bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of a community-based intervention for cardiovascular risk factor control on stroke mortality in rural Gadchiroli, India: study protocol for a cluster randomised controlled trial
Authors: Kalkonde Yogeshwar , Deshmukh Mahesh , Nila Sindhu , Jadhao Sunil , Bang Abhay 
Published: August 2019

Abstract
Background

Stroke has emerged as a leading cause of death in rural India. However, well tested healthcare interventions to reduce stroke mortality in rural under-resourced settings are lacking. The aim of this study is to evaluate the effect of a community-based preventive intervention on stroke mortality in rural Gadchiroli, India.

Methods

The study is a two-arm, parallel group, cluster randimised controlled trial where 32 villages each will be randomised to the intervention and the enhanced usual care (EUC) arm. In the intervention arm, individuals ≥ 50 years of age will be screened for hypertension, diabetes and stroke by trained Community Health Workers (CHWs). Screen positive individuals will be referred to a mobile outreach clinic which will visit intervention villages. A physician in the clinic will confirm the diagnosis, provide guideline-based treatment and follow up patients at periodic intervals. The CHWs will make home visits once a month to ensure medication compliance and counsel patients to reduce salt consumption and quit tobacco and alcohol. In the EUC arm, households will be provided information on the ill effects of tobacco and steps to quit it. Individuals from both the arms will have access to government’s national programme for prevention and control of non-communicable diseases where treatment for hypertension, diabetes and stroke is available at the primary health centres (PHCs). The intervention will be implemented for 3.5 years. The primary outcome will be reduction in stroke mortality in the last 2.5 years of the intervention.

Discussion

This trial will provide important information regarding the feasibility and effect of a community-based preventive intervention package on stroke mortality in a rural under-resourced setting and can inform India’s non-communicable diseases prevention and control programme. If successful, such an intervention can be scaled up in rural regions of India and other countries.
Prevalence and factors associated with re-laparotomy among patients operated in Debre-Markos Referral Hospital, North West Ethiopia: Retrospective cross-sectional study
Authors: Yesuf Nurhusien Nuru , Yohanes Yeneabat Birhanu , Bashah Debrework Tesgera , Walle Tarkie Abebe , Netsere Henok Biresaw 
Published: August 2019

Abstract
Background Re-laparotomy is one of the causes of morbidity and mortality among patients with abdominal surgery; unless efforts are made to prevent in advance by identifying the potential risk factors. Methods Retrospective cross-sectional study was conducted at Debre-Markos Referral Hospital from three hundred and ninety charts (390) from January 1, 2015, to January 30, 2017. Data were analyzed using Statistical Package for Social Science (SPSS) version 22. The associated factors for re-laparotomy were identified using multivariable logistic regression. P-value < 0.05 was considered to be statistically significant. Results We studied 390 patients based on charts. Two hundred seventy-four patients (70.3%) were males. Forty-eight patients (12.3%) performed re-laparotomy. Patients with the duration of operating on initial surgery >60 hrs, AOR=3.30(95%CI [1.40-7.41, p=0.05]), diabetes mellitus, AOR=4.79(95%CI [1.55-14.80, p=0.007]), elective surgery, AOR=0.17(95%CI [0.05-0.56, p= 0.004]) Conclusion Even re-laparotomy is preventive; it is found to be in-patients underwent abdominal surgery. Therefore, appropriate preventive intervention to be taken to change those factors of the first surgery.
Prevalence and predicting factors of non-alcoholic fatty liver disease diagnosed by transient elastography with controlled attenuation parameter in HIV-infected patients
Authors: Jongraksak Tanawat , Sobhonslidsuk Abhasnee , Jatchavala Janjira , Warodomwichit Daruneewan , Kaewduang Piyaporn , Sungkanuparph Somnuek 
Published: August 2019

