bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nursing staff’s evaluation of facilitators and barriers during implementation of wireless nurse call systems in residential care facilities. A cross-sectional study.
Authors: Dugstad Janne , Sundling Vibeke , Nilsen Etty R. , Eide Hilde 
Published: December 2019

Abstract
Background: Traditional nurse call systems used in residential care facilities rely on patients to summon assistance for routine or emergency needs. Wireless nurse call systems (WNCS) offer new affordances for persons unable to actively or consciously engage with the system, allowing detection of hazardous situations, prevention and timely treatment, as well as enhanced nurse workflows. This study aimed to explore facilitators and barriers of implementation of WNCSs in residential care facilities. Methods: The study had a cross-sectional descriptive design. We collected data from care providers (n=98) based on the Measurement Instrument for Determinants of Innovation (MIDI) framework in five Norwegian residential care facilities during the first year of WNCS implementation. The self-reporting MIDI questionnaire was adapted to the contexts. Descriptive statistics were used to explore participant characteristics and MIDI item and determinant scores (D1-29). MIDI items to which ≥20% of participants disagreed/totally disagreed were regarded as barriers and items to which ≥80% of participants agreed/totally agreed were regarded as facilitators for implementation. Results: More facilitators (n=22) than barriers (n=6) were identified. The greatest facilitators, reported by 98% of the care providers, were the expected outcomes: the importance and probability of achieving prompt call responses and increased safety (D9 expected outcomes), and the normative belief of unit managers (D15 subjective norm). During the implementation process, 87% became familiar with the systems (D18 awareness of content), and 86% and 90%, respectively regarded themselves (D17 knowledge) and their colleagues (D14 descriptive norm) as competent users of the WNCS. The most salient barriers, reported by 37%, were their lack of prior knowledge (D17 knowledge) and that they found the WNCS difficult to learn (D8 personal drawback). No features of the technology were identified as barriers. Conclusions: Overall, the care providers gave a positive evaluation of the WNCS implementation. The barriers to implementation were addressed by training and practicing technological skills, facilitated by the influence and support by the manager and the colleagues within the residential care unit. WNCSs offer a range of advanced applications and services, and further research is needed as more WNCS functionalities are implemented into residential care services.
Head and Neck cancer patients’ preferences for individualized prognostic information: a focus group study.
Authors: Hoesseini Arta , Dronkers Emilie A. C. , Sewnaik Aniel , Hardillo Jose A. U. , de Jong Robert J. Baatenburg , Offerman Marinella P. J. 
Published: December 2019

Abstract
Background: Head and Neck cancer (HNC) is characterized by significant mortality and morbidity. Treatment is often invasive and interferes with vital functions, resulting in a delicate balance between survival benefit and deterioration in quality of life (QoL). Therefore, including prognostic information during patient counseling can be of great importance. The first aim of this study was to explore HNC patients’ preferences for receiving prognostic information: both qualitative (general terms like ‘’curable cancer’’), and quantitative information (numbers, percentages). The second aim of this study was to explore patients’ views on ‘’OncologIQ’’, a prognostic model developed to estimate overall survival in newly diagnosed HNC patients.

Methods: We conducted a single center qualitative study by organizing five focus groups with HNC patients (n= 21) and their caregivers (n= 19), categorized in: 1) small laryngeal carcinomas treated with radiotherapy or laser, 2) extensive oral cavity procedures, 3) total laryngectomy, 4) chemoradiation, 5) other treatments. The patients’ perspective was the main focus. The interview guide consisted of two main topics: life-expectancy and the prognostic model OncologIQ. All focus groups were recorded, transcribed and coded. Themes were derived using content analysis.

Results: While all patients considered it somewhat to very important to receive information about their life-expectancy, only some of them wanted to receive quantitative information. Disclosing qualitative prognostic information like ‘’the cancer is curable’’ would give enough reassurance for most patients. Overall, patients thought life-expectancy should not be discussed shortly after cancer diagnosis disclosure, as a certain time is needed to process the first shock. They had a stronger preference for receiving prognostic information in case of a poor prognosis. Prognostic information should also include information on the expected QoL. The pie chart was the most preferred chart for discussing survival rates.

