bluuebunny/crossref_metadata_2025_split huggingface dataset:
The DISCO App: Evaluating an Electronic Patient Intervention to Reduce The Financial Burden of Cancer Through Improved Cost Communication In A Non-Randomized Pilot Trial
Authors: Hamel Lauren M. , Dougherty David W. , Hastert Theresa A. , Seymour Erlene K. , Kim Seongho , Assad Hadeel , Phalore Jasminder , Soulliere Roger , Eggly Susan 
Published: January 2021

Abstract
Background: Financial toxicity affects 30-50% of people with cancer in the US. Although experts recommend patients and oncologists discuss treatment cost, cost discussions occur infrequently. Using a non-randomized pre-test post-test design, we pilot-tested the feasibility, acceptability and preliminary effectiveness of the DIScussions of COst (DISCO) App, a patient communication intervention designed to improve the frequency of cost discussions and related outcomes. Methods: While waiting to see their oncologist, patients (n=32) used the DISCO App on a tablet. Clinic visits were video recorded and patients completed pre- and post-intervention measures of self-efficacy for managing treatment costs, self-efficacy for interacting with oncologists, cost-related distress, and perceptions of the DISCO App. Coders observed the recordings to determine the presence of cost discussions, initiators, and topics. Results: Most patients (84%) reported needing <15 minutes to use the DISCO App. Patients reported the DISCO App made it easier to ask cost-related questions. Findings showed increased self-efficacy for managing treatment costs (p=.02) and for interacting with oncologists (p=.001). All clinic visits included a cost discussion. Conclusion: The DISCO App is feasible, acceptable, and effective in prompting cost discussions and improving outcomes. Prompting patients to discuss costs before meeting with an oncologist may improve treatment cost discussions and related outcomes.Trial registration: Clinical Trials.gov registration number: NCT03676920 (September 19, 2018)
Tracing Sources of PM10 in Central Taiwan by using Chemical Characteristics and Pb Isotope Ratios: Local Versus Long-range Transport
Authors: Wu Po-Chao , Huang Kuo-Fang 
Published: January 2021

Abstract
Central Taiwan is among the most heavily polluted regions in Taiwan because of a complex mixing of local emissions from intense anthropogenic activities with natural dust. Long-range transport (LRT) of pollutants from outside Taiwan also contributes critically to the deterioration of air quality, especially during the northeast monsoon season. To identify the sources of particulate matter <10 μm (PM10) in central Taiwan, this study performed several sampling campaigns, including three local events, one LRT event, and one dust storm event, during the northeast monsoon season of 2018/2019. The PM10 samples were analyzed for water-soluble ion and trace metal concentrations as well as Pb isotope ratios. Local river sand/soil samples were also collected and analyzed to constrain chemical/isotopic signatures of natural sources. The Pb isotope data were interpreted together with the enrichment factors of trace metals in PM10, and reanalysis data sets were used to delineate the sources of PM10 in central Taiwan. Our results suggested that PM10 was predominantly contributed by oil combustion and oil refineries during the local events (48%–88%), whereas the lowest contributions were from coal combustion (<21%). During periods of high wind speed, the contribution from natural sources increased significantly from 7% to 31%. Moreover, the Pb isotopic signals of PM10 collected during the LRT event confirmed the impact of LRT from Mainland China, and the chemical characteristics of the PM10 significantly differed from those of the PM10 collected during local events. This study demonstrates the robustness of using a combination of Pb isotopic compositions and enrichment factors in PM10 for source apportionment in complex and heavily polluted areas.
Hsa_circ_0013401 Accelerates the Growth, Metastasis and Prevents Apoptosis Autophagy of Neuroblastoma Cells by Sponging miR-195 to Release PAK2&nbsp;
Authors: Zhu Shibo , Tang Xiangliang , Gao Xiaofeng , Zhang Jingqi , Cui Yanhong , Li Dian , Jia Wei 
Published: January 2021

