bluuebunny/crossref_metadata_2025_split huggingface dataset:
The phenotypic and molecular diversity of hemoglobinopathies in India: A review of 15 years at a referral center
Authors: Nadkarni Anita H. , Gorakshakar Ajit C. , Sawant Pratibha M. , Italia Khushnooma Y. , Upadhye Dipti S. , Gorivale Manju S. , Mehta Pallavi R. , Hariharan Priya , Ghosh Kanjaksha , Colah Roshan B. 
Published: November 2018

AbstractIntroductionThe hemoglobinopathies pose a significant health burden in India. Apart from the β thalassemias and sickle cell disorders, α thalassemias and structural hemoglobin variants are also common. Here we have reviewed the phenotypic and molecular diversity of hemoglobinopathies encountered at a referral center in western India over a period of 15 years.Materials and MethodsScreening for hemoglobinopathies was done using HPLC and cellulose acetate electrophoresis. Molecular characterization was done using Covalent Reverse Dot Blot Hybridization (CRDB), Amplification Refractory Mutation System (ARMS), GAP PCR and direct DNA sequencing.ResultsThe study includes 31 075 individuals who were referred for diagnosis of hemoglobinopathies and prenatal diagnosis. Of these 14 423 individuals showed various hemoglobin abnormalities. Beta genotyping in 5615 individuals showed the presence of 49 β thalassemia mutations. 143 β thalassemia heterozygotes had normal or borderline HbA2 levels. We identified three δ gene mutations (HbA2 Pellendri, HbA2 St.George, HbA2 Saurashtra) in β thalassemia heterozygotes leading to normal HbA2 levels. The commonest defects among the raised Hb F determinants were Gγ(Αγδβ)0 Indian inversion and the HPFH‐3 Indian deletion. A total of 312 individuals showed the presence of α thalassemia, of which 12.0% had a single α gene deletion (−α/αα). HbH disease was identified in 29 cases with 10 different genotypes. Alpha globin gene triplication was seen in 2.1% of β thalassemia heterozygotes with a thalassemia intermedia phenotype. Seven unusual α chain variants and eight uncommon β chain variants were identified.ConclusionThe repertoire of molecular defects seen in the different globin genes will be valuable for management and control of these disorders both in India as well as in other countries where there is a huge influx of migrant populations from India.
Wartime logistics model for multi‐support unit location–allocation problem with frontline changes
Authors: Koo Hyejung , Moon Ilkyeong 
Published: November 2018

AbstractTo reflect a realistic, changing front line, wartime logistics are illustrated by a dynamic location–allocation model. In this paper, a mixed integer programming (MIP) model is developed for use in deciding the timing of unit relocation for continuous resupply, safe locations for support units, and delivery amounts that minimize total risk to the logistics service. Total risk in wartime logistics is represented by unsatisfied demand, hazard at the support site, and the number of relocations. The proposed MIP model reflects realistic factors in battle situations, such as maximum distance, vehicle capacity, basic load carried by combat units, and limited supplies during unit relocation. Furthermore, special operators for crossover and mutation are developed to maintain feasibility of possible solutions, and an efficient hybrid genetic algorithm is proposed to find optimal and near‐optimal solutions.
Accelerated ISAV replication detection by cell culture methods combined with time‐monitoring RT‐qPCR
Authors: Arseneau Jean‐René , Gautreau Chantal , Boston Linda , Goguen Michel L. , Laflamme Mark 
Published: November 2018

AbstractInfectious salmon anaemia (ISA) is a viral disease that affects farmed Atlantic salmon (Salmo salar L.), often leading to mass mortalities. A quick detection of the ISA virus (ISAV) is crucial for decision‐making and can prevent the occurrence of future outbreaks. Screening done by Canada's National Aquatic Animal Health Laboratory System (NAAHLS) uses quantitative reverse transcription PCR (RT‐qPCR) followed by sequencing of PCR amplicons. As neither technique provides information regarding the infectivity of the virus, suspected virulent strains are subsequently tested using viral isolation. However, this stepwise process can require significant time to deliver results. To speed up this delivery, we have improved on these pre‐existing techniques by combining the use of cell culture with RT‐qPCR to detect replicative virus in as little as 5 days. Preliminary assays enabled the establishment of a minimal shift in Ct values over time, which is representative of viral replication in cultured cells. Subsequent blind panel analyses allowed the establishment of the optimal sampling days, as well as diagnostic sensitivity (DSe) and specificity (DSp) estimates. This method could be adopted not only by laboratories conducting diagnostic analyses for ISAV, but also for other slow‐replicating viral agents that replicate through a budding mechanism.
Association Between Functional Impairment and Medication Burden in Adults with Heart Failure
Authors: Goyal Parag , Bryan Joanna , Kneifati‐Hayek Jerard , Sterling Madeline R. , Banerjee Samprit , Maurer Mathew S. , Lachs Mark S. , Safford Monika M. 
Published: November 2018

