bluuebunny/crossref_metadata_2025_split huggingface dataset:
GC-PROM: Validation of a patient-reported outcomes measure for patients with gastric cancer
Authors: Hu Xiaojuan , Zhao Fen , Yu Hongmei , Luo Yanhong , Liu Jinchun , Zhang Yanbo 
Published: September 2019

Abstract
Background: There is increasing recognition that PROs are important in the estimation of the burden of long-term survival among patients with gastric cancer. The study aimed to develop a disease-specific instrument to assess patient-reported outcomes for patients with gastric cancer.
Method: Following the FDA's draft guidance for patient-reported outcome, conceptual framework and item pool were defined based on relevant existing work. A draft scale was formed after revising some items based on feedback from experts and patients with gastric cancer. The pre-survey and formal survey were conducted in eight different hospitals in Shanxi Province, and two item-selection process based on classical test theory and item response theory. Finally, the patient-reported outcomes measure for patients with gastric cancer (GC-PROM) was validated in terms of reliability, validity, and feasibility. The minimal clinically important difference was determined by distribution-based method.
Results: The final GC-PROM consisted of 38 items, 13 subdomains, and 4 domains. Reliability was verified by Cronbach’s alpha coefficient for four domains and 13 subdomains respectively. The validity results showed that the multidimensional scale fulfilled expectations. In the formal survey, the completion rate was 96.16%, and the average filling time was less than half an hour. The values of the minimal clinically important difference were 4.14, 3.41, 3.37, and 3.28 in the four domains.
Conclusions: The GC-PROM had good reliability, validity, and feasibility and thus can be considered an effective clinical evaluation instrument for patients with gastric cancer.
Characterization of wheat homeodomain-leucine zipper family genes and functional analysis of TaHDZ5-6A in drought tolerance in transgenic Arabidopsis
Authors: Li Shumin , Chen Nan , Li Fangfang , Mei Fangming , Wang Zhongxue , Cheng Xinxiu , Kang Zhensheng , Mao Hude 
Published: September 2019

Abstract
Abstract Background: Many studies in Arabidopsis and rice have demonstrated that HD-Zip transcription factors play important roles in plant development and responses to abiotic stresses. Although common wheat (Triticum aestivum L.) is one of the most widely cultivated and consumed food crops in the world, the function of the HD-Zip proteins in wheat is still largely unknown. Results: To explore the potential biological functions of HD-Zip genes in wheat, we performed a bioinformatics and gene expression analysis of the HD-Zip family. We identified 113 HD-Zip members from wheat and classified them into four subfamilies (I-IV) based on phylogenic analysis against proteins from Arabidopsis, rice, and maize. Most HD-Zip genes are represented by two to three homeoalleles in wheat, which are named as TaHDZX_ZA, TaHDZX_ZB, or TaHDZX_ZD, where X denotes the gene number and Z the wheat chromosome on which it is located. TaHDZs in the same subfamily have similar protein motifs and intron/exon structures. The expression profiles of TaHDZ genes were analysed in different tissues, at different stages of vegetative growth, during seed development, and under drought stress. We found that most TaHDZ genes, especially those in subfamilies I and II, were induced by drought stress, suggesting the potential importance of subfamily I and II TaHDZ members in the responses to abiotic stress. Compared with wild-type (WT) plants, transgenic Arabidopsis plants overexpressing TaHDZ5-6A displayed enhanced drought tolerance, lower water loss rates, higher survival rates, and higher proline content under drought conditions. Additionally, the transcriptome analysis identified a number of differentially expressed genes between 35S::TaHDZ5-6A transgenic and wild-type plants, many of which are involved in stress response. Conclusions: Our results will facilitate further functional analysis of wheat HD-Zip genes, and also indicate that TaHDZ5-6A may participate in regulating the plant response to drought stress. Our experiments show that TaHDZ5-6A holds great potential for genetic improvement of abiotic stress tolerance in crops.
Risk factors associated with the acquisition of linezolid-resistant Enterococcus faecalis
Authors: Rodríguez-Noriega Eduardo , Hernández-Morfin Natalia , Garza-Gonzalez Elvira , Bocanegra-Ibarias Paola , Flores-Treviño Samantha , Esparza-Ahumada Sergio , González-Díaz Esteban , Pérez-Gómez Héctor Raul , Mendoza-Mujica Christian , León-Garnica Gerardo , Morfin-Otero Rayo 
Published: September 2019