Abstract
Background: Circular RNA (circRNA) is a newly discovered non-coding RNA with a covalently closed loop structure. Recently, the increased circRNAs have been identified in a variety of cancers. While, the specific functions and mechanisms of some circRNAs in neuroblastoma (NB) are still largely unexplored.Materials and Methods: The levels of hsa_circ_0045997, hsa_circ_0080307, hsa_circ_0013401, hsa_circ_0077578 and microRNA-195 (miR-195) were confirmed by RT-qPCR assay in NB. Functionally, gain- and loss-of-function assays and the rescued experiment were conducted to determine the influences of hsa_circ_0013401, miR-195 and P21-activated kinase 2 (PAK2) on the proliferation, apoptosis, autophagy, migration and invasion of NB cells. Luciferase reporter gene assay was also applied to examine the relationships between hsa_circ_0013401 and miR-195, miR-195 and PAK2. Hsa_circ_0013401/miR-195/PAK2 axis was also identified by in vivo experiment study.Results: Hsa_circ_0013401 was highly expressed, miR-195 was lowly expressed, and there was a negative correlation between hsa_circ_0013401 and miR-195 in NB. Hsa_circ_0013401 significantly suppressed the proliferation, migration and invasion, and induced apoptosis and autophagy of NB. In mechanism, miR-195 was a direct target of hsa_circ_0013401, and PAK2 was the downstream target gene of miR-195. And the inhibitory effects of hsa_circ_0013401 knockdown on the malignant biological properties of NB can be achieved by targeting miR-195 to upregulated PAK2. Besides, in vivo evidences also revealed that hsa_circ_0013401 promotes tumor formation, and regulated miR-195 and PAK2. Conclusions: Hsa_circ_0013401 induced NB progression through miR-195 to enhance PAK2. Therefore, we might highlight a novel regulatory axis (hsa_circ_0013401/miR-195/PAK2) in NB.
Total Health Expenditure and Its Driving Factors in China: A Gray Theory Analysis
Authors: Jia Huanhuan , Jiang Hairui , Yu Jianxing , Zhang Jingru , Cao Peng , Yu Xihe 
Published: January 2021

Abstract

Background: The continuous growth in total health expenditure (THE) has become a social issue of common concern in most countries. In China, THE is maintaining a rapid growth trend that is faster than that of the economy, and this trend has become increasingly obvious in the 21st century and has placed a heavy burden on the government and residents. Therefore, the aims of this paper are to analyze the main driving factors and establish a predictive model of the growth of THE in China in the 21st century.Methods: Gray system theory was employed to explore the correlation degree between THE and 9 hot topics in the areas of the economy, population, health service utilization, and policy using national data for China from 2000 to 2018. Additionally, a New Structure of the Multivariate Gray (NSGM) prediction model of health expenditure was established and compared with the traditional grey model and widely used Back Propagation (BP) neural network.Results: General government expenditures on health, the economy, and out-of-pocket health expenditures were highly correlated with THE, with all correlation degrees greater than 0.8. The correlation degrees between health institutions, population and THE were 0.6-0.8, whereas infant mortality rate and THE was only 0.573. The average of the residual percentage of the training data of the NSGM(1,10) model is 0.36%, and that of the test data is 1.85%, which is better than the results of the other models.Conclusion: The Chinese government and society have played a crucial role in reducing residents’ medical burden, whereas the improved economy and aging population have increased the demand for health services, leading to the continual increase in THE. The improved NSGM(1,N) model achieved good prediction accuracy and has unique advantages in simulating and predicting THE, which can provide a basis for policy formulation.
Prognostic Factors of Fluid-gas Exchange Outcomes in Patients with Failed Primary Surgery for Idiopathic Macular Hole
Authors: Lee You Hyun , Jang Ji Hye , Lee Soo Jin , Kim Yu Cheol 
Published: January 2021

