL (OR 0.6, 0.4–0.9,P = 0.012). There were no epistatic interactions betweenCASRandRXRA,LXRA, andENHOregarding dyslipidemia. Both rs7652589 and rs1801725 SNPs were not in linkage disequilibrium (D’ = 0.091, r2 = 0.003 for the entire HD group) and their haplotypes did not correlate with dyslipidemia. RelativeCASRtranscript was lower at a borderline significance level in patients harboring the rs1801725 variant allele compared with homozygotes of the major allele (0.20, 0.06–7.80 vs. 0.43, 0.04–5.06,P = 0.058).CASRtranscript correlated positively withRXRAtranscript (adjustedP = 0.001),LXRAtranscript (adjustedP = 0.0009),ENHOtranscript (borderline significance, adjustedP = 0.055), dry body weight (adjustedP = 0.035), and renal replacement therapy duration (adjustedP = 0.013).ConclusionsCASRpolymorphisms (rs7652589, rs1801725) are associated with dyslipidemia in HD patients.CASRcorrelates withRXRA,LXRA, andENHOat the transcript level. Further investigations may elucidate whether otherCASRSNPs contribute to associations shown in this study.