bluuebunny/crossref_metadata_2025_split huggingface dataset:
Users’ Acceptance of Electronic Patient Portals in Lebanon
Authors: Honein-AbouHaidar Gladys , Antoun Jumana , Badr Karim , Hlais Sani , Nazaretian Houry 
Published: August 2019

Abstract
Background
Acceptance of Electronic patient portal (EPP) is instrumental for its success. Studies on users’ acceptance in the Middle East region are scarce. This study aims to explore factors influencing users’ acceptance of EPP, both patients and providers, at a tertiary care center in Lebanon using the Technology Acceptance Model (TAM). We concurrently test the internal construct validity and the reliability of the TAM.
Methods
A cross-sectional survey design and the vignette approach were used. For validation, we needed a minimum of 180 patients; all 35 attending physicians and 11 registered nurses were targeted. We used descriptive statistics to calculate the intention to use EPP and its determinants based on the TAM constructs. Exploratory factor analysis (EFA) and structural equation modeling (SEM) were employed to estimate significant path coefficients for patients only as the sample size of providers was too small.
Results
We had 199 patients, half intended to use EPP; 73% of providers (N=17) intended to use EPP. Perceived ease of use and privacy concerns were significantly higher among providers than patients (Mean (M) = 0.77 vs M= 0.42 (CI: -0.623 ; -0.081)) and (M=3.67 vs M=2.13, CI: -2.16; -0.91) respectively; other constructs were not significantly different. Reliability of TAM revealed a Cronbach Alpha of α=.91. EFA showed that three components explained 73.48% of the variance: Behavioral Intention of Use (14.9%), Perceived Ease of Use (50.74%), Perceived Usefulness (7.84%). SEM found that perceived ease of use increased perceived usefulness (standardized regression weight=0.49); perceived usefulness (0.51) had more predictive value than perceived ease of use (0.27) to explain the behavioral intention of use of the EPP.
Conclusions
We found that providers valued the usefulness of EPP and were mostly intending to use it. This finding has yet to be tested in future studies testing actual use as intention and actual use may not be concordant. The intention to use among patients was lower than those reported in developed countries. We identified two factors that we need to address to increase use, namely perceived ease and usefulness, and proposed practical implications to address them; future research directions were also discussed.
Factors Associated with Salmonella Infection in Patients with Gastrointestinal Complaints Seeking Health Care at Regional Hospital in Southern Highland of Tanzania
Authors: Ngogo Fadhili Ashery , Joachim Agricola , Abade Ahmed M , Rumisha Susan F , Mizinduko Mucho M , Majigo Mtebe Venance 
Published: August 2019

Abstract
Background
Salmonellosis remains an important public health problem globally. The disease is among the leading causes of morbidity and mortality in developing countries experiencing poor hygiene and lack of access to clean and safe water. There was an increase of 1.2% reported cases of Salmonellosis between 2015 and 2016 in Njombe region, Southern Highland of Tanzania. Nevertheless, little is known on the factors contributing to transmission of this disease in the region. This study was conducted to bring up to date the prevalence, antibiotic susceptibility and factors associated with Salmonella infection in-patient having gastrointestinal complaints.
Methods
A cross-sectional study was conducted from December 2017 to February 2018 among patients with gastrointestinal complaints at Njombe Regional Hospital. Stool samples were submitted for culture on Xylose Lysine Deoxycholate Agar, intended for isolation of Salmonella spp. Identification was based on conventional biochemical tests and sero-typing. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method. Factors associated with occurrence of Salmonella infection were determined by regression analysis using Epi Info software version 3.5.4.
Results
The prevalence of Salmonella infection among 297 study participants with gastrointestinal features was 16.5%. All isolates were sensitive to ceftriaxone and ciprofloxacin, whereas 27.8% and 100% were resistant to co-trimoxazole and ampicillin respectively. The odds of Salmonella infection was fourfold higher among participants with formal employment than others (AOR=3.8, 95% CI, 1.53-9.40). Use of water from wells or river (AOR 2.2, 95% CI, 1.07-4.45), drinking untreated water (AOR 2.6, 95% CI, 1.21-5.48) and often eating at restaurant (AOR 3.4, 95% CI, 1.28-8.93) had increased probability of Salmonella infection. Likewise, having abdominal pain (AOR 8.5, 95% CI 1.81-39.78) and diarrhea (AOR 2.3, 95% CI 1.12-4.68) were independently associated with Salmonella infection.
Conclusion
Salmonella infection in Njombe is high, contributed by often eating at restaurant and drinking unsafe water from well and river. In addition, Salmonella spp causing gastroenteritis has developed resistance to commonly used antibiotics. It is high time to emphasize on hygienic practices in order to control and prevent Salmonella infection.
Enterococcal periprosthetic joint infection: Clinical and microbiological findings from a 8-year retrospective cohort study
Authors: Renz Nora , Trebse Rihard , Akgün Doruk , Perka Carsten , Trampuz Andrej 
Published: August 2019

