bluuebunny/crossref_metadata_2025_split huggingface dataset:
Who do we discharge from renal clinic and what does it mean for primary care?
Authors: Pyart Rhodri , Lim Sheryl , Hussein Bilal , Riley Steve , Roberts Gareth 
Published: August 2019

Abstract

Background
It is unclear whether discharging patients from renal clinic to primary care is safe.

Aim
To determine the characteristics, primary care monitoring and renal outcomes of patients discharged from renal clinic.

Design and setting
A retrospective study of 2236 adults discharged from a tertiary renal clinic between 2013–2018.

Method
Patient demographics, primary renal disease, laboratory results and timeline dates were collected from the renal IT system. Timing of blood tests, renal progression, needing dialysis and patient survival were analysed. Reasons for discharge and cause of disease progression were reviewed in patients developing new estimated glomerular filtration rate <20 ml/min/1.73 m2.

Results
Patients were older (median age 75; interquartile range 63–84) with non-progressive, seemingly non-proteinuric renal disease. Median time to repeat blood test post-discharge was 75 days with 90% tested within 12 months. Sixty-six percent saw an improvement in kidney function post-discharge and only 13% had a decline of >10 ml/min/1.73 m2. Only 132 patients (6%) developed new advanced chronic kidney disease (estimated glomerular filtration rate < 20 ml/min/1.73 m2) of whom 40% were palliative, 36% had developed acute kidney injury and 23% discharged for failing to attend clinic. One hundred and thirty-four patients (6%) were referred back to nephrology and eight started dialysis of whom six were discharged for failure to attend clinic.

Conclusion
Most discharged patients are low risk of progressive renal disease and need infrequent monitoring. Non-adherent patients discharged for failing to attend appear to be at risk of poor outcomes and new strategies are needed to better support this population.
Deletion of JEN1 and ADY2 reduces lactic acid yield from an engineered Saccharomyces cerevisiae, in xylose medium, expressing a heterologous lactate dehydrogenase
Authors: Turner Timothy L , Lane Stephan , Jayakody Lahiru N , Zhang Guo-Chang , Kim Heejin , Cho Whiyeon , Jin Yong-Su 
Published: August 2019

ABSTRACT
Microorganisms have evolved to produce specific end products for many reasons, including maintaining redox balance between NAD+ and NADH. The yeast Saccharomyces cerevisiae, for example, produces ethanol as a primary end product from glucose for the regeneration of NAD+. Engineered S. cerevisiae strains have been developed to ferment lignocellulosic sugars, such as xylose, to produce lactic acid by expression of a heterologous lactate dehydrogenase (ldhA from Rhizopus oryzae) without genetic perturbation to the native ethanol pathway. Surprisingly, the engineered yeast strains predominantly produce ethanol from glucose, but produce lactic acid as the major product from xylose. Here, we provide initial evidence that the shift in product formation from ethanol to lactic acid during xylose fermentation is at least partially dependent on the presence of functioning monocarboxylate transporter genes/proteins, including JEN1 and ADY2, which are downregulated and unstable in the presence of glucose, but upregulated/stable on xylose. Future yeast metabolic engineering studies may find the feedstock/carbon selection, such as xylose, an important step toward improving the yield of target end products.
Older Adults' Perceptions of Sedentary Behavior: A Systematic Review and Thematic Synthesis of Qualitative Studies
Authors: Compernolle Sofie , De Cocker Katrien , Cardon Greet , De Bourdeaudhuij Ilse , Van Dyck Delfien 
Published: August 2019

Abstract

Background and Objectives
Reducing sedentary behavior contributes to healthy aging. In order to develop sedentary behavior interventions, insight is needed into older adults' perceptions of (reducing) sedentary behavior. Therefore, this systematic review aims to synthesize qualitative evidence of older adults' perceptions towards (a) the concept of sedentary behavior, (b) barriers and facilitators of sedentary behavior, and (c) solutions and strategies to reduce sedentary behavior.

Research Design and Methods
A systematic search was conducted in four electronic databases. Inclusion criteria comprised qualitative and mixed-methods studies investigating the perceptions of older adults (mean age: ≥60 years) towards (reducing) sedentary behavior. Quality of the included studies was rated using the Critical Appraisal Skills Programme (CASP) Qualitative Checklist. Relevant data on older adults' perceptions were extracted and imported into NVivo. Two independent reviewers analyzed the data by means of thematic synthesis (line-by-line coding, constructing descriptive (sub)themes, developing analytical themes).

