bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors and patterns of portal use in patients with multiple chronic conditions
Authors: Powell Kimberly R , Deroche Chelsea 
Published: October 2018

Objective To explore predictors of portal use by patients (registered portal users) with multiple chronic conditions according to demographic characteristics and use of specific features hypothesized to support self-management. Methods Two data sources were used in this analysis: electronic health records and 12 months of data from web server log files. Patients ( n = 500) included in the analysis were 45 years or older, registered portal users, and diagnosed with at least two chronic conditions. We fit a negative binomial regression model to predict portal use (number of logins) based on practice size and location, demographic characteristics, and use of specific portal features (secure messaging and patient-entered data). Results Among patients with one or more logins, age, distance separating the patient from his or her primary care provider, and having a diagnosis of heart failure were significant predictors of portal use ( p < .05). No significant differences in portal use were found according to gender, ethnicity, or practice size and location. Conclusion Considering the extraordinary investment on implementation and meaningful use of portal technology, low overall use and the large number of registered non-users is especially troubling. Regardless, our results demonstrate potential opportunities to leverage portal technology especially for patients living in rural and underserved areas to improve self-management of chronic illness.
A Safety and Cost Analysis of Outpatient Versus Inpatient Hindfoot Fusion Surgery
Authors: Moon Andrew S. , McGee Andrew S. , Patel Harshadkumar A. , Cone Ryan , McGwin Gerald , Naranje Sameer , Shah Ashish 
Published: October 2018

Background. Hindfoot fusion procedures are increasingly being performed in the outpatient setting. However, the cost savings of these procedures compared with the risks and benefits has not been clearly investigated. The objective of this study was to compare patient characteristics, costs, and short-term complications between inpatient and outpatient procedures. Methods. This was a retrospective review of all patients who underwent inpatient and outpatient hindfoot fusion procedures by a single surgeon, at 1 academic institution, from 2013 to 2017. Data collected included demographics, operative variables, comorbidities, complications, costs, and subsequent reencounters. Results. Of 124 procedures, 34 were inpatient and 90 were outpatient. Between procedural settings, with the numbers available, there was no significant increase in complication rate or frequency of reencounters within 90 days. There were no significant differences in the number of patients with reencounters related to the index procedure within 90 days (P = .43). There were 30 reencounters within 90 days after outpatient surgery versus 4 after inpatient surgery (P = .05). The total number of emergency room visits in the outpatient group within 90 days was significantly higher compared with the inpatient group (P = .04). The average cost for outpatient procedures was US$4159 less than inpatient procedures (P < .0001). Conclusion. Outpatient hindfoot fusion may be a safe alternative to inpatient surgery, with significant overall cost savings and similar rate of short-term complications. On the basis of these findings, we believe that outpatient management is preferable for the majority of patients, but further investigation is warranted. Levels of Evidence: Level III
A Prospective Study on the Safety and Effectiveness of a Composite Sinus Stent for Use After Endoscopic Sinus Surgery
Authors: Yaniv Dan , Shlossberg Lena , Yaniv Eitan 
Published: October 2018

Background The composite sinus stent was developed to support the nasal walls, stabilize the middle turbinate, and prevent adhesions following endoscopic sinus surgery (ESS). Objective This study sought to assess its safety and effectiveness. Methods A prospective clinical trial was conducted in a single medical center in 2016–2018. The study included 30 patients (64% males) with a mean age of 41.9 years, who were scheduled for bilateral ESS, were randomized to undergo composite sinus stent implantation for 14 to 28 days or middle meatus placement of a Telfa tampon for 2 to 3 days. Telfa is a nonadherent absorbent dressing that has been compared favorably with other packs for use following ESS. Both groups received the same postoperative treatment. Outcomes were evaluated endoscopically by the principal investigator and also by an independent investigator blinded to the intervention the patient had and by self-report questionnaires at 3 and 12 weeks postoperatively. Results The stent was successfully implanted and removed in all 29 treated sinuses, without complications. None of the stents showed granulation tissue or crusting. Compared to the tampon group, the stent group had significantly less inflammation (mean visual analog scale scores 0.2 vs 4.2 at 12 weeks, P = .01). The probability of having adhesion was 9.3 times greater in the control group compared to the study group ( P = .026), and middle turbinate lateralization rate at 12 weeks was 3.8% versus 44% in the study group and the control group, respectively, at 12 weeks ( P = .006). Patients who underwent stent implantation experienced higher symptomatic improvement (Sino-Nasal Outcome Test 22 of −37.13 vs −28.07, P = .01, in study and control groups, respectively). During stent implantation (2–4 weeks), patients did not suffer from any discomfort. Conclusions The composite sinus stent is safer and more effective than the Telfa tampon in maintaining sinus cavity patency and promoting healing following ESS.
Effect of Posterior Glenoid Labral Tears at the NFL Combine on Future NFL Performance
Authors: Murphy Colin P. , Frangiamore Salvatore J. , Mannava Sandeep , Sanchez Anthony , Beiter Evan , Whalen James M. , Price Mark D. , Bradley James P. , LaPrade Robert F. , Provencher Matthew T. 
Published: October 2018