Abstract
This retrospective study aimed to evaluate prognostic factors associated with the success of fluid-gas exchange in patients with failed primary idiopathic macular hole (IMH) surgery. Outcomes of the fluid-gas exchange were categorised as unclosed, or U-type, V-type, or W-type closure. Patients were divided into the successful and unsuccessful groups according to the absence or presence of bare retinal pigment epithelium, respectively, following fluid-gas exchange. Demographics, baseline characteristics, and pre-procedure characteristics were assessed. A total of 19 eyes in 19 patients that had failed IMH surgery and then underwent fluid-gas exchange were included. Of those, 18 eyes had MH closure (successful, 15 eyes; unsuccessful, three eyes). One eye was unclosed after fluid-gas exchange; therefore, the patient underwent additional vitrectomy for MH closure (unsuccessful). The successful group showed significantly lower pre-procedure base diameters; higher baseline and pre-procedure macular hole index, hole form factor, and tractional hole index values; and lower baseline and pre-procedure minimum diameter and diameter hole index values. Moreover, a better visual prognosis was observed in the successful group. These results suggest that indices predicting favourable results of primary surgery for IMH are useful to predict the success of fluid-gas exchange in patients with failed primary MH surgery.
The effect of physical exercise on fundamental movement skills and physical fitness among preschool children: study protocol for a cluster-randomized controlled trial
Authors: Wang Guangxu , Zi Yahua , Li Bo , Su Shan , Sun Lei , Wang Fei , Ren Chener , Liu Yang 
Published: January 2021

Abstract

Background Previous evidence has proven that physical exercise is positively related to preschoolers’ fundamental movement skills (FMS) and physical fitness (PF). However, studies to assess the effectiveness of different physical exercise interventions aiming at improving FMS and PF in preschool children are still scarce. To explore and compare the effectiveness of different physical exercise on FMS and PF; ball games (BG), rhythm activities (RA), basic movements (BM) and a combination of all related activities (multiple activities, MA) interventions were conducted among preschoolers.Methods A single-blind, 5-arm, cluster-randomized trial will be conducted in kindergarten in Shanghai, China. Three hundred healthy preschoolers, aged 4 to 5 years, will be randomized to four intervention groups (BG group, RA group, BM group or MA group) and one control group (unorganized physical activities). Four intervention groups will receive three 30-minute lessons weekly for 16 weeks. At the baseline, the end of 16-week intervention, and 6-month follow-up after the end of intervention, the primary outcomes (FMS and PF) and the secondary outcome (physical activity, PA) will be assessed, as well as sociodemographic and anthropometric data.Discussion This study will provide vital information regarding the effect of different physical exercise interventions on preschool children’s FMS and PF, PA, and the potential interactions between these domains. If the results of this trial are positive, the most effective intervention strategy can be generalized to kindergarten and other preschool educational institutions in practice to promote preschooler’s development of FMS and PF.Trial registration Chictr.org.cn ChiCTR2000029333.
Antibiotic accumulation, growth performance, physiologic status and intestinal flora diversification of Nile tilapia (Oreochromis niloticus) feed by diets supplemented with different dose of sulfamethoxazole
Authors: Fang Longxiang , Chen Xi , Shan Xiangbao , Qiu Liping , Fan Limin , Meng Shunlong , Song Chao 
Published: January 2021

Abstract
Background

Sulfamethoxazole (SMZ) is an antibiotic used globally to treat fish disease in aquaculture, but the effects of exposure to legal aquaculture doses of SMZ in fish are still unclear. To comprehensively investigate the effects of exposure to legal doses of sulfamethoxazole (SMZ) in Nile tilapia (Oreochromis niloticus), fish were exposed to diets supplemented with different doses of SMZ (blank group, normal feed; LS, 0.67 g/kg; MS, 6.67 g/kg and HS, 33.33 g/kg) for 4 weeks. General SMZ accumulation, growth performance, physiologic status, intestinal and hepatic health were systemically evaluated.
Results

The exposure experiment indicated that the SMZ accumulation in O. niloticus muscles, intestinal and aquaculture environment were positively related to the exposure dose. And withdrawal of antibiotics feed after 4th week, the SMZ residual in fish muscles, aquaculture water and sediment gradually decreased to safe level. LS and MS amount of antibiotics promoted the growth of fish accompanied by reduced feed coefficient in treated groups, while the fish growth in HS group was retarded. Exposure of O. niloticus to SMZ also increased the content of TG, promoted liver hypertrophy, and increased number of fat particles in liver. Antibiotics changed the content of intestinal short-chain fatty acids (SCFAs), and the changes in acetic acid were the most obvious. SMZ exposure reduced the biological diversity of the intestinal flora subsequently induced microbiota dysbiosis, and the degree was positively related to the exposure doses, and the experimental mainly inhibiting the growth of Fusobacteria.
Conclusions