Conclusions: The participants found it important to receive information on their life-expectancy. While most patients were enough reassured by qualitative prognostic information, some wanted to receive quantitative information like OncologIQs’ estimates. A tailor-made approach is necessary to provide customized prognostic information. A clinical practice guideline was developed to support professionals in sharing prognostic information, aiming to improve shared decision making and patient-centered care.
Sun protection education for adolescents: A feasibility study of a wait-list controlled trial of an intervention involving a presentation, action planning, and SMS messages and using objective measurement of sun exposure
Authors: Hubbard Gill , Cherrie John , Gray Jonathan , Kyle Richard G , Nioi Amanda , Wendelboe-Nelson Charlotte , Cowie Hilary , Dombrowski Stephan 
Published: December 2019

Abstract
Background
People increase their risk of melanoma unless they are protected from the harmful effects of sun exposure during childhood and adolescence. We aimed to assess the feasibility of a three-component sun protection intervention- presentation, action planning, and SMS messages - and trial parameters.
Methods
This feasibility wait-list trial was conducted in the United Kingdom in 2018. Students aged 13-15 years were eligible. Feasibility outcomes were collected for recruitment rates; data availability rates for objective measurements of melanin and erythema using a Mexameter and self-reported sunburn occurrences, severity and body location, tanning, sun protection behaviours and Skin Self-Examination (SSE) collected before (baseline) and after the school summer holidays (follow-up); intervention reach, adherence, perceived impact and acceptability. Quantitative data were analysed using descriptive statistics; qualitative data were analysed thematically.
Results
Five out of eight schools expressing an interest in participating with four allocated to act as intervention and one control. Four parents/carers opted their child out of the study. 487 out of 724 students on the school register consented to the study at baseline (67%). 385 were in intervention group schools. Objective skin measurements were available for 255 (66%) of the intervention group at baseline and 237 (61%) of the group at follow up. Melanin increased; erythema decreased. Complete self-report data were available for 247 (64%) students in the intervention group. The number of students on the school register who attended the presentation and given the booklet was 379 (98%) and gave their mobile phone number was 155 (40%). No intervention component was perceived as more impactful on sun protection behaviours. Adolescents did not see the relevance of sun protection in the UK or for their age group.
Conclusions
This is the first study to use a Mexameter to measure skin colour in adolescents. Erythema (visible redness) lasts no more than three days and its measurement before and after a six week summer holiday may not yield relevant or meaningful data. A major challenge is that adolescents do not see the relevance of sun protection and SSE.
Neonatal Near-Misses in Ghana: A Prospective, Observational, Multi-Center Study
Authors: Bakari Ashura , Bell April J. , Oppong Samuel A. , Bockarie Yemah , Wobil Priscilla , Plange-Rhule Gyikua , Goka Bamenla Q. , Engmann Cyril M , Adanu Richard M , Moyer Cheryl A 
Published: December 2019