OBJECTIVESTo determine whether the number of medications taken by adults with heart failure (HF) and impairment in activities of daily living (ADL)—a subpopulation in whom the risks of a high medication burden may outweigh the benefits—differs from the number taken by those without impairment in ADLs.DESIGNCross‐sectional.SETTINGNational Health and Nutrition Examination Survey (NHANES; 2003–2014), a cross‐sectional survey that produces national estimates of adults in the United States.PARTICIPANTSAdults aged 50 and older (mean 70) with self‐reported HF (N= 947; representing 4.6 million adults with HF in the United States.MEASURMENTSWe assessed ADL impairment and medication count based on self‐report. ADL impairment was defined as having difficulty with or being unable to dress, feed oneself, or get in and out of bed. To determine the independent association between ADL impairment and medication count, we performed sequential Poisson multivariable regression analyses. All analyses were cross‐sectional in nature and accounted for the complex survey design of NHANES.RESULTSMean medication count was 7.2, and 74% of participants were taking 5 or more medications (polypharmacy). In a multivariable model, ADL impairment was not independently associated with medication count. These findings were similar for those with 3 or more hospitalizations in the prior year, declining health status, and cognitive impairment.CONCLUSIONAfter adjusting for confounders including comorbidity, we found that adults with HF and ADL impairment take as many medications as those without ADL impairment. This suggests that providers may not sufficiently consider functional impairment when prescribing medications to adults with HF and thus may unnecessarily expose individuals to risk of adverse outcomes. J Am Geriatr Soc 67:284–291, 2019.
Overexpression of ADAR1 into the cytoplasm correlates with a better prognosis of patients with oral squamous cells carcinoma
Authors: Caponio Vito Carlo Alberto , Troiano Giuseppe , Botti Gerardo , Pedicillo Maria Carmela , Lo Russo Lucio , Mastrangelo Filiberto , Ciavarella Domenico , Losito Nunzia Simona , Aquino Gabriella , Nocini Riccardo , Santoro Rossella , Santoro Angela , Lo Muzio Lorenzo , Pannone Giuseppe 
Published: November 2018

AbstractBackgroundADAR1 is an enzymatic protein, which catalyzes a RNA editing reaction by converting Adenosine to Inosine, and its expression has been found to be dysregulated in many cancer types. The aim of this study was to analyze the expression of ADAR1 in oral squamous cells carcinoma.MethodsIn order to analyze the ADAR1 mRNA expression, data from The Cancer Genome Atlas (TCGA) database were downloaded and analyzed. In addition, immunohistochemistry analysis was performed on an institutional database including 46 samples of oral squamous cell carcinoma in a tissue microarray (TMA).ResultsNo statistically significant correlation linked the mRNA ADAR1 expression to any clinic‐pathological variables in the TCGA database. Immunohistochemistry analysis of ADAR1 showed different expressions between normal mucosa and tumor tissue. Focusing on the subcellular localization, the nuclear expression of ADAR1 correlated with higher grading of differentiation (ρ = 0.442; P‐value = 0.002); the general expression of ADAR1 either in cytoplasm or in nuclei, correlated with the Gender of patients (Cytoplasm expression: ρ = −0.295; P‐value = 0.049; while for nuclear expression: ρ = +0.374; P = 0.011); cytosol expression resulted to be an independent protective prognostic factor (HR = 0.047; C.I. 95% 0.007‐0.321; P‐value = 0.002).ConclusionHigher expression of ADAR1 into the cytoplasm resulted to be an independent prognostic factor. In order to understand ADAR1 role in cancer, further studies should be performed, in bigger cohort and under a bio‐molecular point of view.
Urban and Rural Emergency Department Performance on National Quality Metrics for Sepsis Care in the United States
Authors: Greenwood‐Ericksen Margaret B. , Rothenberg Craig , Mohr Nicholas , Andrea Shawn D. , Slesinger Todd , Osborn Tiffany , Whittle Jessica , Goyal Pawan , Tarrant Nalani , Schuur Jeremiah D. , Yealy Donald M. , Venkatesh Arjun 
Published: November 2018