Results
Fifteen studies were included. Four analytical themes were developed to be considered when aiming to reduce sedentary behavior in older adults: the lack of knowledge on/awareness of sedentary behavior, the habitual nature of sedentary behavior, the importance of enjoyment and convenience, and the key role of aging.

Discussion and Implications
The reduction of older adults' sedentary behavior will likely be challenging as sedentary behavior seems to be firmly incorporated into older adults' daily routines, and strongly linked with positive reinforcement. Both aspects deserve thoughtful attention by intervention developers and health care professionals who aim to promote healthy aging by reducing sedentary behavior.
Aortic root remodelling with external ring annuloplasty in acute type A aortic dissection
Authors: Kato Yasuyuki , Sasaki Kenichi , Yamauchi Hidetaka , Kanno Yasuyuki , Jinno Taiyo , Yamada Muneaki , Kiyama Hiroshi , Koyanagi Toshiya 
Published: August 2019

Abstract

OBJECTIVES
To investigate the early and mid-term results of aortic root remodelling with external ring annuloplasty in acute type A aortic dissection.

METHODS
From January 2015 to April 2019, a total of 194 patients underwent emergency or urgent operation for acute type A aortic dissection in our hospital. Of these, outcomes in 18 patients who underwent valve-sparing aortic root remodelling with external ring annuloplasty were retrospectively evaluated.

RESULTS
The mean age of the 18 patients was 49 ± 14 years. Fourteen patients (78%) were men. Five patients had Marfan syndrome and 2 patients had bicuspid aortic valve. Two patients had coronary malperfusion and 1 patient had cerebral malperfusion. All 18 patients underwent aortic root remodelling with external ring annuloplasty. Cusp repair using central cusp plication was required in 9 patients. Concomitant procedures were hemiarch replacement in 8 patients, total arch replacement in 7 patients, partial arch replacement in 1 patient and coronary artery bypass grafting to the right coronary artery in 3 patients. Thirty-day mortality rate was 5.6% (1 of 18). Postoperative echocardiography showed aortic regurgitation of &lt;1+ in all patients. During follow-up (mean 56 ± 41 months), 1 case of recurrent aortic regurgitation required aortic valve replacement.

CONCLUSIONS
Aortic root remodelling with external ring annuloplasty may be an appropriate treatment in middle-aged or younger patients presenting with acute type A aortic dissection.
(R)-Ketamine Rapidly Ameliorates the Decreased Spine Density in the Medial Prefrontal Cortex and Hippocampus of Susceptible Mice After Chronic Social Defeat Stress
Authors: Zhang Jiancheng , Qu Youge , Chang Lijia , Pu Yaoyu , Hashimoto Kenji 
Published: August 2019

AbstractBackgroundA recent study demonstrated that spine formation rates by ketamine in the prefrontal cortex (PFC) were not altered at 3–6 h following a single injection, but were markedly altered at 12–24 h. Here, we investigated the acute (3 h post-treatment) effects of (R)-ketamine in the decreased spine density in the medial PFC (mPFC) and hippocampus in susceptible mice after chronic social defeat stress (CSDS).Methods(R)-ketamine (10 mg/kg) or saline was administered intraperitoneally to CSDS-susceptible mice. Dendritic spine density in the mPFC and hippocampus was measured 3 h after a single injection.Results(R)-ketamine significantly ameliorated the decreased spine density in the prelimbic area of mPFC, Cornu Ammonis3, and dentate gyrus of the hippocampus of CSDS-susceptible miceConclusionsThis study suggests that (R)-ketamine rapidly ameliorates the decreased spine density in the mPFC and hippocampus of CSDS-susceptible mice, resulting in its rapid-acting antidepressant effects.
Lessons for test and treat in an antiretroviral programme after decentralisation in Uganda: a retrospective analysis of outcomes in public healthcare facilities within the Lablite project
Authors: Kiwuwa-Muyingo S , Abongomera G , Mambule I , Senjovu D , Katabira E , Kityo C , Gibb D M , Ford D , Seeley J 
Published: August 2019

Abstract

Background
We describe the decentralisation of antiretroviral therapy (ART) alongside Option B+ roll-out in public healthcare facilities in the Lablite project in Uganda. Lessons learned will inform programmes now implementing universal test and treat (UTT).