Abstract
Background: HIV infection is one of the most important health problems worldwide. With effective antiretroviral therapy (ART), the mortality rate of HIV-infected patients has significantly declined. Currently, metabolic complications become more common and lead to increasing morbidity and mortality in HIV-infected patients. Non-alcoholic fatty liver disease (NAFLD) has emerged as a common metabolic complication in these patients. Our study was aimed to determine the prevalence and predicting factors of NAFLD in HIV-infected population.Methods: A cross-sectional study was conducted in HIV-infected patients receiving ART without history of regular alcohol consumption or known chronic liver diseases. The data of demographic and clinical parameters, metabolic profiles, bioelectrical impedance analysis, liver ultrasonography and transient elastography (TE) with controlled attenuation parameter (CAP) were collected. The prevalence and predicting factors of NAFLD were analyzed. NAFLD was defined when CAP ≥248 dB/m. Patients were categorized into two groups: NAFLD and non-NAFLD. Significant liver fibrosis was defined when liver stiffness measurement (LSM) >7.0 kPa. Predicting factors of NAFLD were determined using logistic regression analysis.Results: A total of 150 patients were included in the study. Forty-eight (32.0%) patients had NAFLD. Among this group, significant fibrosis was diagnosed in 5 (10.4%) patients and steatosis by ultrasonography was documented in 31 (64.6%) patients. Baseline characteristics including age, sex, CD4 cell count, types of ART regimens and duration of ART between the two groups were not different (p>0.05). Blood pressure, waist circumference, body mass index (BMI), percentage of fat, AST, ALT, HbA1c, LDL, and triglycerides were higher in the NAFLD group (p<0.05). By multivariate analysis, high BMI [odds ratio (OR) 1.596; 95% confidence interval (CI), 1.336-1.907, p<0.001], triglycerides level more than 150 mg/dl [OR 3.722; 95% CI, 1.508-9.187, p<0.004] and advance age [OR 1.076; 95% CI, 1.017-1.139, p<0.011] were predicting factors of NAFLD. Conclusions: NAFLD is commonly found in HIV-infected patients receiving ART while significant fibrosis is relatively uncommon. High BMI, age and triglycerides appear to be predicting factors of NAFLD. The regimen and duration of ART are not associated with NAFLD. Screening for NAFLD by TE with CAP in HIV-infected patients should be recommended for early detection of NAFLD.
Global scale transcriptome analysis reveal differentially expressed genes during early somatic embryogenesis in Dimocarpus longan Lour
Authors: Chen Yukun , Xu Xiaoping , Liu Zhuanxia , Zhang Zihao , Xu XuHan , Lin Yuling , lai zhongxiong 
Published: August 2019

Abstract
Background

Somatic embryogenesis (SE) is a process of somatic cells that dedifferentiate to the totipotent embryonic stem cells and generate embryos in vitro. Longan SE has been established and wildly used as a model system for studying embryogenesis in woody plants, and some SE-related genes had been characterized. In spite of that, a comprehensive overview of SE at a molecular level is still absent. With the aim of understanding the molecular mechanisms underlying SE in longan, we examined the transcriptome changes by using Illumina HiSeq platform from the four distinct developmental stages, including non-embryogenic callus (NEC), embryogenic callus (EC), incomplete compact pro-embryogenic cultures (ICpEC), globular embryos (GE).

Results

RNA-seq of the four samples generated a total of 243.78 million high quality reads, approximately 81.5% of the data were mapped to the reference genome. The cDNA libraries of NEC, EC, ICpEC and GE, generated 22743, 19745, 21144, 21102 expressed transcripts and 1935, 1710, 1816, 1732 novel transcripts, and 2645, 366, 505, 588 unique genes, respectively. Comparative transcriptome analysis revealed the important role of auxin and cytokinin during longan SE. The transcripts profiling of flavonoid and fatty acid biosynthesis related genes suggested that flavonoids were mainly accumulated in NEC, while fatty acid accumulated in early SE. In addition, the extracelluar protein encoding genes LTP, CHI, GLP, AGP, EP1 were related to longan SE. Transcript profiling combined with qRT-PCR performed on selected genes confirmed that 27 SE molecular markers (LEC1, LEC1-like, PDF1.3, GH3.6, AGL80, PIN1, BBM, WOX9, WOX2, ABI3, et al.) and 28 NEC markers (LEA5, CNOT3, DC2.15, PR1-1, NsLTP2, DIR1, PIP1, PIP2.1, TIP2-1, POD-P7 and POD5 et al.) were characterized as potential molecular markers for longan early SE, respectively.