Overall, exposure to of fish to legal doses of SMZ impair general physiological functions, intestinal flora and provokes health risk in fish. This study highlights the importance of rational and regulated use of SMZ in aquaculture.
Efficacy of Bladder Ultrasound in Prediction of Resolution of Vesicoureteral Reflux after Endoscopic Subureteral Hyaluronic Acid/Dextranome (Deflux®) Injection
Authors: Aboutaleb Hamdy , Eldib Diaa , Omar Mohamed , Gharbawy Mohamed El , Zanaty Fouad 
Published: January 2021

Abstract
BACKGROUND: We evaluated the efficacy of bladder ultrasound to predict resolution of vesicoureteral reflux after subureteral endoscopic Hyaluronic acid/dextranome (Deflux) injection.METHODS: Between 2010 and 2018, 120 patients (220 ureters) underwent Subureteral Deflux injection for reflux in children. Male/female ratio was 1: 5. All patients had voiding cystourethrography and bladder ultrasound at 3 months and one year after surgery. Outcome analysis included: Success rates and presence/ absence of Deflux mount by bladder ultrasound. RESULTS: Mean follow-up was 48 months. Mean age at surgery 72 months. Grades of reflux were grade II in 100 ureters (45.4%), III in 90 ureters (41%) and IV-V in 30 ureters (13.6%). Bilateral surgery was performed in 40 patients. Single Deflux injection cured reflux (Success rate) in 85% (187 ureters) at 3 months which improved to 88.2% (194 ureters) at last follow-up. Ultrasound was able to detect Deflux mounts at the base of the bladder in 200 ureters (91%). Sensitivity and specificity of ultrasound was 92.68% and 20% of the correction of reflux at the last follow up. Positive Predictive Value of bladder ultrasound was 94 % and accuracy was 87.7 % at the last follow up. Ultrasound did not detect the mount in 20 ureters (9 %) and 8 of these ureters (3.6%) had persistence of their reflux. Ultrasound was able to detect bilateral mounts as well as unilateral mounts.CONCLUSION: Bladder-US was highly sensitive for detection of Deflux implants and can predict resolution of reflux in 82.7% of refluxing ureters. Postoperative bladder-US could be adjusted as a screening tool in the follow-up of patients with primary low-grade VUR patients treated by Deflux injection, while VCUG could be preserved for follow-up of high-grade VUR patients.
Trends in Prevalence of Extended-Spectrum Beta-Lactamase-Producing Escherichia Coli Isolated From Patients With Community- And Healthcare-Associated Bacteriuria: Results From 2014 To 2020 In An Urban Safety-Net Healthcare System
Authors: Raphael Eva , Glymour Maria , Chambers Henry F 
Published: January 2021

Abstract
BackgroundThe prevalence of infections caused by extended-spectrum beta-lactamase producing Escherichia coli (ESBL-E. coli) is increasing worldwide, but the setting in which this increase is occurring is not well defined. We compared trends and risk factors for ESBL-E. coli bacteriuria in community vs healthcare settings.MethodsWe collected electronic health record data on all patients with E. coli isolated from urine cultures in a safety-net public healthcare system from January 2014 to March 2020. All analyses were stratified by healthcare-onset/associated (bacteriuria diagnosed > 48 hours after hospital admission or in an individual hospitalized in the past 90 days or in a skilled nursing facility resident, N=1,277) or community-onset bacteriuria (all other, N=7,751). We estimated marginal trends from logistic regressions to evaluate annual change in prevalence of ESBL-E. coli bacteriuria among all bacteriuria. We evaluated risk factors using logistic regression models.ResultsESBL-E. coli prevalence increased in both community-onset (0.91% per year, 95% CI: 0.56%, 1.26%) and healthcare-onset/associated (2.31% per year, CI: 1.01%, 3.62%) bacteriuria. In multivariate analyses, age >65 (RR 1.88, CI: 1.17, 3.05), male gender (RR 2.12, CI: 1.65, 2.73), and Latinx race/ethnicity (RR 1.52, CI: 0.99, 2.33) were associated with community-onset ESBL-E. coli. Only male gender (RR 1.53, CI: 1.03, 2.26) was associated with healthcare-onset/associated ESBL-E. coli.ConclusionsESBL-E. coli bacteriuria frequency increased at a faster rate in healthcare-associated settings than in the community between 2004 to 2020. Male gender was associated with ESBL-E. coli bacteriuria in both settings, but additional risks—age >65 and Latinx race/ethnicity—were observed only in the community.
Incidence of Microcarcinoma and Non-Microcarcinoma in Ultrasound-Found Thyroid Nodules
Authors: Chen Zhi , Mosha Singla Sethiel , Zhang Tong , Xu Ming , Li Yanli , Hu Zhuoqing , Liang Weiqiang , Deng Xiaoyi , Ou Tingting , Li Ling , Li Wangen 
Published: January 2021