AbstractPurposeThe Centers for Medicare and Medicaid Services (CMS) and the American College of Emergency Physicians (ACEP) developed national quality measures for emergency department (ED) sepsis care. Like care for many conditions, meeting sepsis quality metrics can vary between settings. We sought to examine and compare sepsis care quality in rural vs urban hospital‐based EDs.MethodsWe analyzed data from EDs participating in the national Emergency Quality Network (E‐QUAL). We collected preliminary performance data on both the CMS measure (SEP‐1) and the ACEP measures via manual chart review. We analyzed SEP‐1 data at the hospital level based on existing CMS definitions and analyzed ACEP measure data at the patient level. We report descriptive statistics of performance variation in rural and urban EDs.FindingsRural EDs comprised 58 of the EDs reporting SEP‐1 results and 405 rural patient charts in the manual review. Of sites reporting SEP‐1 results, 44% were rural and demonstrated better aggregate SEP‐1 bundle adherence than urban EDs (79% vs 71%; P = .049). Both urban and rural hospitals reported high levels of compliance with the ACEP recommended initial actions of obtaining lactate and blood cultures, with urban EDs outperforming rural EDs on metrics of IV fluid administration and antibiotics (74% urban vs 60% rural; P ≤ .001; 91% urban vs 84% rural; P ≤ .001, respectively).ConclusionsSepsis care at both rural and urban EDs often achieves success with national metrics. However, performance on individual components of ED sepsis care demonstrates opportunities for improved processes of care at rural EDs.
Sleep in Farm Adolescents
Authors: Janssen Ian , Berg Richard L. , Marlenga Barbara , Pickett William 
Published: November 2018

AbstractPurposeThe objectives were to: (1) describe sleep timing and patterns among adolescents who live or work on farms; (2) compare these sleep characteristics to those of nonfarm adolescents; (3) explore whether the above sleep and farm versus nonfarm differences varied by age and gender.MethodsParticipants were aged 11‐16 years and were abstracted from the 2014 Canadian Health Behaviour in School‐aged Children study. Records from 2,160 farm adolescents were frequency matched (by school, gender, and grade) to records from 2,210 nonfarm adolescents. Participants self‐reported their bedtimes and wake‐up times on weekdays and weekends.FindingsAmong farm adolescents, average nightly sleep duration (hours:minutes) ranged from 08:34 among 14‐ to 16‐year‐old girls to 09:21 among 11‐ to 13‐year‐old girls. Approximately 24% to 32% of farm adolescents did not meet minimal sleep duration targets. For 11‐ to 13‐year‐olds, sleep characteristics did not differ according to farm status. However, for 14‐ to 16‐year‐olds, farm adolescents had shorter sleep durations than nonfarm adolescents (23 minutes for boys, P = .02; 20 minutes for girls, P = .06). Furthermore, a greater proportion of 14‐ to 16‐year‐old farm boys had sleep duration values less than the recommended 8 hours/night (27.7% vs 19.6%, P = .05).ConclusionsThis study profiles the sleep experiences of 11‐ to 16‐year‐old farm adolescents. Almost 1 in 3 of these adolescents did not get adequate sleep. Older adolescents who lived or worked on a farm slept less than comparably aged nonfarm adolescents. This may reflect their participation in morning chores essential to the farm operation and may increase their injury risk.
Ministry & Society: The Rhetorics of Expectations
Authors: Sweeney James 
Published: November 2018

AbstractWhen we examine ‘who ministers what to whom’ in the church we have to look at our expectations of what the church should do for those inside and out of the church, as well as the expectations of what society should offer. Such an examination of expectations has to consider the structure of this takes place in a relationship between agency and structure: who acts and in what context? This at a time when the place of the individual in the church has changed hugely since the beginning of the twentieth century, from passivity to participation. The article finally relates this theoretical analysis to the current crisis in the church.
Supplementation of micronutrients in children and food fortification initiatives in Sri Lanka: benefits versus risks
Authors: Jayatissa Renuka , Fernando Dulitha N. 
Published: November 2018

