bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exosomal Bta-miR-185 and Bta-miR-378 Are Potential Markers for Quality Control of Milk Infected by Staphylococcus aureus
Authors: Ma Shaoyang , Tong Chao , Ibeagha-Awemu Eveline M. , Zhao Xin 
Published: August 2019

Abstract
MicroRNAs (miRNA) in milk-derived exosomes may reflect pathophysiological changes caused by mastitis. This study profiled miRNAs in milk exosomes and potential markers for quality control of milk infected by Staphylococcus aureus (S. aureus). Total RNA from milk exosomes was collected from healthy cows (n=3) and S. aureus infected cows (n=6). Two hundred ninety miRNAs (221 known and 69 novel ones) were identified. Among them, 22 known and 15 novel miRNAs were differentially expressed (DE). Target genes of DE miRNAs were significantly enriched in intracellular protein transport, endoplasmic reticulum and identical protein binding. Two miRNAs (bta-miR-378 and bta-miR-185) with high read counts and log2 fold changes (>3.5) were considered as potential milk exosome biomarker miRNAs for S. aureus mastitis and milk quality. One target gene (VAT1L) of bta-miR-378 and five target genes (DYRK1B, MLLT3, HP1BP3, NPR2 and PGM1) of bta-miR-185 were validated. DE miRNAs in exosomes from normal and S. aureus infected milk were identified. Two DE miRNAs could be used as potential biomarkers for the infection. The linkage between the validated target genes and diseases suggest that we should pay particular attention to exosome miRNAs from mastitic milk in terms of milk safety.
Patient’s perception of kidney stone prevention within the emergency department and its adherence factors: A single institution study
Authors: Moussa Mohamad , Chakra Mohamed Abou 
Published: August 2019

Abstract
BackgroundNo known data in the literature assessing practice of kidney stone prevention in the emergency department (ED) is available. Objectives: Assess patient perception and compliance to kidney stone prevention given within the emergency department. It also indirectly detects the attitude and practice patterns of primary care providers in kidney stone prevention.Materials and MethodsThis is a qualitative study done in a single institution from January 2018 to January 2019 that includes 99 patients that were diagnosed with kidney or ureteral stone in ED and were discharged home, all of them where stone formers. They were asked to fill a self- administered questionnaire when they are able to read, or interviewed by the resident within the ED when they are unable to read.ResultsThe majority of patients (68%) did not receive any instructions about kidney stones prevention within the ED. Most of patients who follow instructions if it was given were educated (90 %), had an insurance coverage (85%), and had an income higher than $1000 per month (76%), (p<0.05). Seventy one percents of patients believe in the effectiveness of stone prevention if it was provided and most of them are interested in learning about these preventive strategies (82%). Reasons for not following the instructions about kidney stones prevention measures were the cost (53.1%) following by the lack of explanation by ED physicians (18.8%). The majority of patients (62.6%) prefer to receive kidney stones prevention measures from urologists.ConclusionMost of patients in our institute did not receive kidney stones prevention measures in ED despite that they declared their interest in following these measures. Most of the time they did not adhere to those measures due to socioeconomic factors and lack of clarifications. If these instructions were given within the ED, it could lead to an acceptable compliance rate.
The association of change in serum cholesterol levels and clinical treatment response in patients with schizophrenia: a prospective, randomized and open-label study
Authors: Chen Yi-Lung , Chiu Chih-Chiang , Chen Kun-Po , Tai Ming-Hong , Lung For-Wey 
Published: August 2019

Abstract
Background: In the past, it was suggested that dyslipidemia was associated with clinical improvement in patients with schizophrenia treated with antipsychotics; however, measurement at a single time point post-treatment, as done in most studies, could have contributed to the inconsistent results. The aim of this study was to investigate whether changes in serum levels of lipid and other covariates were associated with clinical response in patients with schizophrenia treated with atypical antipsychotics, using repeated measurements and considering time effects.

Method: A total of 90 patients with schizophrenia were enrolled in this 12-week prospective, randomized and open label study. Positive and Negative Syndrome Scale (PANSS) score and a standard serum lipid profile were measured at baseline (day 0) and subsequently followed up at weeks 4, 8 and 12. The generalized estimating equation (GEE) model was applied to examine the relationship between serum lipids and treatment response, controlling for other potential variables.

Results: The results of GEE analysis showed that the increase in serum total cholesterol levels during 12 weeks’ antipsychotic treatment was significantly associated with a reduction in PANSS total score (β = −0.37, p = 0.02) and positive symptom score (β = −0.34, p = 0.01) over time.

Conclusions: These findings revealed that the change in serum total cholesterol level was positively associated with the therapeutic efficacy of atypical antipsychotics. Serum total cholesterol may be a potential predictor of clinical response in patients with schizophrenia treated with atypical antipsychotics.

