bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isolating promoters from Corynebacterium ammoniagenes ATCC 6871 and application in CoA synthesis
Authors: Hou Yingshuo , Chen Siyu , Wang Jianjun , Liu Guizhen , Wu Sheng , Tao Yong 
Published: November 2019

AbstractBackgroundCorynebacterium ammoniagenesis an important industrial organism that is widely used to produce nucleotides and the potential for industrial production of coenzyme A byC. ammoniagenesATCC 6871 has been shown. However, the yield of coenzyme A needs to be improved, and the available constitutive promoters are rather limited in this strain.ResultsIn this study, 20 putative DNA promoters derived from genes with high transcription levels and 6 promoters from molecular chaperone genes were identified. To evaluate the activity of each promoter, red fluorescence protein (RFP) was used as a reporter. We successfully isolated a range of promoters with different activity levels, and among these a fragment derived from the upstream sequence of the 50S ribosomal protein L21 (Prpl21) exhibited the strongest activity among the 26 identified promoters. Furthermore, type III pantothenate kinase fromPseudomonas putida(PpcoaA) was overexpressed inC. ammoniagenesunder the control of Prpl21, CoA yield increased approximately 4.4 times.ConclusionsThis study provides a paradigm for rational isolation of promoters with different activities and their application in metabolic engineering. These promoters will enrich the available promoter toolkit forC. ammoniagenesand should be valuable in current platforms for metabolic engineering and synthetic biology for the optimization of pathways to extend the product spectrum or improve the productivity inC. ammoniagenesATCC 6871 for industrial applications.
Cross-cultural adaptation, reliability and validity of the Italian version of the craniofacial pain and disability inventory in patients with chronic temporomandibular joint disorders
Authors: Monticone Marco , Rocca Barbara , Abelli Paola , Tecco Simona , Geri Tommaso , Gherlone Enrico Felice , Luzzi Deborah , Testa Marco 
Published: November 2019

AbstractBackgroundTo develop an Italian version of the Craniofacial Pain Disability Inventory (CFPDI-I) and investigate its psychometric abilities in patients with temporomandibular disorders (TMD).MethodsThe CFPDI was translated following international standards. The psychometric analyses included reliability by internal consistency (Cronbach’s alpha) and test/retest stability (intraclass correlation coefficient, ICC); construct validity was investigated by matching (a priori hypotheses) the CFPDI-I with the Italian Neck Disability Index (NDI-I), a pain intensity numerical rating scale (NRS), the Italian Pain Catastrophising Scale (PCS-I), the Italian Tampa Scale of Kinesiophobia (TSK-I), and the Italian Migraine Disability Assessment Score Questionnaire (MIDAS) (Pearson’s correlation). Alpha was set at 0.05.ResultsTwo hundred and twelve patients with chronic TMD completed the tool. The questionnaire was internally consistent (α = 0.95) and its stability was good (ICCs = 0.91). As hypothesised, validity figures showed CFPDI-I strongly correlated with the NDI-I (r = 0.66,p < 0.05) and moderately correlated with the NRS (r = 0.48,p < 0.05), PCS (r = 0.37,p < 0.05), TSKI (r = 0.35,p < 0.05) and MIDAS (r = 0.47,p < 0.05). Similar estimates were shown by CFPDI-I subscales.ConclusionsThe cross-culturally adapted version of the Craniofacial Pain and Disability Inventory (CFPDI-I) showed satisfactory psychometric properties that replicate those of the original version and, therefore, can be implemented in the clinical assessment of Italian people affected by TMD.
Effect of smoking cessation on tooth loss: a systematic review with meta-analysis
Authors: Souto Maria Luisa Silveira , Rovai Emanuel Silva , Villar Cristina Cunha , Braga Mariana Minatel , Pannuti Cláudio Mendes 
Published: November 2019

Abstract

Background
Smoking is a major risk factor for periodontitis and tooth loss. Smoking cessation has a positive impact in periodontal treatment. However, so far, no systematic review has evaluated the effect of smoking cessation on tooth loss. Therefore, this review aimed to evaluate if smoking cessation reduces the risk of tooth loss.