Background: Posterior labral injuries have been recognized as a particularly significant clinical problem in collision and contact athletes. Purpose: To evaluate the effect that posterior labral tears have on early National Football League (NFL) performance based on position, associated injuries, and operative versus nonoperative management. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of all participants in the NFL Combine from 2009 to 2015 was performed using medical and imaging reports documented at the combine. Magnetic resonance imaging scans were analyzed for tear location, associated injuries, and evidence of previous surgical interventions. Each player’s NFL draft position, as well as number of games played, number of games started, and snap percentage in his first 2 NFL seasons were collected for performance analysis and were compared with a control group of uninjured counterparts. Results: Players with posterior labral tears were selected significantly later in the draft than those in the control group (draft position, 171.6 vs 156.1, respectively; P = .017). Although no single individual position was significantly affected by posterior labral tears, linemen (both offensive and defensive) with posterior labral tears were drafted significantly later than those without tears (draft position, 164.0 vs 137.7, respectively; P = .018) and had a significantly lower percentage of snaps in their first NFL season (23.8% vs 27.7%, respectively; P = .014). Players who underwent surgical management before the combine had a significantly higher percentage of snaps in their second NFL season than those who were managed conservatively (31.4% vs 22.3%, respectively; P = .022). None of the concomitant injuries recorded (superior labral anterior-posterior tears, glenoid bone loss, reverse Hill-Sachs lesions, rotator cuff tears, reverse humeral avulsions of the glenohumeral ligament, and posterior labral tears combined with anterior tears) significantly affected the draft position, number of games played, number of games started, or snap percentage for the cohort as a whole or any specific position. Conclusion: Posterior labral tears did negatively and significantly affect early NFL outcomes for collegiate football players across several different metrics, especially among linemen. While operative management did not produce significantly superior performance in most outcome measures, it may allow for better longevity of the shoulder and warrants further investigation. Concomitant shoulder injuries did not significantly affect early NFL outcomes in this cohort.
Obstructive sleep apnoea as a risk factor for incident metabolic syndrome: a joined Episono and HypnoLaus prospective cohorts study
Authors: Hirotsu Camila , Haba-Rubio Jose , Togeiro Sonia M. , Marques-Vidal Pedro , Drager Luciano F. , Vollenweider Peter , Waeber Gérard , Bittencourt Lia , Tufik Sergio , Heinzer Raphael 
Published: October 2018

Cross-sectional studies have demonstrated that obstructive sleep apnoea (OSA) and metabolic syndrome (MetS) are often associated, but whether a temporal relationship exists is unknown. We aimed to investigate the effect of OSA on the risk of developing MetS in the general population.A prospective study was conducted combining two population-based samples: Episono (Brazil) and HypnoLaus (Switzerland). MetS was assessed according to unified criteria. Polysomnography (PSG) was performed at baseline and follow-up in Episono, and at baseline in HypnoLaus. OSA was defined according to the apnoea–hypopnoea index as mild (≥5– <15 events h−1) and moderate-to-severe (≥15 events·h−1). We included 1853 participants (mean±sdage 52±13 years, 56% female) without MetS at baseline.After mean±sd6±1 years, 318 (17.2%) participants developed MetS. Moderate-to-severe OSA was independently associated with incident MetS (OR 2.58, 95% CI 1.61–4.11) and increased the number of MetS components from baseline to follow-up through mediation of the percentage of time with arterial oxygen saturation <90%. Subset analysis in Episono confirmed that the increase in this parameter between baseline and follow-up PSGs represented a risk factor for incident MetS (OR 1.42, 95% CI 1.04–1.95, for each 10% increase).OSA is independently associated with an increased risk of developing MetS through mediation of nocturnal hypoxaemia in the general population.
Genotyping and distribution of putative virulence factors and antibiotic resistance genes of Acinetobacter baumannii strains isolated from raw meat
Authors: Tavakol Marziyeh , Momtaz Hassan , Mohajeri Parviz , Shokoohizadeh Leili , Tajbakhsh Elahe 
Published: October 2018