Abstract
Background Linezolid is used to treat vancomycin-resistant enterococcal infections. Vancomycin-resistant and -susceptible Enterococcus faecalis can develop resistance to linezolid in clinical settings with high linezolid consumption. Linezolid-resistant E. faecalis (LREF) has emerged as a major nosocomial pathogen in our hospital, in which linezolid use is considerable.Aim To define risk factors and outcomes associated with LREF infections.Methods A retrospective case-control study was designed to evaluate patients admitted to Hospital Civil de Guadalajara “Fray Antonio Alcalde” from January 2014 to October 2017. Fifty patients meeting case definitions for LREF infection and 100 controls hospitalized in the same rooms and dates as the cases were included. Clinical and demographic data were collected and analyzed.Results Risk factors for LREF, included hospitalization within the previous 6 months, intensive care unit admission, previous surgery, urinary catheterization, parenteral nutrition, and acute renal disease. Multivariate analysis identified prior exposures to linezolid [odds ratio (OR, 6.7] and clindamycin (OR, 6.7), previous hospitalization (OR, 2.8), previous surgery (OR, 5.7), and parenteral nutrition (OR, 3.4) as risk factors for LREF infection. The mortality rate for cases was 18% on the LREF versus 9% for controls.Conclusion Risk factors for LREF infections include antibiotic exposures to linezolid, clindamycin, third-generation cephalosporins, meropenem, and colistin; previous hospitalization; intensive care unit admission; previous surgery; and the use of parenteral nutrition.
Medicines use review service in community pharmacies in Spain: REVISA project
Authors: Soler Nuria García-Agua , Gómez-Bermúdez Eugenia , Baixauli-Fernández Vicente J. , Bellver-Beltrán Sara , Velasco-Martínez Javier , Jiménez-Moreno Pablo , Arranz-Esteban María del Mar , Romero-Sánchez Javier M. , García-Ruiz Antonio J. , Jódar-Sánchez Francisco 
Published: September 2019

Abstract
Background: Community pharmacy services play an important role in controlling some factors related to medicine use, and pharmaceutical services integrated with primary healthcare services are critical to achieve the desired outcomes and to significantly reduce harms that can otherwise arise from multiple medicine use, such as non-adherence or medicine-related problems. The aim of the REVISA project is to carry out a study on preliminary implementation of the medicines use review (MUR) service in Spanish pharmacies through pharmacist-led initiatives to obtain a better understanding of patients’ medication adherence and medicine-related problems, together with satisfaction and acceptability of the service and whether patients might be willing to pay for it in the future. Methods: A preliminary implementation, cross-sectional multicentre study was conducted using a convenience sample of voluntary community pharmacies from all regions of Spain. Descriptive and logistic regression analyses were undertaken. Results: Sixty-four community pharmacies participated and a total of 495 patients were enrolled. A slight predominance of women (56%) was noted, with a mean age of 66.09±14.71 years and a mean consumption of 5.68±2.97 medicines. As results of MUR, a total 550 referrals were made. Non-adherence with the medication (OR=1.74; 95% CI: 1.17 to 2.58), polypharmacy (OR=1.50; 95% CI: 1.02 to 2.20) and help with medication (OR=3.03; 95% CI: 1.45 to 6.34) were associated with referrals. Patients were adherent for 68.3% of their medicines. However, at the patient level, only 31.5% were adherent. Polypharmacy patients older than 65 years increased the risk of non-adherence (OR=1.56; 95% CI: 1.06 to 2.30).The mean time employed by the pharmacists in the MUR was 52.80±31.52 minutes (MUR-related cost of €17.27). Most patients expressed a high level of satisfaction with the MUR service (98.5%) and a willingness to pay for it (84%). Conclusions: The MUR service in community pharmacies in Spain can be delivered, that it appears to be acceptable to patients and that most patients said they would be willing to pay for it. Pharmacists self-reported the length of time taken to deliver a MUR although the feasibility of incorporating into everyday practice would need to be assessed.
Smoking is Associated with a Higher Risk of Unplanned Medical Visits among Adult Patients with Diabetes
Authors: Selya Arielle , Johnson Eric L , Weber Tess L , Russo Jaymi , Stansbury Cheryl , Anshutz Drake , Griese Emily , Hsu Benson 
Published: September 2019