Abstract
Background: For every newborn who dies within the first month, as many as eight more suffer life-threatening complications but survive (termed ‘neonatal near-misses’ (NNM)). However, there is no universally agreed-upon definition or assessment tool for NNM. This study sought to describe the development of the Neonatal Near-Miss Assessment Tool (NNMAT) for low-resource settings, as well as findings when implemented in Ghana. Methods: This prospective, observational study was conducted at two tertiary care hospitals in southern Ghana from April – July 2015. Newborns with evidence of complications and those admitted to NICUs were screened for inclusion using the NNMAT. Incidence of suspected NNM at enrollment and confirmed near-miss (surviving to 28 days) was determined and compared against institutional neonatal mortality rates. Suspected NNM cases were compared with newborns not classified as a suspected near-miss, and all were followed to 28 days to determine odds of survival. Confirmed near-misses were those identified as suspected near-misses at enrollment who survived to 28 days. The main outcome measures were incidence of NNM, NNM:mortality ratio, and factors associated with NNM classification. Results: Out of 394 newborns with complications, 341 (86.5%) were initially classified as suspected near-misses at enrollment using the NNMAT, with 53 (13.4%) being classified as a non-near-miss. At 28-day follow-up, 68 (17%) had died, 52 (13%) were classified as a non-near-miss, and 274 were considered confirmed near-misses. Those newborns with complications who were classified as suspected near-misses using the NNMAT at enrollment had 12 times the odds of dying before 28 days than those classified as non-near-misses. While most confirmed near-misses qualified as NNM via intervention-based criteria, nearly two-thirds qualified based on two or more of the four NNMAT categories. When disaggregated, the most predictive elements of the NNMAT were gestational age < 33 weeks, neurologic dysfunction, respiratory dysfunction, and hemoglobin < 10 gd/dl. The ratio of near-misses to deaths was 0.55 : 1, yet this varied across the study sites. Conclusions: This research suggests that the NNMAT is an effective tool for assessing neonatal near-misses in low-resource settings. We believe this approach has significant systems-level, continuous quality improvement, clinical and policy-level implications.
Improvement and Use of CRISPR/Cas9 to Engineer a Sperm-marking Strain for the Invasive Fruit Pest Drosophila suzukii
Authors: Ahmed Hassan M. M. , Hildebrand Luisa , Wimmer Ernst A. 
Published: December 2019

Abstract
Background: The invasive fruit pest Drosophila suzukii was reported for the first time in Europe and the USA in 2008 and has spread since then. The adoption of type II clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated (Cas) as a tool for genome manipulation provides new ways to develop novel biotechnologically-based pest control approaches. Stage or tissue-specifically expressed genes are of particular importance in the field of insect biotechnology. The enhancer/promoter of the spermatogenesis-specific beta-2-tubulin (β2t) gene was used to drive the expression of fluorescent proteins or effector molecules in testes of agricultural pests and diseases vectors for sexing, monitoring, and reproductive biology studies. Here, we demonstrate an improvement to CRISPR/Cas-based genome editing in D. suzukii and establish a sperm-marking system.
Results: To improve genome editing, we isolated and tested the D. suzukii endogenous promoters of the small nuclear RNA gene U6 to drive the expression of a guide RNA and the Ds heat shock protein 70 promoter to express Cas9. For comparison, we used recombinant Cas9 protein and in vitro transcribed gRNA as a preformed ribonucleoprotein. We demonstrate the homology-dependent repair (HDR)-based genome editing efficiency by applying a previously established transgenic line that expresses DsRed ubiquitously as a target platform. In addition, we isolated the Ds_β2t gene and used its promoter to drive the expression of a red fluorescence protein in the sperm. A transgenic sperm-marking strain was then established by the improved HDR-based genome editing.
Conclusion: The deployment of the endogenous promoters of the D. suzukii U6 and hsp70 genes to drive the expression of gRNA and Cas9, respectively, enabled the effective application of helper plasmid co-injections instead of preformed ribonucleoproteins used in previous reports for HDR-based genome editing. The sperm-marking system should help to monitor the success of pest control campaigns in the context of the Sterile Insect Technique and provides a tool for basic research in reproductive biology of this invasive pest. Furthermore, the promoter of the β2t gene can be used in developing novel transgenic pest control approaches. The CRISPR/Cas9 system can be used as an additional tool for the modification of previously established transgenes.
Genomic analysis of Escherichia coli strains isolated from diseased chicken in the Czech Republic
Authors: Papoušková Aneta , Masaříková Martina , Valček Adam , Šenk David , Čejková Darina , Jahodářová Eva , Čížek Alois 
Published: December 2019