Abstract
Background
Acinetobacter baumannii strains with multiple antimicrobial resistance are primarily known as opportunistic nosocomial bacteria but they may also be regarded as emerging bacterial contaminants of food samples of animal origin. Here we aimed to study the molecular characteristics of the A. baumanni strains isolated from raw meat samples.

Methods
A total of 22 A. baumanni strains were isolated from 126 animal meat samples and were genotyped by ERIC-PCR method and by PCR detection of their virulence and antimicrobial resistance determinants. A. baumannii strains with 80% and more similarities were considered as one cluster.

Results
Sixteen different genetic clusters were found amongst the 22 A. baumanni strains. Of the 22 strains, 12 (54.54%) had similar genetic cluster. A. baumannii strains exhibited the highest percentage of resistance against tetracycline (90.90%), trimethoprim (59.09%), cotrimoxazole (54.54%) and gentamicin (50.00%). TetA (81.81%), tetB (72.72%), dfrA1 (63.63%), aac(3)-IV (63.63%), sul1 (63.63%) and aadA1 (45.45%) were the most commonly detected antibiotic resistance genes. FimH (81.81%), afa/draBC (63.63%), csgA (63.63%), cnf1 (59.09%), cnf2 (54.54%) and iutA (50.00%) were the most commonly detected virulence factors. A. baumannii strains isolated from the chicken meat samples had the highest similarities in the genetic cluster.

Conclusions
A. baumannii strains with similar genetic cluster (ERIC-Type) had the same prevalence of antibiotic resistance, antibiotic resistance genes and virulence factors. Genetic cluster of the A. baumannii strains is the main factor affected the similarities in the genotypic and phenotypic properties of the A. baumannii strains.
C-reactive protein point of care testing in the management of acute respiratory infections in the Vietnamese primary healthcare setting – a cost benefit analysis
Authors: Lubell Yoel , Do Nga T. T. , Nguyen Kinh V. , Ta Ngan T. D. , Tran Ninh T. H. , Than Hung M. , Hoang Long B. , Shrestha Poojan , van Doorn Rogier H. , Nadjm Behzad , Wertheim Heiman F. L. 
Published: October 2018

Abstract
Aim
We assess the cost-benefit implications of C-reactive protein (CRP) testing in reducing antibiotic prescription for acute respiratory infection in Viet Nam by comparing the incremental costs of CRP testing with the economic costs of antimicrobial resistance averted due to lower antibiotic prescribing.

Findings
Patients in the CRP group and the controls incurred similar costs in managing their illness, excluding the costs of the quantitative CRP tests, provided free of charge in the trial context. Assuming a unit cost of $1 per test, the incremental cost of CRP testing was $0.93 per patient. Based on a previous modelling analysis, the 20 percentage point reduction in prescribing observed in the trial implies a societal benefit of $0.82 per patient. With the low levels of adherence to the test results observed in the trial, CRP testing would not be cost-beneficial. The sensitivity analyses showed, however, that with higher adherence to test results their use would be cost-beneficial.
p62-mediated phase separation at the intersection of the ubiquitin-proteasome system and autophagy
Authors: Danieli Alberto , Martens Sascha 
Published: October 2018