Abstract
Background

Smoking exacerbates the complications of diabetes, but little is known about whether patients with diabetes have more unplanned medical visits. This study examines the association between smoking status and unplanned medical visits among patients with diabetes.

Methods

Data were drawn from electronic medical records (EMR’s) from a large healthcare provider in the Northern Plains region of the US, from adult (≥18 years old) patients with type 1 or type 2 diabetes who received care within this healthcare system at least once during the 3-year period spanning 2014-16 (N=62,149). The association between smoking status (current, former, or never smoker) and having ≥1 unplanned visit (comprised of emergency department visits, hospitalizations, hospital observations, and urgent care) was examined after adjusting for age, race/ethnicity, and body mass index (BMI). The top ten most common diagnoses for unplanned visits were examined by smoking status.

Results

Both current and former smoking were associated with an approximately 1.2-fold increase in the odds of having at least one unplanned medical visit in the 3-year period (OR=1.22, 95% CI=1.16-129; OR=1.23, 95% CI=1.19-1.28, respectively), relative to never-smokers. Most common diagnoses for all patients were pain-related. However, diagnoses related to musculoskeletal system and connective tissue disorders were more common among smokers. Smoking is associated with a higher rate of unplanned medical visits among patients with diabetes in this regional healthcare system.

Conclusions

Results from this study reveal higher rates of unplanned visits among smokers and former smokers, as well as increased frequencies of unplanned medical visits among current smokers.
Closing the pediatric gap in the first 90: is caregiver sex associated with HIV status of orphans and vulnerable children? Learning from the USAID Kizazi Kipya Project in Tanzania
Authors: Exavery Amon , Charles John , Kuhlik Erica , Barankena Asheri , Koler Alison , Kikoyo Levina , Jere Elizabeth 
Published: September 2019

Abstract
Background Tanzania has met only 50.1% of the 90% target for diagnosing HIV in children. Context-specific strategies are necessary to find the hidden children for HIV testing. This study assesses the association between caregiver sex and HIV status of orphans and vulnerable children (OVC). Methods Data originate from the community-based, USAID-funded Kizazi Kipya Project, which works towards increasing OVC’s and their caregivers’ uptake of HIV/AIDS and other social services in Tanzania. Included in this study are 39,578 OVC ages 0–19 years who the project served during January-March 2017 in 18 regions of Tanzania and who voluntarily reported their HIV status. Data analysis involved multi-level logistic regression, with OVC HIV status as the outcome and caregiver’s sex the main independent variable.Results Three-quarters (74.3%) of the OVC included in the study had female caregivers, and their overall HIV prevalence was 7.1%. The prevalence was significantly higher (p<0.001) among OVC with male caregivers (7.8%) than among OVC with female caregivers (6.8%), and indeed, multivariate analysis showed that OVC with male caregivers were significantly 40% more likely to be HIV-positive than those with female caregivers (OR=1.40, 95% CI 1.08–1.83). This effect was the strongest among 0–4 year-olds (OR=4.02, 95% CI 1.61–10.03), declined to 1.72 among 5–9 year-olds (OR=1.72, 95% CI 1.02–2.93), and lost significance for children over age 9 years. This effect was adjusted for OVC sex and nutritional status; caregiver marital status, education level, and HIV status; family’s place of residence, size, wealth quintile, and health insurance ownership; and co-residence of multiple OVC. Conclusion OVC in Tanzania with male caregivers have a 40% higher likelihood of being HIVpositive than those with female caregivers. HIV risk assessment activities should target OVC with male caregivers, as well as OVC who have malnutrition, HIV-positive caregivers, or caregivers who do not disclose their HIV status to community volunteers. Further, younger HIV-positive OVC are more likely to live in rural areas, while older HIV-positive OVC are more likely to live in urban areas. These factors should be integrated in HIV risk assessment algorithms to enhance HIV testing yields and pediatric case-finding in the OVC population in Tanzania.
Integration of Palliative Care in Services for Children with Life Limiting Neurodevelopmental Disabilities and Their Families: A Delphi Study
Authors: Guerin Suzanne , Kiernan Gemma , Courtney Eileen , McQuillan Regina , Ryan Karen 
Published: September 2019