Conclusion

Our transcriptome reveals the transcription regulation of auxin, cytokinin and other hormones signaling pathway, flavonoids biosynthesis, fatty acid biosynthesis, extracelluar protein encoding genes, and other SE-related genes during early SE. Furthermore, we characterizes the potential molecular markers to distinguish NEC and early SE of longan. The present work provides new insights into future functional studies, as a means of studying the molecular mechanisms in SE.
Chronic pain diagnoses and opioid dispensings among individuals with serious mental illness
Authors: Owen-Smith Ashli , Stewart Christine , Sesay Musu M. , Strasser Sheryl M. , Yarborough Bobbi Jo , Ahmedani Brian , Miller-Matero Lisa R. , Waring Stephen C. , Haller Irina V. , Waitzfelder Beth E. , Sterling Stacy A. , Campbell Cynthia I. , Hechter Rulin C. , Zeber John E. , Copeland Laurel A. , Scherrer Jeffrey F. , Rossom Rebecca , Simon Greg 
Published: August 2019

Abstract
Background

Individuals with major depressive disorder (MDD) and bipolar disorder (BD) have particularly high rates of chronic non-cancer pain (CNCP) and are also more likely to receive prescription opioids for their pain. However, there have been no known studies published to date that have examined opioid treatment patterns among individuals with schizophrenia.

Methods

Using electronic medical record data across 13 Mental Health Research Network sites, individuals with diagnoses of MDD (N=65,750), BD (N=38,117) or schizophrenia or schizoaffective disorder (N=12,916) were identified and matched on age, sex and Medicare status to controls with no documented mental illness. CNCP diagnoses and prescription opioid medication dispensings were extracted for the matched samples. Multivariate analyses were conducted to evaluate (1) the odds of receiving a pain-related diagnosis and (2) the odds of receiving opioids, by separate mental illness diagnosis category compared with matched controls, controlling for age, sex, Medicare status, race/ethnicity, income, medical comorbidities, healthcare utilization and chronic pain diagnoses.

Results

Multivariable models indicated that having a MDD (OR=1.90; 95% CI=1.85–1.95) or BD (OR=1.71; 95% CI=1.66–1.77) diagnosis was associated with increased odds of a CNCP diagnosis after controlling for age, sex, race, income, medical comorbidities and healthcare utilization. By contrast, having a schizophrenia diagnosis was associated with decreased odds of receiving a chronic pain diagnosis (OR=0.86; 95% CI=0.82– 0.90). Having a MDD (OR=2.59; 95% CI=2.44–2.75) or BD (OR=2.12; 95% CI=1.97–2.28) diagnosis was associated with increased odds of receiving chronic opioid medications, even after controlling for age, sex, race, income, medical comorbidities, healthcare utilization and chronic pain diagnosis; having a schizophrenia diagnosis was not associated with receiving chronic opioid medications.

Conclusions

Individuals with serious mental illness, who are most at risk for developing opioid-related problems, continue to be prescribed opioids more often than their peers without mental illness. Healthcare providers need to be especially conservative in prescribing opioids – or avoid opioid therapy altogether – for this population. Mental health clinicians may be particularly well-suited to lead pain assessment and management efforts for these patients.
Recognizing states of psychological vulnerability to suicidal behavior: a Bayesian Network of Artificial Intelligence applied to a clinical sample.
Authors: Barros Jorge , Morales Susana , García Arnol , Echávarri Orietta , Fischman Ronit , Szmulewicz Marta , Moya Claudia , Núñez Catalina , Tomicic Alemka 
Published: August 2019

Abstract
This study aimed to determine conditional dependence relationships for variables that contribute to psychological vulnerability associated with suicide risk. A Bayesian Network was developed and applied to establish conditional dependence relationships among variables for each individual subject studied. These conditional dependencies represented the different states that patients could have adopted in relation to suicidal behavior (SB). The clinical sample included 650 mental health patients with mood and anxiety symptomatology. Results mainly indicated that variables within the Bayesian Network are part of each patient’s state of psychological vulnerability, having the potential to impact such states, and that variables coexist and are relatively stable over time. These results have enabled us to offer a tool to detect states of psychological vulnerability associated with suicide risk. If we accept that suicidal behaviors (vulnerability-ideation-suicidal attempts) exist in constant change and are unstable, we can investigate what happens to individuals at specific moments as doorways toward intervening in a timely manner so as to prevent such behaviors. Future testing of the tool developed in this study is needed, not only in specialized mental health environments, but also in other places with high rates of mental illness such as primary healthcare facilities and educational institutions (schools and universities), among others.
Comparison of the predictive values of two binary diagnostic tests subject to a case-control sampling
Authors: Roldán-Nofuentes Jose Antonio , Sidaty-Regad Saad Bouh 
Published: August 2019