Abstract
Background: Treatment of enterococcal periprosthetic joint infections (PJI) is challenging due to heterogeneous pathogenesis, non-standardized management strategies and lack of biofilm-active antibiotics. The optimal surgical and antimicrobial therapy are unknown. Therefore, we evaluated characteristics and outcome of enterococcal PJI.
Methods : Consecutive patients with enterococcal PJI from two specialized orthopedic institutions were retrospectively analyzed. Both institutions are following the same diagnostic and treatment concepts. The probability of relapse-free survival was estimated using Kaplan-Meier survival curves and compared by log-rank test.
Results: Included were 75 enterococcal PJI episodes, involving 41 hip, 30 knee, 2 elbow and 1 shoulder prostheses. PJI occurred postoperatively in 61 episodes (81%), hematogenously in 13 (17%) and by contiguous spread in one. E. faecalis grew in 64 episodes, E. faecium in 10 and E. casseliflavus in one. Additional microorganism(s) were isolated in 38 patients (51%). Enterococci were susceptible to vancomycin in 73 of 75 isolates (97%), daptomycin in all 75 isolates, and fosfomycin in 21 of 22 isolates (96%). The treatment success after 3 years was 83.7% (95% confidence interval [CI]; 76.1-96.7%) and the clinical success was 67.5% (95% CI; 57.3-80.8%). In 11 patients (17%), a new PJI episode caused by a different pathogen occurred. All failures occurred within the three years of surgery.
Conclusion: About half of enterococcal PJI were polymicrobial infections. The treatment success was unexpected high (84%), suggesting that enterococcal PJI are not difficult to treat. All treatment failures occurred within the first three years after revision surgery. Interestingly, 17% of patients experienced a new PJI caused by another pathogen at a later stage.
Trial registration: The study was retrospectively registered with the public clinical trial identification NCT0253022 at https://www.clinicaltrials.gov.
Creating cell model of phenylketonuria disease by CRISPR-Cas9 mediated genome editing method
Authors: aliabadi Bahram Elmi , sarbandi Farahnaz Farahani , moradi Sepide , falahi jafar , Tabei Seyed Mohammad Bagher 
Published: August 2019

Abstract
Phenylketonuria (PKU) is a monogenic disorder resulting from Phenylalanine hydroxylase (PAH) enzyme deficiency in liver hepatocytes. Untreated patients have clinical signs including growth retardation, microcephaly, short stature and low IQ. As the production of tyrosine from Phenylalanine is generally dependent on this enzyme, mutant PAH will result in accumulation of byproducts (liver cells), that is generated during deficient phenylalanine metabolism.

This study aimed to produce a liver cell model harboring deletion in PAH, which could be applied to investigate mutations and their effect on cell metabolism as well as response to drugs and supplement administration. A large deletion in exon 6 of PAH was created by CRISPR/Cas9 system, using pSpCas9(BB)-2A-Puro (PX459) V2.0 and pSpCas9(BB)-2A-GFP (PX458) vectors.