Abstract
Background The aim of this study was to explore expert professionals’ opinions on service provision to children under six with life-limiting neurodevelopmental disabilities (LLNDD), including the goals of care and the integration and coordination of palliative care in general and specialist services.Methods A Delphi design was used with three survey rounds, one open-ended and two closed response rounds. Primary data collected over a six-month period from expert professionals with five years’ (or more) experience in pediatric, intellectual disability and/or palliative care settings. Ratings of agreement and prioritization were provided with agreement expressed as a median (threshold = 80%) and consensus reported as interquartile ranges. Stability was measured using non-parametric tests.Results Primary goals of care were achievement of best possible quality of life, effective communication and symptom management. Service integration and coordination were considered inadequate, and respondents agreed that areas of deficiency included palliative care. Improvement strategies included a single care plan, improved communication and key worker appointments.Conclusions The findings suggest that services do not serve this group well with deficiencies in care compounded by a lack of information on available services and sub-optimal communication between settings. Further research is needed to develop an expert-based consensus regarding the care of children with LLNDD.
Analysis rates of drunk driving accidents and temporal distribution between 2012 and 2016 and risk factors
Authors: Shen Mei , Du Yue , Zhou Hua sheng 
Published: September 2019

Abstract
Background: This study aimed to understand the temporal distribution characteristics of road traffic collisions and the drunk driving collisions and casualty rates in some districts of Guangzhou city to develop suggestions for prevention of drunk driving. Methods: Data such as test results, casualties, and occurrence time from a total of 4986 traffic collisions reports issued by the Health Laboratory Centre of Southern Medical University between 2012 and 2016 were retrospectively analyzed. Results: Outcome measures included the relationship between the temporal distribution and rate of drunkdriving collisions and casualties. Data from the recent five years indicated that the number of collisions declined yearly, and the detection detection rate of drunk driving increased yearly. Drunk driving collisions mainly occurred during the period from 22:00-04:00 every day. The number of traffic collisions and the detection rate of drunk driving were significantly higher in the nighttime than that in the daytime. Most collisions occurred on Wednesday. The detection rate of drunk driving collisions was high in February, October, November and December, all with a percentage of more than 63%. The casualty rate of collisions that did not involve drunk driving was significantly higher than that of drunk driving collisions. Conclusion: Through the analysis of drunk driving in some districts of Guangzhou, we can control the intensity of drunk driving inspection so as to prevent road traffic collisions caused by drunk driving. At the same time, the government should step up publicity and education on the hazards of drunk driving to reduce the occurrence of drunk driving Road traffic collisions.
Overweight and Obesity among children under five in Ethiopia: Further Analysis of 2016 National Demographic Health Survey: A Case Control Study
Authors: Weldearegay Haftom Gebrehiwot , Gebrehiwot Tesfay Gebregzabher , Abrha Mulugeta Woldu , Mulugeta Afework 
Published: September 2019

Abstract
Objective

The objective of this study was to assess the determinants of overweight and obesity among children under five years in Ethiopia.

