bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smart Pumps Improve Medication Safety but Increase Alert Burden in Neonatal Care
Authors: Melton Kristin , Timmons Kristen , Walsh Kathleen E , Meinzen-Derr Jareen K , Kirkendall Eric 
Published: August 2019

Abstract
Background: Smart pumps have been widely adopted but there is limited evidence to understand and support their use in pediatric populations. Our objective was to assess whether smart pumps are effective at reducing medication errors in the neonatal population and determine whether they are a source of alert burden and alert fatigue in an intensive care environment. Methods: Using smart pump records, over 370,000 infusion starts for continuously infused medications used in neonates and infants hospitalized in a level IV NICU from 2014-2016 were evaluated. Attempts to exceed preset soft and hard maximum limits, percent variance from those limits, and pump alert frequency, patterns and salience were evaluated. Results: Smart pumps prevented 160 attempts to exceed the hard maximum limit for doses that were as high as 7-29 times the maximum dose and resulted in the reprogramming or cancellation of 2093 infusions after soft maximum alerts. While the overall alert burden from smart pumps was not high, alerts clustered around specific patients and medications, and a small portion (17%) of infusions generated the majority of alerts. Soft maximum alerts were often overridden (79%), consistent with low alert salience. Conclusions: Smart pumps have the ability to improve neonatal medication safety when compliance with dose error reducing software is high. Numerous attempts to administer high doses were intercepted by dosing alerts. Clustered alerts may generate a high alert burden and limit safety benefit by desensitizing providers to alerts. Future efforts should address ways to improve alert salience.
Surgical Workflow Simulation for the Design and Assessment of Operating Room Setups in Orthopedic Surgery
Authors: Neumann Juliane , Angrick Christine , Höhn Celina , Zajonz Dirk , Ghanem Mohamed , Roth Andreas , Neumuth Thomas 
Published: August 2019

Abstract
Background The design and internal layout of modern operating rooms are influencing the team’s collaboration and communication, ergonomics, as well as intraoperative hygiene substantially. Nevertheless, there is no objective method for the assessment and design of the personnel and table positions for different surgical disciplines and intervention types available. The aim of this work is to establish an optimal OR setup for common procedures in arthroplasty.Methods With the help of computer simulation techniques, a method for the objective design and assessment of optimal OR setups was developed. In this work, new OR setups were designed, analyzed in a computer simulation environment and evaluated in the actual intraoperative setting.Results It was shown that the implementation of an optimized OR setup reduces the intraoperative instrument handover time between the surgeon and the scrub nurse, the travel paths of the OR team as well as shorten the procedure duration. Additionally, the ergonomics of the OR staff could be improved.Conclusion The developed simulation method was intraoperatively evaluated and proved its benefit for the design and optimization of OR setups for different surgical intervention types. As a clinical result, optimized setups for total knee arthroplasty and total hip arthroplasty surgeries were established in daily clinical routine and the OR efficiency was improved.
Effectiveness of HPV vaccination against the development of high grade cervical lesions in young Japanese women
Authors: Shiko Yuki , Konno Ryo , Konishi Hiroshi , Sauvaget Catherine , Ohashi Yasuo , Kakizoe Tadao 
Published: August 2019

Abstract
Background Although more than 8 years have passed since HPV vaccination was implemented first, as an interim programme (Emergent vaccine promotion programme) in November 2010, followed by incorporating into the National Immunization Programme in April, 2013 and suspended in June 2013, limited studies have investigated the HPV vaccine effectiveness against high-grade cervical lesions in Japan. Methods We collected the matched data of the results of cervical biopsy and history of vaccination from the Japan Cancer Society database. The subjects were women aged 20 to 29 years screened for cervical cancer between April, 2015 and March, 2017, and with information on HPV vaccination status. We estimated the relative risk of developing high-grade cervical lesions in a vaccinated group using Poisson regression as compared to an unvaccinated group. Results Among the 34,281 women screened, 3,770 (11.0%) were vaccinated. The prevalence of CIN2+ was significant lower in the vaccinated women as compared to the unvaccinated women (Vaccine Effectiveness (VE) =76%; RR=0.24, 95% CI:0.10-0.60). High VE against CIN3+ was also observed (91%; RR=0.09, 95% CI:0.00-0.42). Conclusion Women aged 20–29 years who received at least one dose of HPV vaccine had a significantly lower risk of high-grade cervical lesions than those not vaccinated. In Japan, HPV vaccination should be resumed in order to reduce the incidence of cervical cancer.
How heterogeneous are MSM from Brazilian cities? An analysis of sexual behavior and perceived risk and a description of trends in awareness and willingness to use PrEP
Authors: Torres Thiago S , Marins Luana M. S. , Veloso Valdilea G. , Grinsztejn Beatriz , Luz Paula M. 
Published: August 2019