Abstract
Background: The main parameters to compare binary tests are the sensitivity and the specificity. Case-control sampling to compare two binary tests is frequent in clinical practice. This design consists of applying the two binary tests to all of the individuals in a sample of those who have the disease and in another sample of those who do not have the disease. In this design, the sensitivities (specificities) are compared from the case (control) sample applying the McNemar’s test. Other parameters of a binary test are the predictive values. The predictive values of a binary test represent the clinical accuracy of a binary test when it is applied to the individuals in a population with a determined disease prevalence.
Methods: This article studies the comparison of the predictive values of two diagnostic tests subject to a case-control sampling. A global hypothesis test, based on the chi-square distribution, is proposed to compare the predictive values simultaneously. The comparison of the predictive values is also studied individually. The hypothesis tests studied require knowledge of an estimation of the disease prevalence.
Results: Simulation experiments were carried out to study the type I errors and the powers of the hypothesis tests, as well as to study the effect of a misspecification of the prevalence on the behaviour of the hypothesis tests and on the estimators of the predictive values. The results obtained were applied to an example on the diagnosis of the Human African Trypanosomiasis.
Conclusions: A method has been proposed to compare the predictive values of two diagnostic tests subject to a case-control sampling. This method consists in: 1) Simultaneously comparing the predictive values applying the global hypothesis test based on the chi-square distribution to an error alpha; 2) If the global test is not significant, then the equality of the predictive values is not rejected. If the global test is significant to an error alpha , then the causes of the significance are studied solving the individual hypothesis tests and applying Bonferroni’s method (or Holm’s method) to an error alpha.
Keywords: Binary diagnostic test, Chi-square distribution, Positive and negative predictive values.
Management of urolithiasis associated with tuberous sclerosis complex
Authors: Hatano Takashi , Imai Yu , Mori Kei-ichiro , Moritake Jun , Endo Katsuhisa , Tamari Mayumi , Egawa Shin 
Published: August 2019

Abstract
The most common renal symptoms of tuberous sclerosis complex (TSC) are angiomyolipomas (AMLs) and renal cysts; however, some patients with TSC also develop urolithiasis. In this study, we evaluated the incidence, risk factors and clinical courses of TSC-associated urolithiasis. We analyzed a total of 102 patients who met the diagnostic criteria for TSC, of whom 15 (14.7%) had urolithiasis. We compared urinary specific gravity, urine pH, serum calcium, intact parathyroid hormone and the use of antiepileptic agents of the urolithiasis and non-urolithiasis groups. The urine specific gravity and urine pH were higher in the urolithiasis group than in the non-urolithiasis group (P = 0.005, P = 0.042, respectively). No significant difference was found between the two groups with regard to the serum corrected calcium and intact parathyroid hormone levels. The antiepileptic drugs topiramate and zonisamide were more frequently administered to the urolithiasis group than the non-urolithiasis group (P <0.001, P = 0.039, respectively). Four patients in the urolithiasis group underwent surgery. Three patients could not receive extracorporeal shock wave lithotripsy due to the risk of bleeding from the AML, and therefore underwent transurethral lithotripsy. If urolithiasis is comorbid with TSC-associated AML, the treatment options are more limited in cases with multiple AMLs around the stone due to an increased risk of hemorrhage. Prevention and early detection of urolithiasis are beneficial to patients with TSC.
Matrine protects retinal ganglion cells from apoptosis in experimental optic neuritis
Authors: Kang Jian , Liu Shu-Qing , Song Yi-Fan , Wang Meng-Ru , Chu Yao-Juan , Shi Ya-Min , Zhang Feng-Yan , Wu Hongyang , Zhu Lin 
Published: August 2019