Abstract
Background: Avian pathogenic Escherichia coli (APEC) can cause various extraintestinal infections in poultry, resulting in massive economic losses in poultry industry. In addition, some avian E. coli strains may have zoonotic potential, making poultry a possible source of infection for humans. Due to its extreme genetic diversity, this pathotype remains poorly defined. This study aimed to investigate the diversity of colibacillosis-associated E. coli isolates from Central European countries with a focus on the Czech Republic. Results: Of 95 clinical isolates subjected to preliminary characterization, 32 were selected for whole-genome sequencing. A multi resistant phenotype was detected in a majority of the sequenced strains with the predominant resistance to β -lactams and quinolones being associated with TEM-type beta-lactamase genes and chromosomal gyrA mutations respectively. The phylogenetic analysis confirmed a great diversity of isolates, that were derived from nearly all phylogenetic groups, with predominace of B2, B1 and C phylogroups. Clusters of closely related isolates within ST23 (phylogroup C) and ST429 (phylogroup B2) indicated a possible local spread of these clones. Besides, the ST429 cluster carried blaCMY-2, -59 genes for AmpC beta-lactamase and isolates of both clusters were generally well-equipped with virulence-associated genes, with considerable differences in distribution of certain virulence-associated genes between phylogenetically distant lineages. Other important and potentially zoonotic APEC STs were detected, incl. ST117, ST354 and ST95, showing several molecular features typical for human ExPEC.Conclusions: The results support the concept of local spread of virulent APEC clones, as well as of zoonotic potential of specific poultry-associated lineages, and highlight the need to investigate the possible source of these pathogenic strains.
Genome-wide association mapping of Sclerotinia sclerotiorum resistance in soybean using whole-genome resequencing data
Authors: Boudhrioua Chiheb , Bastien Maxime , Torkamaneh Davoud , Belzile François 
Published: December 2019

Abstract
Sclerotinia stem rot (SSR), caused by Sclerotinia sclerotiorum (Lib.) de Bary, is an important cause of yield loss in soybean. Although many papers have reported different loci contributing to partial resistance, few of these were proved to reproduce the same phenotypic impact in different populations. In this study, we identified a major quantitative trait loci (QTL) associated with resistance to SSR progression on the main stem by using a genome-wide association mapping (GWAM). A population of 127 soybean accessions was genotyped with 1.5M SNPs derived from genotyping-by-sequencing (GBS) and whole-genome sequencing (WGS) ensuring an extensive genome coverage and phenotyped for SSR resistance. SNP-trait association led to discovery of a new QTL on chromosome 1 (Chr01) where resistant lines had shorter lesions on the stem by 29 mm . A single gene (Glyma.01g048000) resided in the same LD block as the peak SNP, but it is of unknown function. The impact of this QTL was even more significant in the descendants of a cross between two lines carrying contrasted alleles for Chr01. Individuals carrying the resistance allele developed lesions almost 50% shorter than those bearing the sensitivity allele. These results suggest that this region harbors a promising resistance QTL to SSR that can be used in soybean breeding program.
MicroRNA-21 inhibitor (miR-21i) and Simvastatin-loaded poly (D,L-lactide-co-glycolide)/polyethylenimine (PLGA/PEI) nanoparticles for synergistic anticancer effect in Gastric Cancers
Authors: Liu Yuxia , Yang Bin , Zhang Lirong , Cong Xianling , Liu Hongyu , Yu Mengxi , Song Bin 
Published: December 2019

Abstract
Background: In this study, we have successfully developed a simvastatin (SMV) and miR-21i-loaded poly (D,L-lactide-co-glycolide)/polyethylenimine (PLGA/PEI) nanoparticles (NP) to enhance the therapeutic efficacy in gastric cancers. Methods: The PLGA/PEI nanoparticles by sonication method. The nanoparticles were characterized for in vitro physicochemical and biological assays and pharmacokinetic study was performed in rats. Results: CLSM/FACS results clearly showed the ability of SMV/miR-21i-loaded PLGA/PEI NP (PPN-S21i) to deliver the combinational therapeutics of SMV and miR-21i to the cancer cells. Combination of SMV+miR-21i showed significantly lower cell viability compared to that of free SMV. Our results clearly highlight the importance of simultaneous interaction of SMV+miR-21i and that it could significantly decrease the cell proliferation in BGC-823, SGC-7901 and HGC-27 gastric cancer cells while it was significantly less cytotoxic to normal gastric mucosa cells (GES-1). Cell apoptosis of SMV+miR-21i was significantly higher compared to that of individual drug or miRNA. Finally, pharmacokinetic analysis revealed that PPN-S21i significantly prolonged the blood circulation time of SMV compared to that of free SMV indicating the potential of carrier system. Conclusion: Overall, results clearly indicate that the combination of SMV+miR-21i (gene + drug therapy) might provide a valuable strategy for the clinical management of gastric cancers.
Coronary heart disease mortality is decreasing in Argentina and Colombia, but keeps increasing in Mexico: a time trend study
Authors: Arroyo-Quiroz Carmen , Barrientos-Gutierrez Tonatiuh , O'Flaherty Martin , Guzman-Castillo Maria , Mejia Lina Sofia Palacio , Saldarriaga Elkin de Jesus Osorio , Rodriguez Andrea Yanira Rodriguez 
Published: December 2019