Methods
Routine data were retrospectively extracted from ART registers between October 2012 and March 2015 for all adults and children initiating ART at two primary care facilities (spokes) and their corresponding district hospitals (hubs) in northern and central Uganda. We describe ART initiation over time and retention and use of Cox models to explore risk factors for attrition due to mortality and loss to follow-up. Results from tracing of patients lost to follow-up were used to correct retention estimates.

Results
Of 2100 ART initiations, 1125 were in the north, including 944 (84%) at the hub and 181 (16%) at the spokes; children comprised 95 (10%) initiations at the hubs and 14 (8%) at the spokes. Corresponding numbers were 642 (66%) at the hub and 333 (34%) at the spokes in the central region (77 [12%] and 22 [7%], respectively, in children). Children &lt;3 y of age comprised the minority of initiations in children at all sites. Twenty-three percent of adult ART initiations at the north hub were Option B+ compared with 45% at the spokes (25% and 65%, respectively, in the central region). Proportions retained in care in the north hub at 6 and 12 mo were 92% (95% CI 90 to 93) and 89% (895% CI 7 to 91), respectively. Corresponding corrected estimates in the north spokes were 87% (95% CI 78 to 93) and 82% (95% CI 72 to 89), respectively. In the central hub, corrected estimates were 84% (95% CI 80 to 87) and 78% (95% CI 74 to 82), and were 89% (95% CI 77.9 to 95.1) and 83% (95% CI 64.1 to 92.9) at the spokes, respectively. Among adults newly initiating ART, being older was independently associated with a lower risk of attrition (adjusted hazard ratio [aHR] 0.93 per 5 y [95% CI 0.88 to 0.97]). Other independent risk factors included initiating with a tenofovir-based regimen vs zidovudine (aHR 0.60 [95% CI 0.46 to 0.77]), year of ART initiation (2013 aHR 1.55 [95% CI 1.21 to 1.97], ≥2014 aHR 1.41 [95% CI 1.06 to 1.87]) vs 2012, hub vs spoke (aHR 0.35 [95% CI 0.29 to 0.43]) and central vs north (aHR 2.28 [95% CI 1.86 to 2.81]). Independently, patient type was associated with retention.

Conclusions
After ART decentralisation, people living with human immunodeficiency virus (HIV) were willing to initiate ART in rural primary care facilities. Retention on ART was variable across facilities and attrition was higher among some groups, including younger adults and women initiating ART during pregnancy/breastfeeding. Interventions to support these groups are required to optimise benefits of expanded access to HIV services under UTT.
A Growing Queer Divide: The Divergence between Transnational Advocacy Networks and Foreign Aid in Diffusing LGBT Policies
Authors: Velasco Kristopher 
Published: August 2019

AbstractDespite years of success, lesbian, gay, bisexual, and transgender (LGBT) norms are becoming increasingly polarized across the global landscape—with some countries strongly complying with new expectations while others openly defy them. To explain these divergent paths, I investigate the transmission of global LGBT norms via two mechanisms: transnational advocacy networks and foreign aid conditionalities. In examining LGBT policy adoption across 110 non-Organisation for Economic Co-operation and Development (OECD) countries between 1990 and 2016, I find evidence that the process through which states are exposed to LGBT norms can indeed help explain these different approaches. Exposure to LGBT norms through transnational advocacy networks enhances the effect of these norms and is associated with more progressive policy adoption, while greater dependence on foreign aid pushes states to reject LGBT norms. Consequently, this study provides new insights into how the mechanism through which countries are exposed to norms shapes compliance and adds new evidence questioning the effectiveness of foreign aid as a tool to advance LGBT rights.
Cephalosporin nitric oxide-donor prodrug DEA-C3D disperses biofilms formed by clinical cystic fibrosis isolates of Pseudomonas aeruginosa
Authors: Soren Odel , Rineh Ardeshir , Silva Diogo G , Cai Yuming , Howlin Robert P , Allan Raymond N , Feelisch Martin , Davies Jane C , Connett Gary J , Faust Saul N , Kelso Michael J , Webb Jeremy S 
Published: August 2019