Abstract
Background: Inflammatory demyelination and axonal injury of the optic nerve are hallmarks of optic neuritis (ON), which often occurs in multiple sclerosis and is a major cause of blindness in young adults. Although a high dose of corticosteroids can promote visual recovery, it cannot prevent permanent neuronal damage. Novel and effective therapies are thus required. Given the recently defined capacity of matrine (MAT), a quinolizidine alkaloid derived from the herb Radix Sophorae flavescens, in immunomodulation and neuroprotection, we tested in this study the effect of matrine on ON in rats with experimental autoimmune encephalomyelitis, an animal model of multiple sclerosis. Results: MAT administration, started at disease onset, significantly suppressed optic nerve infiltration and demyelination, with reduced numbers of Iba1+ macrophages/microglia and CD4+ T cells, compared to those from vehicle-treated rats. Increased expression of neurofilaments, an axon marker, and decreased apoptosis in retinal ganglion cells (RGCs) were also observed after MAT treatment. Conclusions: Taken as a whole, our results demonstrate that MAT attenuated inflammation, demyelination and axonal loss in the optic nerve, and protected RGCs from inflammation-induced cell death. MAT may therefore have potential as a novel treatment for this disease that causes blindness.
Lymphocyte Count and Serum PCT L ev els Improve the Sensitivity of CURB-65 in Prediction of 30-day Mortality of Patients with Community-acquired Pneumonia
Authors: Zhang Jin , Tao Rui , Liu Pengcheng , Zhao Dahai , Xu Jiegou 
Published: August 2019

Abstract
Background Community-acquired pneumonia (CAP) is an infectious disease with high morbidity and mortality worldwide. The CURB-65 score and other blood biomarkers were used to evaluate prognosis of hospitalized patients with CAP. The aim of our study is t o evaluate the prognostic values of other blood biomarkers and the CURB-65 score in hospitalized patients with community-acquired pneumonia (CAP). Methods A retrospective study of clinical data of in-hospitalized adult CAP patients who fulfilled the CAP criteria and were admitted to the Second Affiliated Hospital of Anhui medical university between January 2015 and December 2018 was conducted. The CURB-65 score was calculated, and other biomarkers including blood lymphocyte countat and serum PCT (a propeptide of calcitonin) level were collected at enrolment. Logistic regression analysis was performed to develop combined models to predict 30-day mortality in overall hospitalized and/or the ICU admission of CAP patients. Then, receiver operating characteristics curve (ROC) analysis was conducted to measure and compare the prognostic values of the CURB-65 score and biomarkers in the combined models.Results The ROC curve analysis using logistic regression of the new combined models showed that the CURB-65 score combined with lymphocyte count and serum PCT level (designated as CURB-65L P) improved the predictive value and was sensitive diagnostic model in predicting the 30-day mortality of CAP patients.Conclusion Serum level of lymphocytes or PCT alone is a strong prognostic factor for evaluation of 30-day mortality of CAP patients. Incorporation of both factors improves the sensitivity of the CURB-65 scoring system in the prediction of the 30-day mortality. This new CURB-65LP scoring system is simple, but more accurate for evaluating the severity of CAP with higher sensitivity and specificity than the current CURB-65 scoring system.
Analysis of CYP2J2 polymorphisms in the Chinese Uyghur population
Authors: Jin Tianbo , Bai Mei , He Yongjun , Wang Li , Li Shanqu , Yan Dongya 
Published: August 2019

Abstract
Background: Genetic characteristics of CYP2J2 in different populations may be helpful to explore inter-ethnic variability in drug response and disease susceptibility. There is no information about the genetic profile of CYP2J2 in the Chinese Uygur population.Methods: We used PCR and direct sequencing to investigate the whole CYP2J2 in 100 unrelated healthy individuals of Chinese Uygur populations. Chi-square test was used to compare genotyping data of CYP2J2 in the Chinese Uygur population with other races. The SIFT and PolyPhen-2 online tools were used to predict the protein function of the novel non-synonymous mutations in CYP2J2. The CADD software was used to predict pathogenicity for mutations.Results: We detected twenty-eight polymorphisms in the CYP2J2, including five new mutations, three alleles (*1, *7 and *8), and three genotypes (*1/*1, *1/*7 and *1/*8) of CYP2J2 in Chinese Uyghur population. The allele frequencies of CYP2E1*1, *7 and *8 were 96%, 3.45%, and 0.5%, respectively. Interethnic comparison found that *1 was significantly higher than Taiwanese and African-Americans; and*7 was relatively lower when compared with Taiwanese and African-Americans (p < 0.05). Furthermore, the protein prediction results revealed that the five non-synonymous mutations could influence the protein structure and function.Conclusion: The observations of this study give rise to useful information on CYP2J2 polymorphisms in Chinese Uygur individuals. We hope the results will indicate important clinical implications for the use of medications metabolized by CYP2J2.