AbstractIn recent decades, Sri Lanka has made substantial progress in reducing the burden of micronutrient deficiencies in children by the provision of vitamin A megadose and micronutrient supplementation programs for children of 6–23 months, along with universal iodization of salt. Consumption of voluntarily fortified foods by children was also considerably increased. The objective of our study here was to review such interventions, which are beneficial in childhood, and to assess the risk of toxicity due to excessive intakes of iron, vitamin A, and iodine. Our analysis was performed using data from two national micronutrient surveys, market surveys, and key informant interviews. Data on coverage, usage, and nutrient content of certain foods were compiled to gauge consumption of iron, vitamin A, and iodine among children. We found that the severity of anemia and vitamin A and iodine deficiencies declined from moderate‐to‐severe and that supplementation and fortification can lead to an excess of vitamin A that may cause toxicity, while iron and iodine deficiency appears to be no longer a public health concern in Sri Lanka. We recommend review and scaling back of national supplementation programs and monitoring of fortification initiatives to prevent micronutrient toxicity in the future.
Aluminum granuloma in a child secondary to DTaP‐IPV vaccination: A case report
Authors: Haag Carter K. , Dacey Elizabeth , Hamilton Nick , White Kevin P. 
Published: November 2018

AbstractReports detailing the acute formation of aluminum granulomas, which can cause persistent, intensely pruritic nodules secondary to the administration of aluminum‐containing vaccines, are infrequently described in medical literature. To our knowledge, this is the first report describing the development of an aluminum granuloma causing a persistent, pruritic nodule at the injection site following the administration of the DTaP‐IPV vaccine. We present the case of a 6‐year‐old girl who developed a severely pruritic subcutaneous nodule on her anterior right thigh at the injection site three weeks after the administration of the aluminum‐containing DTaP‐IPV (Kinrix) vaccine. The nodule was eventually excised 14 months after its initial appearance, after which her symptoms resolved. Histologic inspection demonstrated a dense, deep dermal and subcutaneous nodular mixed infiltrate of lymphocytes, histiocytes, and eosinophils, with germinal center formation. The bluish, amphophilic granular cytoplasm found in most of the histiocytes is a characteristic feature of “aluminum granulomas.” This adverse reaction should be considered in any patient presenting with similar findings in the weeks following a DTaP‐IPV vaccination or other aluminum‐containing vaccines. Furthermore, the self‐limiting tendency of these nodules should not preclude affected patients from any future vaccinations, though vaccines without aluminum should be preferentially selected when possible.
Progress and perspectives of short‐chain fatty acids in aquaculture
Authors: Tran Ngoc Tuan , Li Zhongzhen , Wang Shuqi , Zheng Huaiping , Aweya Jude Juventus , Wen Xiaobo , Li Shengkang 
Published: November 2018

AbstractGut microbiota is important and plays a crucial role in the host health and nutritional metabolism through multiple mechanisms. Short‐chain fatty acids (SCFAs), which are carboxylic acids with aliphatic tails < 6 carbons, are mainly produced by anaerobic microbiota through fermentation of carbohydrates in the intestine. Acetate, propionate and butyrate are the most abundant SCFAs metabolites, important in energy homoeostasis, metabolism and the maintenance of gut health. In this review, we describe and document what is known about the production, absorption, transport and receptors as well as the factors that affect SCFA production in aquatic animals. Some evidence on the roles that SCFAs as feed additives play in improving growth performance, digestibility, survival rate, immune responses, disease resistance and structure and function of the intestinal tract and abundance of commensal microbiota in aquatic animals is summarized. In addition, the immune regulatory mechanism of SCFAs is highlighted. Although the effects of SCFAs in aquatic animals have been explored, further research is needed to profoundly investigate the mechanisms that by which SCFAs induce their effects on host metabolism.
The challenge of inclusive coproduction: The importance of situated rituals and emotional inclusivity in the coproduction of health research projects
Authors: Clarke Jenelle , Waring Justin , Timmons Stephen 
Published: November 2018