Trial Registration:
ClinicalTrials.gov identifier: NCT03730857. The trial was retrospectively registered on 11 Feb, 2019.
Effectiveness of cross-sectoral treatment models for patients with mental disorders - meta-analysis of 13 controlled studies from Germany
Authors: Baum Fabian , Schoffer Olaf , Neumann Anne , Seifert Martin , Kliemt Roman , March Stefanie , Swart Enno , Häckl Dennis , Pfennig Andrea , Schmitt Jochen 
Published: August 2019

Abstract
Background

Individuals with mental disorders demand for a continuous and efficient collaboration between different sectors of care. In 2012, a new law in Germany enabled the implementation of cross-sectoral and patient-centered treatment models in psychiatry (FIT64b). These projects have been evaluated by a scientific consortium in controlled cohort studies. We present results of effectiveness based on a meta-analysis from 13 FIT64b hospitals.

Methods/Design

We undertook a series of claims-data-based controlled cohort studies. Data from over 70 statutory health insurance (SHI) funds in Germany were analyzed. All patients insured by any of the participating SHI funds and treated in one of the FIT64b hospitals for any of 16 pre-defined mental disorders were compared with matched control patients from routine care. The collective was subdivided into hospital-new and hospital-known patients. Primary outcomes were duration of inpatient care and duration of sick leave. Individual treatment effects of the 13 FIT64b hospitals were pooled in a random-effects meta-analysis. Meta-regression analysis was used to explore potential reasons for heterogeneity in model effectiveness.

Results

Meta-analyses indicated a significant effect of a reduction by over 5 days on the cumulated duration of inpatient care in hospital-new intervention (IG) compared to control patients (CG). This effect was even stronger among FIT64b hospitals with a pre-existing FIT64b-like environment. Regarding the duration of sick leave there was no overall significant effect between the two groups. Further meta-regression for hospital-new patients revealed that sick leave duration was significantly reduced by almost 13 days in intervention hospitals with a pre-existing FIT64b-like contract compared to hospitals without such a contract.

Conclusions

This meta-analysis suggests positive effects of FIT64b for patients with mental disorders with shorter duration of inpatient treatment. We additionally found a trend towards a reduced duration of sick leave days in FIT64b hospitals with a pre-existing FIT64b–like structure in the pre period. Pre-existing FIT64b-like contracts appear to have facilitated the transition into the new treatment environment. The results should still be interpreted with caution, as this manuscript only covers the first year of the five-year evaluation period in thirteen of eighteen FIT64b hospitals.
Oxytocin Receptor Gene, Childhood Maltreatment and Borderline Personality Disorder among Male Inmates in China
Authors: Zhang Min , Liu Na , Chen Haocheng , Zhang Ning 
Published: August 2019

Abstract
Background

Borderline personality disorder (BPD) is caused by a variety of biological and environmental factors. Accumulating evidence suggests that childhood maltreatment is a risk environmental factor in the development of BPD, but research on the genetic pathology of BPD is still in its early stages, and very little is known about the oxytocin receptor (OXTR) gene. The purpose of this study is to further explore the interaction between OXTR gene polymorphism and childhood maltreatment in BPD.

Methods

A total of 1804 prison inmates and 196 normal controls participated in this study. Childhood maltreatment was measured by a self-reported questionnaire, as was BPD. Venous blood was collected for the genotype test.

Results

Analyses revealed that the BP group had higher rs53576 AA genotype frequency and rs237987 AA genotype frequency than the non-BP group. Childhood maltreatment and its dimension could positively predict BPD risk. Among the prison samples, rs53576 GG genotype carriers had higher BPD scores at higher levels of emotional abuse, physical abuse and sexual abuse and lower BPD scores at lower levels of physical abuse and sexual abuse.

Conclusions

The finding suggests that the interaction between childhood maltreatment and OXTR gene variations is an important mechanism for the development of BPD. The moderating role of the OXTR gene provides evidence for gene plasticity.
Clinical, genetical and microbiological characterization of pediatric patients with Cystic Fibrosis in Ecuador
Authors: Lascano-Vaca Yazmina , Ortiz-Prado Esteban , Gomez-Barreno Lenin , Simbaña-Rivera Katherine , Vasconez Eduardo , Lister Alexander , Arteaga-Espinosa María Emilia , Perez Geovanny F 
Published: August 2019

Abstract
Summary

Objective

To characterize the epidemiology and the clinical, pathological, microbiological and genetical profile of children with cystic fibrosis treated in Ecuador.

Methods

We conducted a cross-sectional analysis of the pediatric population with a confirmed diagnosis of cystic fibrosis (CF) attending to one of the biggest III-level hospitals in Ecuador. All demographic, clinical and genetical variables were obtained from the electronic medical records (EMR) from 2017-2018.

Results

47 patients with CF were observed and followed for more than a year. Gender distribution was similar between male (48.9%, n = 23) and female patients (51.1%, n = 24). The Tiffeneau-Pinelli index (FEV1/FVC) changed significantly after 9 months post-diagnosis (85.55 ± 13.26; p <0.05). The most common pathogenic genetical mutation was F508del, found in 52.78% of the cohort (n = 19); H609R, found in 36.11% (n = 13) and the G85E and the N1303K with 11.11% respectively (n = 3). Finally, there were 14.1% (n = 7) of patients with a mutation g.204099A> C, which has only been reported among Ecuadorians.