Abstract
Background Brazil has the largest population of individuals living with HIV/AIDS in Latin America, with a disproportional prevalence of infection among gays, bisexuals and other men who have sex with men (MSM). Of relevance to prevention and treatment efforts, Brazilian MSM from different regions may differ in behaviors and risk perception related to HIV.Methods We report on MSM living in 29 different cities: 26 Brazilian state capitals, the Federal District and two large cities in São Paulo state assessed in three web-based surveys (2016-2018) advertised on Grindr, Hornet and Facebook. Using logistic regression models, we assessed factors associated with high-risk behavior and high HIV perceived risk.Results A total of 16,667 MSM completed the survey. Overall, MSM from the North and Northeast were younger, more black/mixed-black, of lower income and lower education compared to MSM from the South, Southeast and Central-west. Though 17% had never tested for HIV (with higher percentages in the North and Northeast), condomless receptive anal sex (previous 6 months) and high-risk behavior as per HIV Incidence Risk scale for MSM were observed for 41% and 64%, respectively. Sexual behaviors and HIV perceived risk had low variability by city. Younger age, being gay/homosexual, having a steady partner, binge drinking, report of STI and ever testing for HIV increased the odds of high-risk behavior. In contrast, younger age and having a steady partner decreased the odds of high HIV perceived risk, while report of STI most strongly increased the odds of high HIV perceived risk. All variables that serve as proxies for low socio-economic status (black/mixed-black race, low income and low education) were associated with increased odds of high HIV perceived risk. Awareness and willingness to use PrEP increased from 2016 to 2018 in most cities.Conclusions Overall, MSM socio-demographic characteristics were heterogeneous among Brazilian cities, but similarities were noted among the cities from the same administrative region with a marked exception of the Federal District not following the patterns for the Central-West. The observed dissonance between sexual behavior and HIV perceived risk may be a barrier to effective PrEP implementation.
DNA methylomes and transcriptomes analysis reveal implication of host DNA methylation machinery in BmNPV proliferation in Bombyx mori
Authors: Huang Haoling , Wu Ping , Zhang Shaolun , Shang Qi , Yin Haotong , Hou Qirui , Zhong Jinbo , Guo Xijie 
Published: August 2019

Abstract
Background

Bombyx mori nucleopolyhedrosis virus (BmNPV) is a major pathogen that threatens the sustainability of the sericultural industry. DNA methylation is a widespread gene regulation mode in epigenetics, which plays an important role in host immune response. Until now, little has been known about epigenetic regulation on virus diseases in insects. This study aims to explore the role of DNA methylation in BmNPV proliferation.Results

Inhibiting DNA methyltransferase (DNMT) activity of silkworm can suppress BmNPV replication. The integrated analysis of transcriptomes and DNA methylomes in silkworm midguts infected with or without BmNPV showed that both the expression pattern of transcriptome and DNA methylation pattern are changed significantly upon BmNPV infection. A total of 291 differentially methylated genes (DMGs) were observed in BmNPV infected midguts, among which, 126 genes were hypermethylated and 115 genes were hypomethylated. Significant differences in both mRNA transcript level and DNA methylated levels were found in 26 genes. BS-PCR validated the hypermethylation of BGIBMGA014008 , a structural maintenance of chromosomes protein gene in the BmNPV-infected midgut. In addition, DNMT inhibition reduced the expression of inhibitor of apoptosis family genes, iap1 from BmNPV, Bmiap2, BmSurvivin1 and BmSurvivin2 .Conclusion