Methods
Observational (cross-sectional and longitudinal) studies that investigated the association between smoking cessation and tooth loss were included. MEDLINE, EMBASE and LILACS databases were searched for articles published up to November 2018. Pooled results for subgroups of current and former smokers were compared in meta-analysis. Meta-regression was used to test the influence of smoking status on estimates and explore the heterogeneity.

Results
Of 230 potentially relevant publications, 21 studies were included in the qualitative review and 12 in the quantitative analysis. Meta-analysis of cross-sectional studies did not show any differences between former and current smokers in the chance of losing 1 or more teeth (OR = 1.00; 95% CI = 0.80 to 1.24, I2 = 80%), losing more than 8 teeth (OR = 1.02; 95% CI = 0.78 to 1.32, I2 = 0%) or being edentulous (OR = 1.37; 95% CI = 0.94 to 1.99, I2 = 98%). Meta-analysis from longitudinal studies showed that, when compared to never smokers, former smokers presented no increased risk of tooth loss (RR = 1.15; 95% CI = 0.98 to 1.35, I2 = 76%), while current smokers presented an increased risk of tooth loss (RR = 2.60; 95% CI = 2.29 to 2.96, I2 = 61%). Meta-regression showed that, among former smokers, the time of cessation was the variable that better explained heterogeneity (approximately 60%).

Conclusions
Risk for tooth loss in former smokers is comparable to that of never smokers. Moreover, former smokers have a reduced risk of tooth loss, when compared to current smokers.
Hospice use and one-year survivorship of residents in long-term care facilities in Canada: a cohort study
Authors: Xiong Beibei , Freeman Shannon , Banner Davina , Spirgiene Lina 
Published: November 2019

AbstractBackgroundHospice care is designed for persons in the final phase of a terminal illness. However, hospice care is not used appropriately. Some persons who do not meet the hospice eligibility receive hospice care, while many persons who may have benefitted from hospice care do not receive it. This study aimed to examine the characteristics of, and one-year survivorship among, residents who received hospice care versus those who did not in long-term care facilities (LTCFs) in Canada.MethodsThis retrospective cohort study used linked health administrative data from the Canadian Continuing Reporting System (CCRS) and the Discharge Abstract Database (DAD). All persons who resided in a LTCF and who had a Resident Assessment Instrument Minimum Data Set Version 2.0 (RAI-MDS 2.0) assessment in the CCRS database between Jan. 1st, 2015 and Dec 31st, 2015 were included in this study (N = 185,715). Death records were linked up to Dec 31th, 2016. Univariate, bivariate and multivariate analyses were performed.ResultsThe reported hospice care rate in LTCFs is critically low (less than 3%), despite one in five residents dying within 3 months of the assessment. Residents who received hospice care and died within 1 year were found to have more severe and complex health conditions than other residents. Compared to those who did not receive hospice care but died within 1 year, residents who received hospice care and were alive 1 year following the assessment were younger (a mean age of 79.4 [+ 13.5] years vs. 86.5 [+ 9.2] years), more likely to live in an urban LTCF (93.2% vs. 82.6%), had a higher percentage of having a diagnosis of cancer (50.7% vs. 12.9%), had a lower percentage of having a diagnosis of dementia (30.2% vs. 54.5%), and exhibited more severe acute clinical conditions.ConclusionsThe actual use of hospice care among LTCF residents is very poor in Canada. Several factors emerged as potential barriers to hospice use in the LTCF population including ageism, rurality, and a diagnosis of dementia. Improved understanding of hospice use and one-year survivorship may help LTCFs administrators, hospice care providers, and policy makers to improve hospice accessibility in this target group.
Heracleum moellendorffii roots inhibit the production of pro-inflammatory mediators through the inhibition of NF-κB and MAPK signaling, and activation of ROS/Nrf2/HO-1 signaling in LPS-stimulated RAW264.7 cells
Authors: Kim Ha Na , Kim Jeong Dong , Yeo Joo Ho , Son Ho-Jun , Park Su Bin , Park Gwang Hun , Eo Hyun Ji , Jeong Jin Boo 
Published: November 2019

Abstract

Background
Heracleum moellendorffii roots (HM-R) have been long treated for inflammatory diseases such as arthritis, backache and fever. However, an anti-inflammatory effect and the specific mechanism of HM-R were not yet clear. In this study, we for the first time explored the anti-inflammatory of HM-R.