ABSTRACT
The degradation of misfolded proteins is essential for cellular homeostasis. Misfolded proteins are normally degraded by the ubiquitin-proteasome system (UPS), and selective autophagy serves as a backup mechanism when the UPS is overloaded. Selective autophagy mediates the degradation of harmful material by its sequestration within double-membrane organelles called autophagosomes. The selectivity of autophagic processes is mediated by cargo receptors, which link the cargo to the autophagosomal membrane. The p62 cargo receptor (SQSTM1) has a main function during the degradation of misfolded, ubiquitylated proteins by selective autophagy; here it functions to phase separate these proteins into larger condensates and tether them to the autophagosomal membrane. Recent work has given us crucial insights into the mechanism of action of the p62 cargo receptor during selective autophagy and how its activity can be integrated with the UPS. We will discuss these recent insights in the context of protein quality control and the emerging concept of cellular organization mediated by phase transitions.
Invertebrate serotonin receptors: a molecular perspective on classification and pharmacology
Authors: Tierney Ann Jane 
Published: October 2018

ABSTRACT
Invertebrate receptors for the neurotransmitter serotonin (5-HT) have been identified in numerous species from diverse phyla, including Arthropoda, Mollusca, Nematoda and Platyhelminthes. For many receptors, cloning and characterization in heterologous systems have contributed data on molecular structure and function across both closely and distantly related species. This article provides an overview of heterologously expressed receptors, and considers evolutionary relationships among them, classification based on these relationships and nomenclature that reflects classification. In addition, transduction pathways and pharmacological profiles are compared across receptor subtypes and species. Previous work has shown that transduction mechanisms are well conserved within receptor subtypes, but responses to drugs are complex. A few ligands display specificity for different receptors within a single species; however, none acts with high specificity in receptors across different species. Two non-selective vertebrate ligands, the agonist 5-methoxytryptamine and antagonist methiothepin, are active in most receptor subtypes in multiple species and hence bind very generally to invertebrate 5-HT receptors. Future challenges for the field include determining how pharmacological profiles are affected by differences in species and receptor subtype, and how function in heterologous receptors can be used to better understand 5-HT activity in intact organisms.
System dynamic modelling of electricity planning and climate change in West Africa
Authors: Momodu Abiodun S. , Kivuti-Bitok Lucy 
Published: October 2018

Background: It is imperative to develop an efficient strategic approach to managing the push-pull factor in economic development, particularly as relates to climate change and energy interactions in the West African Region. This article demonstrates the use of System Dynamics Modelling (SDM) for that purpose; to manage the development of energy growth with reduced impact in regards to climate change. The complexities of energy planning in relation to climate change necessitates the need for the tool to examine low carbon economy mixed with traditional approaches of planning. Methods: Vensim DSS version 6.2 was used to develop the model. WAPP member country level data elicited from WAPP and ECOWAS Regional Electricity Regulatory Authority (ERERA) serves as the set of basic data used to develop and run the main model. These were complemented with other data elicited from various journal articles and internet sources. These include population and its average growth rate, GDP, per capita income, average per capita electricity demand, electricity generated, average electricity tariff, generation technology type, amongst others. Results: SDM demonstrates the capability to understand the theoretical frame for trade-offs between economic development and climate change, by handling the nonlinear relationship between generation adequacy and greenhouse gas (GHG) emission reduction for better targeted strategic regional intervention on climate change. Conclusion: The primary goal of this paper was to demonstrate the use of SDM to aid in resource planning in an inexpensive way to examine low carbon pathway. With the SDM, the goal of low carbon pathway in the energy system was achieved without the cost of controlled trials.
Predicting transcription factor binding using ensemble random forest models
Authors: Ardakani Fatemeh Behjati , Schmidt Florian , Schulz Marcel H. 
Published: October 2018