Our results indicate that DNA methylation plays positive roles in BmNPV proliferation and loss of DNMT activity could induce the apoptosis of infected cells to suppress BmNPV proliferation. Our results may provide a new idea and research direction for the molecular mechanism on insect-virus interaction.
The Application of Enhanced Recovery after Surgery for Upper Gastrointestinal Surgery: Meta-Analysis
Authors: Huang Zhen-Dong , Gu Hui-Yun , Zhu Jie , Luo Jie , Shen Xian-Feng , Deng Qi-Feng , Zhang Chao , Li Yan-Bing 
Published: August 2019

Abstract
Background: Although enhanced recovery after surgery (ERAS) has made great progress in the field of surgery, the guidelines point to the lack of high-quality evidence in upper gastrointestinal surgery. Methods: Randomized controlled trials in four electronic databases that involved ERAS protocols for upper gastrointestinal surgery were searched through December 12, 2018. The primary endpoints were lung infection, urinary tract infection, surgical site infection, postoperative anastomotic leakage and ileus. The secondary endpoints were postoperative length of stay, the time from end of surgery to first flatus and defecation, and readmission rates. Subgroup analysis was performed based on the type of surgery. Results: A total of 17 studies were included. The results of the meta-analysis indicate that there was a decrease in rates of lung infection (RR =0.50, 95%CI: 0.33 to 0.75, P <0.01), PLOS (MD =-2.53, 95%CI: -3.42 to -1.65, P <0.01), time until first postoperative flatus (MD =-0.64, 95%CI: -0.84 to -0.45, P <0.01) and time until first postoperative defecation (MD =-1.10, 95%CI: -1.74 to -0.47, P <0.01) in patients who received ERAS, compared to conventional care. However, other outcomes were no significant difference. There was no significant difference between ERAS and conventional care in rates of urinary tract infection (P =0.10), surgical site infection (P =0.42), postoperative anastomotic leakage (P =0.45), readmissions (P =0.31) and ileus (P =0.25). Conclusions: ERAS protocols can reduce the risk of postoperative infection and accelerating patient recovery time. Nevertheless, we should also consider further research ERAS should be performed in elderly patients undergoing gastrectomy.
Profiling of inflammatory mediators in the synovial fluid related to pain in knee osteoarthritis
Authors: Li Li , Li Zhenxing , Li Yuyan , Hu Xi , Zhang Yu , Fan Pei 
Published: August 2019

Abstract
Background: Inflammatory mediators in the synovial fluid (SF) play critical roles in the initiation and development of pain in knee osteoarthritis (KOA). However, the expression of inflammatory mediators is controversial and the role of SF inflammatory mediators in neuropathic pain is not clear. Therefore, the aim of this study is to identify the SF inflammatory mediators associated with nociceptive and neuropathic pain in KOA. Methods: The levels of IL-1β, IL-6, TNF-α, macrophage colony-stimulating factor, MMP-3, MMP-13, metalloproteinase with thrombospondin motifs 5, calcitonin gene-related peptide, neuropeptide Y, substance P and bradykinin were measured in 86 patients using enzyme-linked immunosorbent assays. Nociceptive pain was measured using the numeric rating scale (NRS), visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score. Neuropathic pain was measured using the PainDETECT questionnaire. Moreover, knee function was evaluated by the WOMAC score and range of motion (ROM) assessments. Radiological grade was defined using the Kellgren-Lawrence (K-L) grading scale. Results: Pain scores measured using different methods were highly correlated to each other. The worse the pain, the worse the K-L grade and knee function were. The expression of IL-1β and IL-6 was increased in the early stage compared with the late stage. The NRS was positively correlated to age, K-L grade, and the WOMAC score and negatively correlated to ROM and TNF-α expression. The VAS was positively correlated to age, K-L grade, and the WOMAC score but negatively correlated to ROM and the levels of IL-1β, IL-6 and TNF-α. The WOMAC pain score was not correlated to any of the measured inflammatory mediators; it correlated to only ROM. The PainDETECT score correlated to only the WOMAC score. The expression of other inflammatory mediators was not correlated to any of the pain scores. Conclusions: IL-1β, IL-6 and TNF-α play critical roles in pain in the early stage of KOA and correlated to pain. The measured catabolic enzymes and neuropeptides are not correlated to nociceptive and neuropathic pain. New biomarkers related to pain in the late stage need to be further investigated.
Respectful family planning service provision in Sidama zone, Southern Ethiopia
Authors: Siyoum Melese , Astatkie Ayalew , Melese Teshome , Tenaw Zelalem , Abeje Abebaw , Roosevelt Lee 
Published: August 2019