HPLC method was used to measure the level of phenylalanine and tyrosine in the cell with deleted PAH gene. Contrary to our expectation, a decrease in the phenylalanine level was observed in the culture medium and inside the cell, but the tyrosine level exhibited an anticipated decrease in the culture medium and inside the cell.
Use of the rSpaA415 antigen for detection of IgG anti-Erysipelothrix rhusiopathiae in farmed cattle indicates a low prevalence in dairy and feedlot cattle in the United States of America and Great Britain
Authors: Atienzar Ana Isabel Cubas , Gerber Priscilla F. , Opriessnig Tanja 
Published: August 2019

Abstract
Background
Clinical cases of Erysipelothrix rhusiopathiae, a zoonotic gram-positive bacterium, have been reported in many ruminant species, including in cattle, deer, moose and muskoxen. Fatal cases have been repeatedly reported in cattle over the years but to date there is only one Japanese study investigating the seroprevalence of this bacterium in bovine using the growth agglutination test (GAT). This technique is subjective, time-consuming, expensive and hazardous compared to modern serological tests such as enzyme-linked immunosorbent assays (ELISA) or the newly developed fluorescent microbead-based immunoassays (FMIA).
Results
A FMIA based on the surface protein SpaA (rSpaA415) antigen of E. rhusiopathiae developed in this study had an almost perfect agreement with the GAT (k=0.83) and showed a sensitivity of 89.7% and a specificity of 92.9% when compared to the GAT. Overall, detection rates of E. rhusiopathiae antibody positive samples were 13.8% (51/370) in British herds and 6% (12/200) in US herds. Positive cattle were present in 34.3% (24/70) of the investigated British farms and in 34.7% (8/23) of the US farms with an on-farm prevalence of 7.1% to 100% for the British and 8.3-30% for the US.
Conclusions
FMIA is a fast, safe and economic alternative to the GAT for the diagnosis of E. rhusiopathiae in cattle. This work is the first seroprevalence study of E. rhusiopathiae in healthy farmed cattle in the Great Britain and the US and revealed that infection occurs at a low level. Further investigations to evaluate risks of zoonotic transmission when handling cattle are needed.
The prognostic significance of NLR in non-metastatic renal cell carcinoma undergoing nephrectomy, A meta-analysis
Authors: Na Li , Feng Huimin , Wu Ligang , Han Xuebo , Cao Jia , Wang Danni , Li Xiaohan , Ma Fang , Hua Yongqiang , Wang Libin 
Published: August 2019

Abstract
INTRODUCTION

Neutrophil to Lymphocyte ratio (NLR) has been reported to correlate with poor survivals in many tumors. However, the association between preoperative NLR elevation and survival outcome in non-metastatic renal cell carcinoma (RCC) underdoing nephrectomy remains controversial. The aim of this meta-analysis was to investigate the prognostic significance of elevated NLR in non-metastatic RCC.

EVIDENCE ACUISITION

We systematically searched PubMed, EmBase, and the Cochrane Library databases in may 2018. Cancer specific survival (CSS), disease-free survival (DFS) and overall survival (OS) were pooled by hazard ratio (HR) with corresponding 95% confidence interval.

EVIDENCE SYNTHESIS

A total of 3,175 patients from 8 studies were analyzed. The results demonstrated that elevated pretreatment NLR was significantly related to poor CSS (HR 1.91, 95% CI=1.53-2.40), DFS (HR 1.38, 95% CI=1.09-1.74), and OS (HR 1.84, 95% CI=1.58-2.14) in patients with non-metastatic RCC.