Background: Understanding the location and cell-type specific binding of Transcription Factors (TFs) is important in the study of gene regulation. Computational prediction of TF binding sites is challenging, because TFs often bind only to short DNA motifs and cell-type specific co-factors may work together with the same TF to determine binding. Here, we consider the problem of learning a general model for the prediction of TF binding using DNase1-seq data and TF motif description in form of position specific energy matrices (PSEMs). Methods: We use TF ChIP-seq data as a gold-standard for model training and evaluation. Our contribution is a novel ensemble learning approach using random forest classifiers. In the context of the ENCODE-DREAM in vivo TF binding site prediction challenge we consider different learning setups. Results: Our results indicate that the ensemble learning approach is able to better generalize across tissues and cell-types compared to individual tissue-specific classifiers or a classifier applied to the data aggregated across tissues. Furthermore, we show that incorporating DNase1-seq peaks is essential to reduce the false positive rate of TF binding predictions compared to considering the raw DNase1 signal. Conclusions: Analysis of important features reveals that the models preferentially select motifs of other TFs that are close interaction partners in existing protein protein-interaction networks. Code generated in the scope of this project is available on GitHub: https://github.com/SchulzLab/TFAnalysis (DOI: 10.5281/zenodo.1409697).
Evaluation of the diagnostic accuracy and cost of different methods for the assessment of severe anaemia in hospitalised children in Eastern Uganda
Authors: Olupot-Olupot Peter , Prevatt Natalie , Engoru Charles , Nteziyaremye Julius , Amorut Denis , Chebet Martin , Senyondo Tonny , Ongodia Paul , Ndila Carolyne M. , Williams Thomas N. , Maitland Kathryn 
Published: October 2018

Background: Severe anaemia in children requiring hospital admission is a major public health problem in malaria-endemic Africa. Affordable methods for the assessment of haemoglobin have not been validated against gold standard measures for identifying those with severe anaemia requiring a blood transfusion, despite this resource being in short supply. Methods: We conducted a prospective descriptive study of hospitalized children aged 2 months – 12 years at Mbale and Soroti Regional Referral Hospitals, assessed to have pallor at triage by a nurse and two clinicians. Haemoglobin levels were measured using the HemoCue® Hb 301 system (gold standard); the Haemoglobin Colour Scale; calorimetric and Sahli’s methods. We report clinical assessments of the degree of pallor, clinicians’ intention to transfuse, inter-observer agreement, limits of agreement using the Bland-Altman method, and the sensitivity and specificity of each method in comparison to HemoCue® Results: We recruited 322 children assessed by the admitting nurse as having severe (164; 51.0%), moderate (99; 30.7%) or mild (57; 17.7%) pallor. Agreement between the clinicians and the nurse were good: Clinician A Kappa=0.68 (0.60–0.76) and Clinician B Kappa=0.62 (0.53–0.71) respectively (P<0.0001 for both). The nurse, clinicians A and B indicated that of 94/116 (81.0%), 83/121 (68.6%) and 93/120 (77.5%) respectively required transfusion. HemoCue® readings indicated anaemia as mild (Hb10.0–11.9g/dl) in 8/292 (2.7%), moderate (Hb5.0–9.9g/dl) in 132/292 (45.2%) and severe (Hb<5.0g/dl) in 152/292 (52.1%). Comparing to HemoCue® the Sahli’s method performed best in estimation of severe anaemia, with sensitivity 84.0% and specificity 87.9% and a Kappa score of  0.70 (0.64–0.80). Conclusions: Clinical assessment of severe pallor results has a low specificity for the diagnosis of severe anaemia. To target blood transfusion Hb measurement by either Hemocue® or Sahli’s method for the cost of USD 4 or and USD 0.25 per test, respectively would be more cost-effective.
Clarifying the nomenclature of some Euro‐Mediterranean quillworts (Isoetes, Isoetaceae): Indicator species and species of conservation concern
Authors: Troia Angelo , Rouhan Germinal 
Published: October 2018

AbstractTo stabilize the application of some names in the genus Isoetes in the Mediterranean biodiversity hotspot, we studied herbarium specimens and imaged spores with scanning electron microscopy, with special reference to those taxa in the I. lon‐gissima and I. histrix groups that were described from France, Algeria and Turkey, and are in need of a taxonomic revision. The following names are lectotypified: I. adspersa, I. boryana, I. delalandei, and I. viollaei. Holotypes of I. perralderiana and I. olympica were ascertained. We conclude that I. boryana (listed in the “Bern Convention” and in the European Union “Habitats” Directive) justifies consideration at species rank, but I. adspersa should be synonymized with I. longissima. Isoetes tenuissima and I. perralderiana are proposed as distinct species pending further studies. In the I. histrix group, we tentatively accept I. delalandei as a species, presenting some observations on “I. histrix f. subinermis” nom. nud. The latter might also represent a distinct species.