Abstract
Introduction Disrespect and abusive care is a violation of women’s basic human rights and it is serious global problem that needs urgent intervention. In Ethiopia disrespect and abusive care is very common (21-78%) across health facilities. Objective To assess the status of respectful family planning service in Sidama zone, south Ethiopia. Methodology Health facility-based cross-sectional study was conducted from June to August 2018. Data were collected from 920 family planning clients’ recruited from 40 randomly selected health facilities. The Mother on Respect index (MORi) questionnaire was used to collect the data through client exit interview. Partial proportional odds ordinal regression was employed to identify determinants of respectful family planning service. Result The level of respectful family planning service was found to be: Zero (0%) in the very low respect category, 75(18.5%) low respect, 382(41.52%) moderate respect and 463(50.33%) high respect. Being a short acting method client (AOR=0.3, 95%CI [0.12, 0.72]), participants’ level of education (uneducated (AOR=0.39, 95%CI [0.25, 0.61), elementary (AOR=0.41, 95%CI [0.23, 0.73]), low income(AOR=0.75, 95%CI [0.56, 0.99]), long waiting time (AOR=0.46, 95%CI [0.30, 0.69]), were negatively associated with moderate and high respect compared to low respect. Preference of male service providers (AOR=2, 95%CI [1.1, 3.8]), service providers’ work satisfaction (AOR=1.55, 95%CI [1.13, 2.14]) and health workers’ prior training on respectful care (AOR=8.75, 95%CI [4.61, 16.61]) were positively associated. Being a client of short acting contraceptives (AOR=2.1, 95%CI [1.42, 3.12]), preference of male service providers (AOR=0.55, 95%CI [0.4, 0.76]) and health workers’ prior training on respectful care (AOR=3.03, 95%CI [2.24, 4.1]) had significant association with high respect compared to low and moderate respect. Conclusion Considering the current strategy of zero tolerance for disrespect in Ethiopia, the level of respectful care in this study is sub-optimal. We recommend community awareness and short term training for service providers.
Acumulação, Distribuição e Estratégia sob Mao
Authors: Nogueira Isabela 
Published: August 2019

O objetivo deste artigo é expor e sistematizar os principais paradoxos do regime de acumulação chinês, entre 1949 e 1976, a fim de traçar as linhas gerais do legado maoísta para o desenvolvimento recente da China. Problematiza-se, assim, a narrativa dominante de que o boom econômico chinês se inicia apenas a partir das reformas pós-1978, que teriam rompido com um suposto profundo atraso econômico durante as décadas sob Mao. Neste artigo, argumenta-se que o período maoísta é marcado por grandes paradoxos, que deixaram um legado determinante para a atual trajetória da China, dentre os quais exploraremos: o rápido processo de industrialização e transformação estrutural sem urbanização; a estratégia militar para a guerra, que levou a industrialização para regiões remotas do país, mas sem especialização ou autonomia produtiva; a melhora nos indicadores de bem-estar com concomitante estagnação na produtividade agrícola e consolidação do gap urbano-rural.
Characteristics of domestic wastewater and estimation of required johkasou capacity for buildings in Japan
Authors: Kumokawa S. , Shirakawa Y. , Flamand P. 
Published: August 2019

Abstract
Quantity and quality of raw domestic wastewater are reviewed and discussed for packaged plants, known as johkasou, in Japan. A method for the estimation of johkasou capacity in terms of population equivalent, or PE, was introduced and discussed in this paper. It was found that the pollutant loads of domestic wastewater were respectively BOD 45 g, CODMn 23 g, SS 37 g, TN 9.3 g and TP 1.1 g per capita per day on average. It shows that the BOD load of wastewater from kitchens is higher than that of black water. The estimation of the johkasou capacity needed for buildings can be done using a series of formulas, which forms an important estimation method for the implementation of on-site wastewater treatment.
Removal of sulfonamide antibiotics from water by high-silica ZSM-5
Authors: Zuo Xingtao , Qian Cheng , Ma Senlin , Xiong Juan , He Jiajie , Chen Zhongbing 
Published: August 2019