Abstract
Backgrounds: The incidence of thyroid nodules is increasing year by year around the world. However, ultrasound is not recommended as a screening test for the general population or patients with a normal thyroid on palpation by the American Association of Clinical Endocrinologists (AACE). In practice, some individuals with normal thyroid palpation have nodules that can just be found out by ultrasound. No studies have directly described the risk of nodules found by ultrasound or by palpation up to now. More evidence is needed to carry out for helping us balance the over diagnosis and missed diagnosis of malignant lesions. Therefore, we carried out a retrospective study to investigate the incidence of malignant lesions in ultrasound-found nodules in a large cohort.Methods: We conducted a retrospective analysis involving 2957 patients who underwent thyroid ultrasound evaluation and fine-needle aspiration (FNA) between Jan 2013 and Dec 2019. The cytologic examinations were analyzed based on the Bethesda system. For nodules suspected to be follicular neoplasm or other malignant tumors by cytological tests, patients were recommended for surgery and histopathology examinations.Results: Compared with palpation-found nodules, ultrasound-found nodules were presenting less as purely cystic nodules (10.1% vs 39.9%, x2=355.69, p=0.000), smaller size (17.5±9.9 mm vs 28.0±12.5 mm, t=23.876 p=0.000), and higher TI-RADS score (5.5±2.9 vs 3.4±3.3, t=18.084, p=0.000), respectively. More ultrasound-found nodules were diagnosed as carcinoma by histology examinations [136 (11.2%) nodules found by ultrasound vs 68 (3.9%) by palpation, x2=59.737, p=0.000], and 88 (64.7%) nodules found by ultrasound were non-microcarcinoma. Among the malignant nodules confirmed by histopathology, a higher proportion of microcarcinoma was detected in ultrasound-found nodules [35.3% (48/136) vs 16.2% (11/68), x2=8.183, p=0.004]. Conclusions: In view of the results observed in our research that malignant nodules were more common screened out by ultrasound, and nearly two thirds of them were non-microcarcinoma. We recommend reassessment of the recommendations for thyroid nodule screening.
A Pseudomonas plant pathogen uses distinct modes of stationary phase persistence to survive bacteriocin and streptomycin treatments
Authors: Patel Ravikumar R. , Kandel Prem P. , Traverso Eboni , Hockett Kevin L. , Triplett Lindsay R. 
Published: January 2021

Abstract
Antimicrobial treatment of bacteria often results in a small population of surviving tolerant cells, or persisters, that may contribute to recurrent infection. Antibiotic persisters are metabolically dormant, but the basis of persistence to membrane-disrupting biological compounds is less well-understood. We previously found that the model plant pathogen Pseudomonas syringae pv. phaseolicola 1448A (Pph) exhibits persistence to tailocin, a membrane-disrupting biocontrol compound with potential for sustainable disease control. Here we compared physiological traits associated with persistence to tailocin and to the antibiotic streptomycin, and established that both treatments leave similar frequencies of persisters. Microscopic profiling of treated populations revealed that while tailocin rapidly permeabilizes most cells, streptomycin treatment results in a heterogeneous population of redox and membrane permeability states. Sorting cells according to redox reporter intensity identified streptomycin persisters among the low-redox fraction, but tailocin persisters were only cultured from the fraction with intermediate redox activity. Cells from culturable fractions were able to infect host plants, while nonculturable redox-active cells were not. Tailocin and streptomycin were effective in eliminating all persisters when applied sequentially, in addition to eliminating cells in other viable states. This study identifies distinct redox states associated with antibiotic persistence, tailocin persistence, and virulence, and demonstrates that tailocin is highly effective in eliminating dormant cells.