Methods
The cytotoxicity of HM-R against RAW264.7 cells was evaluated using MTT assay. The inhibition of NO and PGE2 production by HM-R was evaluated using Griess reagent and Prostaglandin E2 ELISA Kit, respectively. The changes in mRNA or protein level following HM-R treatment were assessed by RT-PCR and Western blot analysis, respectively.

Results
HM-R dose-dependently blocked LPS-induced NO and PGE2 production. In addition, HM-R inhibited LPS-induced overexpression of iNOS, COX-2, IL-1β and IL-6 in RAW264.7 cells. HM-R inhibited LPS-induced NF-κB signaling activation through blocking IκB-α degradation and p65 nuclear accumulation. Furthermore, HM-R inhibited MAPK signaling activation by attenuating the phosphorylation of ERK1/2, p38 and JNK. HM-R increased nuclear accumulation of Nrf2 and HO-1 expression. However, NAC reduced the increased nuclear accumulation of Nrf2 and HO-1 expression by HM-R. In HPLC analysis, falcarinol was detected from HM-R as an anti-inflammatory compound.

Conclusions
These results indicate that HM-R may exert anti-inflammatory activity by inhibiting NF-κB and MAPK signaling, and activating ROS/Nrf2/HO-1 signaling. These findings suggest that HM-R has a potential as a natural material for the development of anti-inflammatory drugs.
Use of smartphone and perception towards the usefulness and practicality of its medical applications among healthcare workers in Saudi Arabia
Authors: Abolfotouh Mostafa A. , BaniMustafa Ala’a , Salam Mahmoud , Al-Assiri Mohammed , Aldebasi Bader , Bushnak Ibraheem 
Published: November 2019

Abstract

Background
In Saudi Arabia, healthcare industry is undergoing major expansions to meet the demand of rapidly growing healthcare needs. The aims of this study were; (1) to assess the pattern of smartphone use in healthcare facilities, and (2) to determine perception towards its use among healthcare workers.

Method
A cross-sectional survey of 351 healthcare workers (HCWs) at King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia was conducted, from October to November 2016, using a previously validated perception domain to measure perception towards usefulness (5 statements) and practicality (5 statements) of smartphones in clinical settings. Pattern of use of smartphones and health-related applications in healthcare facilities was also investigated. Logestic regression models were applied to identify the predictors of smartphone use and installation of health-related applications for use in healthcare facilities. Significance was considered at p-value of < 0.05.

Results
Utilization rate of smartphone was 42.3%, and only 6.1% of all healthcare providers reported always using applications in their practice. Reasons for use were: as a source of drug information (69.8%), for disease diagnosis (56.4%), to access medical websites (42.5%), to review guidelines and protocols related to healthcare (34.1%), for procedure documentation (23.5%), and as a source of patients education materials (22.3%). Perceptions of HCWs towards smartphone use was less than satisfactory (Overall percentage mean score = 60.4 ± 18.7), with only 11.6% reporting positive perception. After adjusting for possible confounders, the total perception mean score was a significant predictor of both smartphone use (β = 0.033, p < 0.001) and medical applications installation (β = 0.033, p < 0.001). Installation of medical applications was also predicted by being a physician (β = 0.008, p = 0.024).