Abstract
Background: Coronary heart disease (CHD) mortality rates have decreased in most countries, but increased in low and middle-income countries. Few studies have analyzed CHD mortality trends in Latin America, specifically the trends in young-adults and the effect of correcting these comparisons for nonspecific causes of death (garbage codes). Objective: To describe and compare standardized, age-specific, and garbage-code corrected mortality trends for CHD from 1985 to 2015 in Argentina, Colombia, and Mexico. Methods: CHD deaths were grouped by country, year of registration, sex, and 10-year age bands to calculate age-adjusted and age and sex specific rates for adults aged ≥25. We corrected for garbage-codes using the Global Burden of Disease methodology. Finally, we fitted Joinpoint regression models. Results: In 1985, age-standardized mortality rates per 100,000 were 136.6 in Argentina, 160.6 in Colombia and 87.51 in Mexico. Compared to 2015, mortality fell in Argentina and Colombia (51% and 6.5% respectively) and increased by 61% in Mexico. The steepest decline was observed in Argentinian women and the sharpest increment in Mexican men. There has been an upward trend in young Mexicans since 1985. Garbage-code corrections produced increases in mortality rates, particularly in Argentina: approximately 80 additional deaths per 100,000 (14 in Colombia and 13 in Mexico). Conclusions: Latin American countries are at different stages of the epidemic. The disease burdens are bigger after correcting for misclassification. Although CHD mortality is falling in Argentina, the modest falls in Colombia and substantial rises in Mexico highlight the region’s need for effective, population-wide prevention policies.
Association between motoric cognitive risk syndrome and frailty among Chinese older adults
Authors: Shen Shanshan , Zeng Xingkun , Xu Liyu , Chen Lingyan , Liu Zixia , Chu Jiaojiao , Yang Yinghong , Wu Xiushao , Chen Xujiao 
Published: December 2019

Abstract
Background: Motoric cognitive risk syndrome (MCR) is a newly proposed pre-dementia syndrome incorporating subjective cognitive complaints and slow gait. Previous studies have shown that subjective cognitive complaints and slow gait are reported to be associated with frailty in cognitively unimpaired older adults, but little is known giving attention to the link between MCR and frailty in older adults. Therefore, the aim of the study was to explore the associations of MCR and its components and frailty in Chinese older adults. Methods: In an observation cross-sectional study, a total of 429 older adults aged 60 years and older were admitted to the geriatric department. According to MCR criteria, all participants were classified to 4 groups: 1) MCR group; 2) subjective cognitive complaints only group; 3) slow gait only group; 4) healthy control group. Physical frailty was assessed by Clinical Frailty Scale (CFS). The multivariate logistic regression analysis was used to examine the association between MCR and frailty in older adults. Results: The prevalence of subjective cognitive complaints, slow gait and MCR was 15.9%, 10.0% and 4.0%, respectively. After adjusting for confounding variables, the logistic regression analysis showed that slow gait (odds ratio [OR] 3.40, 95% confidence interval [CI] 1.40-8.23, P=0.007) and MCR (odds ratio [OR] 5.53, 95% confidence interval [CI] 1.46-20.89, P=0.012) were independently associated with frailty, but not subjective cognitive complaints. Conclusions: MCR and slow gait were significantly associated with frailty in Chinese older adults. Further study should prospectively determine the causal relationship between MCR and frailty.