Results

Data from a total of 672 (224 cases and 448 controls) under five years of age children were included in the study. Urban residence (AOR = 2.63, 95% CI: 1.29, 5.34), boys (AOR = 1.56, 95% CI: 1.10, 2.22) and age of the child less than six months (AOR=3.40, 95%CI: 2.05, 5.64) were the determinants for being childhood overweight and obesity.
Birth order is associated with caries development in young children: a register-based cohort study
Authors: Julihn Annika , Soares Fernanda Cunha , Hammarfjord Ulrika , Hjern Anders , Dahllöf Göran 
Published: September 2019

Abstract
Background: Birth order has been shown to affect the health of the child; less is known, however, about how birth order affects caries development in children. Thus, the present study investigated the association between birth order and dental caries development in young children. Methods: This retrospective registry-based cohort study included all children born in 2000–2003 who were residing in Stockholm County, Sweden, at age 3 years (n = 83,147). The study followed the cohort until subjects reached 7 years of age. Children with registry data on dental examinations and sociodemographic characteristics at ages 3- and 7 years constituted the final study cohort (n = 65,259). The outcome variable was “caries increment from age 3- to 7 years” (Δdeft > 0) and the key exposure, “birth order”, was divided into five groups. A forward stepwise logistic binary regression was done for the multivariate analysis with adjustments for sociodemographic factors. Results: At age 3 years, 94% had no fillings or manifest caries lesions. During the study period, 22.5% (n = 14,711) developed dental caries. The final logistic regression analysis found a statistically significant positive association between birth order and caries increment. Further, excess risk increased with higher birth order; with the mother’s first-born child as reference, risk for the second-born child was OR 1.17, 95% CI=1.12–1.23; for the third-born child, OR 1.47, 95% CI=1.38–1.56; for the fourth-born child, OR 1.69, 95% CI=1.52–1.88; and for the fifth-born or higher birth-order child, OR 1.84, 95% CI=1.58–2.14. Conclusions: These findings show that birth order influences caries development in siblings, suggesting that birth order can be regarded as a predictor for caries development in young children. This factor may be helpful in assessing caries risk in preschool children and should be considered in caries prevention work in young children with older siblings.
Does sunlight drive seasonality of TB in Vietnam? A retrospective environmental ecological study of Tuberculosis seasonality in Vietnam from 2010-2015
Authors: Bonell Ana , Contamin Lucie , Thai Pham Quang , Thuy Hoang Thi Thanh , Doorn Rogier H van , White Richard , Nadjm Behzad , Choisy Marc 
Published: September 2019

Abstract
Background Tuberculosis (TB) is a major global health burden, with an estimated quarter of the world’s population being infected. The World Health Organization (WHO) launched the “End TB Strategy” in 2014 with emphasis placed on knowing the epidemic. Vietnam is 12th in the world ranking of high burden countries by WHO definition. TB spatial and temporal patterns have been observed globally with evidence of Vitamin D playing a role in the seasonality. We explored the presence of temporal and spatial clustering of TB in Vietnam and their determinants to aid public health measures.Methods Data were collected by the National TB program of Vietnam from 2010-2015 and linked to the following datasets: socio-demographic characteristics; climatic variables; influenza-like-illness (ILI) incidence; geospatial data. The TB dataset was aggregated by province and quarter. Descriptive time series analyses using LOESS regression were completed per province to determine seasonality and trend. Harmonic regression was used to determine the amplitude of seasonality by province. A mixed-effect linear model was used with province and year as random effects and all other variables as fixed effects.Results There were 610,676 cases of TB notified between 2010-2015 in Vietnam. Heat maps of TB incidence per quarter per province showed substantial temporal and geospatial variation. Time series analysis demonstrated seasonality throughout the country, with peaks in spring/summer and troughs in autumn/winter. Incidence was consistently higher in the south. However, relative seasonal amplitude was more pronounced in the north. Mixed-effect linear model confirmed that TB incidence was associated with time and latitude. Of the demographic, socio-economic and health related variables, population density, percentage of those under 15 years of age, and HIV infection prevalence per province were associated with TB incidence. Of the climate variables, absolute humidity, average temperature and sunlight were associated with TB incidence.Conclusion Incidence decreased and the relative seasonal amplitude of TB increased with latitude in Vietnam. Temporal and spatial hotspots were found. Seasonality of TB was associated with reduced hours of sunlight at a lag of six months.