Conclusion
Smartphone utilization in healthcare facilities by HCWs in Saudi Arabia is low. This could be attributed to their less than satisfactory level of perception towards its use. Smartphone use and installation of medical applications for use in health facilities were predicted by perceived usefulness and practicality of its use. Intervention from higher health authorities is necessary to enforce the importance of smartphone use in clinical practice. Conduction of further studies on the impact of smart phone use on the healthcare quality in Saudi Arabia is recommended.
Specific timely appointments for triage to reduce wait times in a medical outpatient clinic: protocol of a pre-post study with process evaluation
Authors: Lewis Annie K. , Taylor Nicholas F. , Carney Patrick W. , Harding Katherine E. 
Published: November 2019

Abstract

Background
Managing demand for services is a problem in many areas of healthcare, including specialist medical outpatient clinics. Some of these clinics have long waiting lists with variation in access for referred people. A model of triage and appointment allocation has been developed and tested that has reduced waiting times by about a third in community outpatient services. This study aims to determine whether the model can be applied in the setting of a specialist medical outpatient clinic to reduce wait time from referral to first appointment.

Methods
A pre-post study will collect data before and after implementing the Specific Timely Appointments for Triage (STAT) model of access and triage. The study will incorporate a pre-implementation period of 12 months, an implementation period of up to 6 months and a post STAT-implementation period of 6 months. The setting will be the epilepsy clinic at a metropolitan health service in Melbourne. Included will be all people referred to the clinic, or currently waiting, during the allocated periods of data collection (total sample estimated n = 975). Data routinely collected by the health service and qualitative data from staff will be analysed to determine the effects of introducing the STAT model. The primary outcome will be wait time, measured by number of patients on the wait list at monthly time points and the mean number of days waited from referral to first appointment. Secondary outcomes will include patient outcomes, such as admission to hospital while waiting, and service outcomes, including rate of discharge. Analysis of the primary outcome will include interrupted time series analysis and simple comparisons of the pre and post-implementation periods. Process evaluation will include investigation of the fidelity of the intervention, adaptations required and qualitative analysis of the experiences of clinic staff.

Discussion
Prompt access to service and optimum patient flow is important for patients and service providers. Testing the STAT model in a specialist medical outpatient clinic will add to the evidence informing service providers and policy makers about how the active management of supply and demand in health care can influence wait times. The results from this study may be applicable to other specialist medical outpatient clinics, potentially improving access to care for many people.
Incremental economic burden associated with exudative age-related macular degeneration: a population-based study
Authors: Kim Siin , Park Sang Jun , Byun Seong Jun , Park Kyu Hyung , Suh Hae Sun 
Published: November 2019

Abstract

Background
The exudative age-related macular degeneration (AMD) causes considerable healthcare costs for patients and healthcare system, which are expected to grow as the population ages. The objective of this study was to assess the incremental economic burden of exudative AMD by comparing total healthcare costs between the exudative AMD group and non-AMD group to understand economic burden related to exudative AMD.

Methods
This retrospective cohort study used the National Health Insurance Service database including the entire Korean population. Exudative AMD group included individuals with at least one claim for ranibizumab and one claim using the registration code for exudative AMD (V201). Non-AMD group was defined as individuals without any claims regarding the diagnostic code of H35.3 or ranibizumab. The exudative AMD group and non-AMD group were matched using a propensity-score model. Incremental healthcare resource utilization and healthcare costs were measured during a one-year follow-up by employing econometric models: ordinary least squares (OLS) with log transformation and heteroscedastic retransformation; and generalized linear model (GLM) with a log link function and gamma distribution.

Results
A total of 7119 exudative AMD patients were matched to 7119 non-AMD patients. The number of outpatient visits was higher in the exudative AMD group (P-value < 0.0001), while the length of hospitalization was shorter in exudative AMD group (P-value < 0.0001). Exudative AMD patients had total costs 2.13 times (95%CI, 2.08–2.17) greater than non-AMD group using OLS, and total costs 4.06 times (95%CI, 3.82–4.31) greater than non-AMD group using GLM. Annual incremental total costs were estimated as $5519 (OLS) and $3699 (GLM).