Abstract
Adsorption characteristics of high-silica zeolites (HSZSM-5) for two selected sulfonamide antibiotics (SAs) (sulfamethoxazole and sulfadiazine) were investigated. The SAs were almost completely (&gt;90%) removed from the water by HSZSM-5. Adsorption followed second-order kinetics with liquid–film diffusion as the dominant mechanism. SA adsorption capacity on high-silica zeolites was examined in terms of pH, temperature, and the presence of natural organic matter (NOM). HSZSM-5 had better adsorption performance in acidic conditions, and the apparent distribution coefficient indicated that SA0 species were the major contribution to the overall adsorption at pH of 2–10. Adsorption of SAs on HSZSM-5 was a spontaneous and exothermic physisorption process. SA removal by HSZSM-5 was a mixed mechanism through ion-exchange and hydrophobic interaction. HSZSM-5 has potential application prospects in removing SAs from wastewater.
Molecular Mechanisms of Complement System Proteins and Matrix Metalloproteinases in the Pathogenesis of Age-Related Macular Degeneration
Authors: Mansoor Naima , Wahid Fazli , Azam Maleeha , Shah Khadim , den Hollander Anneke I. , Qamar Raheel , Ayub Humaira 
Published: August 2019

:Age-related macular degeneration (AMD) is an eye disorder affecting predominantly the older people above the age of 50 years in which the macular region of the retina deteriorates, resulting in the loss of central vision. The key factors associated with the pathogenesis of AMD are age, smoking, dietary, and genetic risk factors. There are few associated and plausible genes involved in AMD pathogenesis. Common genetic variants (with a minor allele frequency of >5% in the population) near the complement genes explain 40–60% of the heritability of AMD. The complement system is a group of proteins that work together to destroy foreign invaders, trigger inflammation, and remove debris from cells and tissues. Genetic changes in and around several complement system genes, including the CFH, contribute to the formation of drusen and progression of AMD. Similarly, Matrix metalloproteinases (MMPs) that are normally involved in tissue remodeling also play a critical role in the pathogenesis of AMD. MMPs are involved in the degradation of cell debris and lipid deposits beneath retina but with age their functions get affected and result in the drusen formation, succeeding to macular degeneration. In this review, AMD pathology, existing knowledge about the normal and pathological role of complement system proteins and MMPs in the eye is reviewed. The scattered data of complement system proteins, MMPs, drusenogenesis, and lipofusogenesis have been gathered and discussed in detail. This might add new dimensions to the understanding of molecular mechanisms of AMD pathophysiology and might help in finding new therapeutic options for AMD.
The Application of the RNA Interference Technologies for KRAS: Current Status, Future Perspective and Associated Challenges
Authors: Shao Yu-Ting , Ma Li , Zhang Tie-Hui , Xu Tian-Rui , Ye Yuan-Chao , Liu Ying 
Published: August 2019

:
KRAS is a member of the murine sarcoma virus oncogene-RAS gene family. It plays an important
role in the prevention, diagnosis and treatment of tumors during tumor cell growth and angiogenesis.
KRAS is the most commonly mutated oncogene in human cancers, such as pancreatic cancers,
colon cancers, and lung cancers. Detection of KRAS gene mutation is an important indicator for tracking
the status of oncogenes, highlighting the developmental prognosis of various cancers, and the efficacy
of radiotherapy and chemotherapy. However, the efficacy of different patients in clinical treatment
is not the same. Since RNA interference (RNAi) technologies can specifically eliminate the expression
of specific genes, these technologies have been widely used in the field of gene therapy for exploring
gene function, infectious diseases and malignant tumors. RNAi refers to the phenomenon of highly specific
degradation of homologous mRNA induced by double-stranded RNA (dsRNA), which is highly
conserved during evolution. There are three classical RNAi technologies, including siRNA, shRNA and
CRISPR-Cas9 system, and a novel synthetic lethal interaction that selectively targets KRAS mutant cancers.
Therefore, the implementation of individualized targeted drug therapy has become the best choice
for doctors and patients. Thus, this review focuses on the current status, future perspective and associated
challenges in silencing of KRAS with RNAi technology.