AbstractObjectivesThe cephalosporin nitric oxide (NO)-donor prodrug DEA-C3D (‘DiEthylAmin-Cephalosporin-3′-Diazeniumdiolate’) has been shown to initiate the dispersal of biofilms formed by the Pseudomonas aeruginosa laboratory strain PAO1. In this study, we investigated whether DEA-C3D disperses biofilms formed by clinical cystic fibrosis (CF) isolates of P. aeruginosa and its effect in combination with two antipseudomonal antibiotics, tobramycin and colistin, in vitro.Methodsβ-Lactamase-triggered release of NO from DEA-C3D was confirmed using a gas-phase chemiluminescence detector. MICs for P. aeruginosa clinical isolates were determined using the broth microdilution method. A crystal violet staining technique and confocal laser scanning microscopy were used to evaluate the effects of DEA-C3D on P. aeruginosa biofilms alone and in combination with tobramycin and colistin.ResultsDEA-C3D was confirmed to selectively release NO in response to contact with bacterial β-lactamase. Despite lacking direct, cephalosporin/β-lactam-based antibacterial activity, DEA-C3D was able to disperse biofilms formed by three P. aeruginosa clinical isolates. Confocal microscopy revealed that DEA-C3D in combination with tobramycin produces similar reductions in biofilm to DEA-C3D alone, whereas the combination with colistin causes near complete eradication of P. aeruginosa biofilms in vitro.ConclusionsDEA-C3D is effective in dispersing biofilms formed by multiple clinical isolates of P. aeruginosa and could hold promise as a new adjunctive therapy to patients with CF.
Is the subcutaneous route an alternative for administering ertapenem to older patients? PHACINERTA study
Authors: Roubaud Baudron Claire , Legeron Rachel , Ollivier Julien , Bonnet Fabrice , Greib Carine , Guerville Florent , Cazanave Charles , Kobeh David , Cressot Véronique , Moneger Nicolas , Videau Marie-Neige , Thiel Elise , Foucaud Carine , Lafargue Aurélie , de Thezy Albane , Durrieu Jessica , Bourdel Marchasson Isabelle , Pinganaud Geneviève , Breilh Dominique 
Published: August 2019

Abstract

Background
Antibiotic administration by subcutaneous (SC) injection is common practice in French geriatric wards as an alternative to the intravenous (IV) route, but few pharmacokinetic/pharmacodynamic data are available. Ertapenem is useful for the treatment of infections with ESBL-producing enterobacteria.

Objectives
To report and compare ertapenem pharmacokinetic data between IV and SC routes in older persons.

Methods
Patients >65 years of age receiving ertapenem (1 g once daily) for at least 48 h (IV or SC, steady-state) were prospectively enrolled. Total ertapenem concentrations [residual (C0), IV peak (C0.5) and SC peak (C2.5)] were determined by UV HPLC. Individual-predicted AUC0–24 values were calculated and population pharmacokinetic analyses were performed. Using the final model, a Monte Carlo simulation involving 10 000 patients evaluated the influence of SC or IV administration on the PTA. Tolerance to ertapenem and recovery were also monitored. ClinicalTrials.gov identifier: NCT02505386.

Results
Ten (mean ± SD age=87±7 years) and 16 (age=88±5 years) patients were included in the IV and SC groups, respectively. The mean C0 and C2.5 values were not significantly different between the IV and SC groups (C0=12±5.9 versus 12±7.4 mg/L, P=0.97; C2.5=97±42 versus 67±41 mg/L, P=0.99). The mean C0.5 was higher in the IV group compared with the SC group (C0.5=184±90 versus 51±66 mg/L, P=0.001). The mean individual AUCs (1126.92±334.99 mg·h/L for IV versus 1005.3±266.0 mg·h/L for SC, P=0.38) and PTAs were not significantly different between groups. No severe antibiotic-related adverse effects were noted.

Conclusions
SC administration of ertapenem is an alternative to IV administration in older patients.
Leaf: an open-source, model-agnostic, data-driven web application for cohort discovery and translational biomedical research
Authors: Dobbins Nicholas J , Spital Clifford H , Black Robert A , Morrison Jason M , de Veer Bas , Zampino Elizabeth , Harrington Robert D , Britt Bethene D , Stephens Kari A , Wilcox Adam B , Tarczy-Hornoch Peter , Mooney Sean D 
Published: August 2019

Abstract

Objective
Academic medical centers and health systems are increasingly challenged with supporting appropriate secondary use of clinical data. Enterprise data warehouses have emerged as central resources for these data, but often require an informatician to extract meaningful information, limiting direct access by end users. To overcome this challenge, we have developed Leaf, a lightweight self-service web application for querying clinical data from heterogeneous data models and sources.

Materials and Methods
Leaf utilizes a flexible biomedical concept system to define hierarchical concepts and ontologies. Each Leaf concept contains both textual representations and SQL query building blocks, exposed by a simple drag-and-drop user interface. Leaf generates abstract syntax trees which are compiled into dynamic SQL queries.