Conclusions
Exudative AMD was associated with significantly increased healthcare costs compared to the non-AMD group. Attention is needed to manage the socioeconomic burden of exudative AMD.
Health system constraints affecting treatment and care among women with cervical cancer in Harare, Zimbabwe
Authors: Tapera O. , Dreyer G. , Kadzatsa W. , Nyakabau A. M. , Stray-Pedersen B. , SJH Hendricks 
Published: November 2019

Abstract

Background
Cervical cancer is a major cause of morbidity and mortality among women yet access to treatment and care remains a huge challenge in Zimbabwe. The objective of this study was to investigate health system constraints affecting engagement into treatment and care by women with cervical cancer in Harare, Zimbabwe.

Methods
A sequential explanatory mixed methods design was used for this study. Phase 1 comprised of two surveys namely: patient and health worker surveys with sample sizes of 134 and 78 participants respectively. Validated structured questionnaires programmed in Android tablet with SurveytoGo software were used for data collection during the surveys. Univariate analyses were conducted using STATA® version 14 to generate descriptive statistics. In phase 2, 16 in-depth interviews, 20 key informant interviews and 6 focus groups were conducted to explain survey results. Participants were purposively selected and sample sizes were informed by saturation principle. Participants in phase 1 and 2 were different. English transcripts were manually coded line by line in Dedoose software using the thematic codes that had been established from the survey data. The final codes were used to support and explain the survey data at the interpretation stages.

Results
Health system constraints identified in surveys were: limited or lack of training for health workers, weakness of surveillance system for cervical cancer, limited access to treatment and care, inadequate health workers, reliance of patients on out-of-pocket funding for treatment services, lack of back-up for major equipment. Qualitative inquiry revealed the following barriers to treatment and care: high costs of treatment and care, lack of knowledge about cervical cancer and bad attitudes of health workers, few screening and treating centres located mostly in urban areas, lack of clear referral system resulting in bureaucratic processes, and limited screening and treating capacities in health facilities due to lack of resources.

Conclusion
The results of this study show that health system and its organization present barriers to access of cervical cancer treatment and care among women. Strong political will, mobilization of resources both domestically and from partners in addition to sound policies are imperative to address key health system challenges.
Presentations and outcomes of interstitial lung disease and the anti-Ro52 autoantibody
Authors: Sclafani A. , D’Silva K. M. , Little B. P. , Miloslavsky E. M. , Locascio J. J. , Sharma A. , Montesi S. B. 
Published: November 2019

Abstract

Background
Distinct clinical presentations of interstitial lung disease (ILD) with the myositis-specific antibodies, including anti-synthetase antibodies, are well-recognized. However, the association between ILD and the myositis-associated antibodies, including anti-Ro52, is less established. Our objectives were to compare presenting phenotypes of patients with anti-Ro52 alone versus in combination with myositis-specific autoantibodies and to identify predictors of disease progression or death.

Methods
We performed a retrospective cohort study of 73 adults with ILD and a positive anti-Ro52 antibody. We report clinical features, treatment, and outcomes.

Results
The majority of patients with ILD and anti-Ro52 had no established connective tissue disease (78%), and one-third had no rheumatologic symptoms. Thirteen patients (17.8%) required ICU admission for respiratory failure, with 84.6% all-cause mortality. Of the 73 subjects, 85.7% had a negative SS-A, and 49.3% met criteria for idiopathic pneumonia with autoimmune features (IPAF). The 50 patients with anti-Ro52 alone were indistinguishable from patients with anti-Ro52 plus a myositis-specific autoantibody. ICU admission was associated with poor outcomes (HR 12.97, 95% CI 5.07–34.0, p < 0.0001), whereas rheumatologic symptoms or ANA > = 1:320 were associated with better outcomes (HR 0.4, 95% CI 0.16–0.97, p = 0.04, and HR 0.29, 95% CI 0.09–0.81, p = 0.03, respectively).

Conclusions
Presentations of ILD with the anti-Ro52 antibody are heterogeneous, and outcomes are similar when compared to anti-Ro52 plus myositis-specific antibodies. Testing for anti-Ro52 may help to phenotype unclassifiable ILD patients, particularly as part of the serologic criteria for IPAF. Further research is needed to investigate treatment of ILD in the setting of anti-Ro52 positivity.