AbstractPrevious studies highlight that coproduced research initiatives are influenced by how individuals interact together and that group inclusivity amongst diverse members is crucial. However, it is not fully understood how inclusivity is sustained over time, particularly through routine encounters. Our study examines how coproduction occurs through routine and ritualistic patterns of everyday practices, which have the potential to facilitate sustainable and inclusive research initiatives. Using ethnographic data with four applied health research projects, we explored how everyday rituals generate and sustain inclusivity. Informed by interactional ritual change theory, we identify two types of interlinked inclusivity: relational, individuals routinely engaging together; and emotional, the feeling of being included. The process of producing and maintaining both types requires ongoing reflexivity from members. Groups with sustained inclusivity build interpersonal momentum through situated practices that enable them to mitigate external pressures and internal disagreements. Where groups experience a breakdown in inclusivity, they also experience a loss of momentum that makes them vulnerable to disintegration and collapse. Building and sustaining inclusivity are worked out through everyday interactions and operate as a feedback loop that sustains the cohesiveness of the network and supports coproduction of knowledge.
Integration of physical activity in reablement for community-dwelling older adults: a scoping review protocol
Authors: Mjøsund Hanne Leirbekk , Burton Elissa , Moe Cathrine F. , Uhrenfeldt Lisbeth 
Published: November 2018

ABSTRACT

Objective:
The objectives of this scoping review are to map existing evidence of how physical activity strategies are integrated and explored in studies of reablement for community-dwelling older adults and to identify knowledge gaps.

Introduction:
Reablement is a home-based interdisciplinary practice that aims to improve function and independence among persons receiving home care services. There is insufficient knowledge of what constitutes reablement and how it affects older adults’ function and independence. Physical activity is known to influence older adults’ function, but it is unclear how physical activity is integrated into reablement interventions.

Inclusion criteria:
This review will consider studies that investigate or explore multidisciplinary and time-limited (less than six months) reablement for community-dwelling older adults. There will be no restrictions regarding study design. Studies focusing on professionals working with reablement and carers of reablement participants will also be included. Studies focusing on persons who need end-of-life care or on reablement provided in long-term care facilities or housing arrangements with 24-hour care will be excluded.

Methods:
PubMed, Cochrane Central Register of Controlled Trials, Embase, PsycINFO, AMED, PEDro, CINAHL, ProQuest Dissertations and Theses, and Google Scholar will be searched for studies published from 1996. Studies published in English, Norwegian, Danish, Swedish and German will be considered for inclusion. Study selection will be performed independently by two reviewers, and data will be extracted by two reviewers using predefined data charting forms. Data will be presented in a narrative summary.
To what extent are GCS and AVPU equivalent to each other when assessing the level of consciousness of children with head injury? A cross-sectional study of UK hospital admissions.
Authors: Nuttall Amy GL , Paton Katie M , Kemp Alison M 
Published: November 2018

ObjectiveTo evaluate utility and equivalence of Glasgow Coma Scale (GCS) and the Alert, Voice, Pain, Unresponsive (AVPU) scale in children with head injury.DesignCross sectional study.SettingUK hospital admissions: September 2009–February 2010.Patients<15 years with head injury.InterventionsGCS and/or AVPU at injury scene and in emergency departments (ED).Main outcomeMeasures used, the equivalence of AVPU to GCS, GCS at the scene predicting GCS in ED, CT results by age, hospital type.ResultsLevel of consciousness was recorded in 91% (5168/5700) in ED (43%: GCS/30.5%: GCS+AVPU/17.3%: AVPU) and 66.1% (1190/1801) prehospital (33%: GCS/26%GCS+AVPU/7%: AVPU). Failure to record level of consciousness and the use of AVPU were greatest for infants. Correlation between AVPU and median GCS in 1147 children <5 years: A=15, V=14, P=8, U=3, for 1163 children ≥5 years: A=15, V=13, P=11, U=3. There was no significant difference in the proportion of infants who had a CT whether AVPU=V/P/U or GCS<15. However diagnostic yield of intracranial injury or depressed fracture was significantly greater for V/P/U than GCS<15 :7/7: 100% (95% CI 64.6% to 100%) versus 5/17: 29.4% (95% CI 13.3% to 53.1%). For children >1 year significantly more had a CT scan when GCS<14 was recorded than ‘V/P/U only’ and the diagnostic yield was greater. Prehospital GCS and GCS in the ED were the same for 77.4% (705/911).ConclusionThere was a clear correlation between Alert and GCS=15 and between Unresponsive and GCS=3 but a wider range of GCS scores for responsive to Pain or Voice that varied with age. AVPU was valuable at initial assessment of infants and did not adversely affect the proportion of infants who had head CT or the diagnostic yield.