CONCLUSION

Elevated NLR indicates a poor long-term survival (CSS, DFS and OS) in non-metastatic RCC. Patients with elevated NLR are more likely to have poor prognosis than those with lower NLR.
Effect of cervical curvature reduction after ACCF on adjacent segmental lesions
Authors: Li Lifeng , Li Na , Zhou Jiahui , Li Handong , Du Xianping , He Haibo , Rong Pengfei , Liu Yin , Wang Wei 
Published: August 2019

Abstract
Objective: To investigate the relationship of adjacent segment degeneration (RASP) and the variation of cervical curvature and vertebral height after Anterior Cervical Corpectomy and Fusion (ACCF).
Methods: A retrospective analysis of 80 patients with cervical spondylotic myelopathy (CSM) who had been followed up for at least 1 year after ACCF. The patients were divided into RASP group and no RASP group according to whether the RASP occured after surgery. On the standing cervical lateral radiograph of all patients before and after surgery at the short-term and final follow-up, the C2-7 Cobb angle of the cervical vertebrae, the Cobb angle of the surgical segment and the height of the fusion segment for the anterior and posterior segments of the vertebral body were measured. The difference between the two groups of patients before and after surgery was calculated, as well as its correlation with the occurrence of RASP.
Result: there were 37 patients in the RASP group and 43 patients in the no-RASP group. In RASP group, the short-term average curvature of cervical vertebra was significantly reduced after surgery. However, there was no significant difference in no RASP group. The height of the anterior and posterior fusion segments in two groups was significantly higher than that before surgery, however, which was significantly lower during the final follow-up than that in the short-term after surgery. Cox regression analysis showed that only the variation of postoperative C2-7Cobb angle was associated with RASP.
Conclusion: The reduction of cervical curvature after ACF may be related to postoperative RASP. Maintaining good cervical curvature after operation may be expected to reduce the occurrence of RASP after ACF.
Social acceptance of alcohol use in Uganda.
Authors: Ssebunnya Joshua , Kituyi Caroline , Nabanoba Justine , Nakku Juliet , Bhana Arvin , Kigozi Fred 
Published: August 2019

Abstract
Abstract:
Background: Alcohol use is part of many cultural, religious and social practices, and provides perceived pleasure to many users. In many societies, alcoholic beverages are a routine part of the social landscape for many in the population. Relatively low rates were reported for Alcohol Use Disorders (AUD) in a community based survey and facility detection survey conducted in the study site contrary to findings in earlier formative studies where alcohol use was reported to be a major health problem. The aim of this study was to understand reasons for under-reporting and the low detection rate for AUDs, exploring the societal perceptions of alcohol use in the study district.
Methods: The study was conducted in Kamuli District (implementation site for the PRIME project). Semi-structured interviews and focus group discussions were conducted with purposively selected participants that included local and religious leaders, lay people, health workers as well as heavy alcohol drinkers and their spouses. Interviews were tape-recorded and transcribed verbatim. The analysis followed 4 thematic areas, which include the extent and acceptability of alcohol use, patterns of alcohol use, perceived health problems associated with alcohol use and help-seeking behavior for persons with alcohol related problems.
Results: The findings indicate that alcohol consumption in the study site was common and widely acceptable across all categories of people, with minimal restrictions. Society tends to overlook problems associated with alcohol use except when it is life-threatening. Help-seeking for such problems was therefore reported to be relatively rare.
Conclusion: Alcohol was readily available in the community and its consumption widely acceptable with minimal restrictions to the minors. There is low recognition of alcohol use related health problems, resulting in poor help-seeking behavior.
Key words: Alcohol, Kamuli, Alcohol Use Disorder, PRIME acceptability
To Choose or not to Choose? -User Perspectives on Medication Free Treatment for Persons With Psychosis: a Qualitative Study
Authors: Oedegaard Christine Henriksen , Davidson Larry , Stige Brynjulf , Veseth Marius , Blindheim Anne , Garvik Linda , Sørensen Jan-Magne Tordenhjerte , Søraa Øystein , Engebretsen Ingunn Marie Stadskleiv 
Published: August 2019