Results
Leaf is a successful production-supported tool at the University of Washington, which hosts a central Leaf instance querying an enterprise data warehouse with over 300 active users. Through the support of UW Medicine (https://uwmedicine.org), the Institute of Translational Health Sciences (https://www.iths.org), and the National Center for Data to Health (https://ctsa.ncats.nih.gov/cd2h/), Leaf source code has been released into the public domain at https://github.com/uwrit/leaf.

Discussion
Leaf allows the querying of single or multiple clinical databases simultaneously, even those of different data models. This enables fast installation without costly extraction or duplication.

Conclusions
Leaf differs from existing cohort discovery tools because it does not specify a required data model and is designed to seamlessly leverage existing user authentication systems and clinical databases in situ. We believe Leaf to be useful for health system analytics, clinical research data warehouses, precision medicine biobanks, and clinical studies involving large patient cohorts.
The Epidemiology of Burns in Children in Guatemala: A Single Center Report
Authors: Santiso Lourdes , Tapking Christian , Lee Jong O , Zapata-Sirvent Ramon , Pittelli Christine A , Suman Oscar E 
Published: August 2019

Abstract
Children in low- to middle-income countries are at high risk for sustaining severe burns. This study aimed to analyze the characteristics of pediatric burns in Guatemala that could help identify risk factors and guide prevention efforts. A retrospective review of the characteristics of patients < 18 years of age that were burned in Guatemala between 2015 and 2018 and treated at the Hospital Roosevelt Burn Unit in Guatemala City was performed. The medical records of 949 patients were reviewed (year 2015: 224, year 2016: 238, year 2017: 251, year 2018: 236). Mean age of the patients was 4.0 ± 3.6 years. Majority of the patients were male (54.2%) and suffered from scald burns (68.5%) due to spilling or falling into hot water. Children under the age of 9 years predominantly suffered from scald burns, whereas older children more frequently sustained flame burns. The mortality rate over the 4-year period was 5.2%. As in other low-income countries, pediatric burns in Guatemala are frequent and usually due to scald. Demographic characteristics have to be taken into account when developing strategies for improvements of prevention and treatment or transferring these from high-income countries. Especially education of parents and safety of daily tasks are crucial. Special attention and focusing of efforts in areas of higher incidence should be sought.
Exchange rate effects on cross-border commuting: evidence from the Swiss–Italian border
Authors: Bello Piera 
Published: August 2019

Abstract
Are cross-border workers responsive to changes in the exchange rate between the home and host countries’ currencies? I answer this question by examining the effects of the appreciation of the Swiss franc (CHF) relative to the euro (EUR) on labour supply decisions of Italian cross-border workers. I use hourly data on traffic flows in Ticino, the southernmost canton of Switzerland, together with three additional datasets (the Cross-border Commuter Statistics, the Swiss Earnings Structure Survey, and Google trend data). The results show that a 10% appreciation in the CHF increases the number of cars along the Swiss–Italian border by 1.6–2.7% more than in the rest of the canton. This effect is found only during specific time intervals, which differ according to the direction of traffic flow; specifically, from Italy to Switzerland in early morning, from Switzerland to Italy in the afternoon, and in both directions in late morning. Moreover, when the CHF is stronger, more people from Italy look for jobs in Ticino, and the number of cross-border workers increases in municipalities within a driving distance of up to 10 km from the border. Finally, additional evidence suggests that cross-border workers also react to the appreciation by increasing their number of hours worked.
Roundwood Use by Southern Wood Pellet Mills: Findings from Timber Product Output Mill Surveys
Authors: Brandeis Consuelo , Abt Karen Lee 
Published: August 2019

AbstractBetween 2012 and 2017, southern wood pellet exports grew by approximately 180 percent, whereas the regions’ wood pellet mill capacity increased from 3.8 to 7.7 million tons over the same period. This capacity and production growth generates concerns regarding impacts on resource sustainability and to traditional forest industries that use feedstocks similar to those used by pellet mills. Information on wood pellet producers’ patterns and levels of roundwood consumption can help evaluate the potential impacts of the industry on the forest resource. We use mill-level data collected by the USDA Forest Service Southern Research Station Forest Inventory and Analysis program to help characterize activity by southern wood pellet mills that consume roundwood. Our analysis shows that the volume of roundwood used for pellet production has increased, representing close to 2 percent of all southern timber products output and 27 percent of all industrial fuelwood output (excluding firewood) during 2015.