Abstract
Abstract: Background: Norway recently changed national policies in psychiatry emphasizing the right for persons with psychosis to choose medication-free treatment. Long-term anti-psychotic medication is debated, in terms of effectiveness and side effects. New guidelines generate increased treatment options for patients with severe mental illness. Methods: This study explore users’ experiences with treatment choices in this unique context. We interviewed eleven patients diagnosed with psychosis about their experiences of choosing treatment, analysing the transcribed data team based and stepwise. Results: Findings show how choosing treatment appears to be a complicated process with many influencing factors. Emerging themes were about the dialogue between patient and therapist, the importance of having a treatment choice, difficulties choosing the unknown not knowing what helps, choice influenced by the level of experience with in particular medication, and coercive measures contrasting the freedom of choice. Conclusion: The freedom to choose was perceived important, but the complexity of choosing showed how optimal care might not always equal the freedom to choose. Aiming for optimal care, we need to consider how involuntary admission and other coercive measures are used, and possibly improved, in order to care without further traumatizing people who are already in extreme distress. Ethical approval: The Regional Ethics Committee for Medical Health Research (REK southeast 2017/736) defined this study as health service research and hence according to the Norwegian health research legislation, the study was to be approved by the local data protection officer. The data protection officer for Health Bergen approved the study in July 2017 (2017/8692).
The strategy of coping with stress and selected health related behavioural patterns of demobilized battle participants
Authors: Ortenburger Dorota , Wąsik Jacek , Andriejczuk Olga 
Published: August 2019

Abstract
Background: The aim of the herein paper is to express knowledge of the role of ties (relations) between mental factors such as trust in your own possibilities of coping with pain and availing of the active strategies of coping with stress, while also the degree of readiness to limit stress with the aid of the use of alcohol. Methods: The research covered the group of 38 demobilized ATO participants (21-46 years) undergoing treatment and rehabilitation in the Hospital. A measurement was conducted with the aid of certified psychological questionnaires and from medical documentation. Results: A correlation occurred between the active strategy of coping with the stress felt and the strategy of coping with pain of the ICS type – Internal control of pain (r=0.71; p<0.05), as well as the negative correlation between the readiness to utilize stimulants with the aim of easing stress and the strategy of coping with pain of the ICS type (r=-0.58; p<0.05). Conclusion: The ways of coping with stress and pain by the hospitalized participants of combat action may be significant factors (of a psychological nature) that have an impact on their readiness to undertake behaviour that is significant for their health (such as alcohol and others) with the aim of reducing the symptoms of nervous tension felt.
Caffeine citrate improves outcomes of apnea of prematurity based on gestational ages
Authors: Zhao Dongchi , Lijun Li , Xia Wang , Pu Yang , Junwen Zheng 
Published: August 2019

Abstract
ObjectiveThis study aimed to evaluate the therapeutic effect of caffeine citrate on early premature infants with apnea of prematurity (AOP), and the impact on movement and neurobehavioral development in their early lives.Study designAmongst 397 premature infants whose gestational age (GA) were less than 32 weeks, 172 premature infants were eligible for this study from January 2014 to May 2017. 94 infants received caffeine citrate intervention, 20 infants were given aminophyline and the rest 58 infants didn't received any methylxanthines. According to the incidence of apnea, caffeine using was divided into two situations of therapeutic and preventive administration. The primary clinical outcomes were recorded which included length of stay (LOS), duration of mechanical ventilation, the incidence of complications and outcomes.Results62 cases (66%) were assigned to receive caffeine within 3 days after birth, and 69 cases (74%) received caffeine less than one month. Caffeine could reduce LOS, duration of MV and nasal continues positive airway pressure (nCPAP), the incidence of nosocomial infection and bronchial pulmonary dysplasia (BPD) (p<0.05). There was no significant difference in the incidence of abdominal distension, necrotizing enterocolitis (NEC), patent ductus arteriosus (PDA) and intraventricular hemorrhage (IVH) compared with aminophylline and conservative groups (P >0.05). Caffeine showed different effects on clinical outcomes in early premature infants based on their GAs, and premature infants with larger GA could benefit more from the intervention (p<0.001), and caffeine didn’t affect their early lives in short-term prognosis by follow-up.Conclusion Caffeine can improve AOP clinical outcomes in those premature infants with larger GA, and didn't have side effects on the movement and neurobehavioral development in short-term prognosis.