Conclusions

This is the first study carried out in Ecuador exploring the clinical, genetical and bacteriological analysis of patients with CF. Children with CF are often colonized by four species of gram-positive bacteria (S. aureus, Coagulase-Negative Staphylococcus, Streptococcus pneumoniae and M. catarrhalis) were the most predominant this condition atients were hospitalized for complications related to cystic fibrosis, with an average of 19 days of stay.
The pattern of blood loss during correction surgery combined with three column osteotomy for adult spine deformity
Authors: Qiao Jun , Liu Zhen , Xu Leilei , Shi Benlong , Sun Xu , Qian Bangping , Zhu Zezhang , Qiu Yong 
Published: August 2019

Abstract
Background: It is of great importance to perform a precise management for blood loss according to stage of surgery. To analyze blood loss during different stages of three column osteotomy (3CO) surgery for scoliosis and to find predictors of blood loss during different stages and to evaluate effectiveness of some blood conservative technique modalities.

Methods: A retrospective review was performed for adult spine deformity (ASD) patients who underwent posterior-only correction along with 3CO. Surgical procedure was divided into four stages: Stage A, exposure; Stage B, screw placement; Stage C, osteotomy; Stage D, rod installment and wound closure. EBL was recorded at the end of each stage. Demographic and radiographic data were collected.

Results: Highest EBL was observed at neuromuscular scoliosis group, while least at idiopathic. 9 patients experienced massive blood loss (EBL>5000 ml). Multivariate linear regression identified fusion level main curve Cobb angle and use of TXA as influential factors for stage A; fusion level, use of TXA and use of navigation system for stage B; kyphosis and use of bone scalpel for stage C; fusion level and main curve Cobb angle for stage D (P<0.05).

Conclusion: Etiology significantly influences blood loss of scoliosis surgery with 3CO. Risk factors of blood loss were varied among different surgical stages. Use of TXA, navigation system and ultrasonic bone scalpel could reduce blood loss.
Clinical features of inflammatory bowel disease combined with severe complications: a retrospective study of hospitalized patients
Authors: Yang Shanbing , Li Lei , Du Shuwen , Zhang Limin , Fan Xin , Li Shu , Kang Zilin , Su Hui , Lu Xiaojuan , Tang Yufen , Tao Yurong , Jia Yan , Yang Xinyan , Jin Peng , Fan Ruying , Sheng Jianqiu , Han Ying , Li Shirong , Wang Jiheng 
Published: August 2019

Abstract
Background

The population characteristics of Inflammatory Bowel Disease (IBD) in China are different from those of western countries, and this population lacks large sample clinical data. This study aimed to analyze the clinical characteristics of inpatients with severe complications of IBD in our center. Methods In this study, medical records of 510 hospitalized IBD patients (excluding pediatrics) were included, digestive tract perforation, massive digestive tract hemorrhage, thrombosis, toxic megacolon, digestive tract fistula, digestive tract stenosis, severe malnutrition, severe infection, and carcinogenesis were defined as severe complications. The clinical process and follow-up were retrospectively analyzed. Results The incidence of severe complications in patients with IBD was 39.02%, 71.31%, 23.81% and 50.68% for CD, UC and IBDU, respectively, and the incidence of severe complications in CD was significantly higher than that in UC (P<0.005). The cumulative incidence of serious complications in IBD patients with the course of 0-10 years was 36.99%, which was significantly lower than 48.35% of the course of >10 years (χ2=4.054, P=0.044). The incidence of carcinogenesis in UC patients with the course of 0-10 years was 1.56%, which was significantly lower than 8.47% of UC patients with the course of >10 years (P<0.01). The incidence of severe complications of UC patients with onset age ≥50 years old was 37.18%, which was significantly higher than 19.00% of that with onset age 20-49 years (P=0.001). The surgical rate of IBD patients was 10.39%, the surgical rate of CD patients was 27.87%, which was significantly higher than 5.08% of UC patients and 4.11% of IBDU patients (P<0.001), and the mortality rate of IBD patients was 1.57%, that of CD and UC was 3.28% and 1.27%, respectively. Conclusions Compared with western countries, IBD patients in China have similar incidence of severe complications, but the surgical rate was lower and the prognosis was better. The onset age ≥50 years old may be an independent risk factor for severe complications of UC patients, and the disease course of > for 10 years is an independent risk factor for carcinogenesis of UC patients.
Working Well: Strategies to Strengthen the Workforce of the Indigenous Primary Healthcare Sector
Authors: Jongen Crystal , McCalman Janya , Campbell Sandy , Fagan Ruth 
Published: August 2019

Abstract
Background: The capacity of the Indigenous primary healthcare (PHC) sector to continue playing a crucial role in meeting the health needs of Aboriginal and Torres Strait Islander Australians is in large part reliant on the skills, motivation and experience of its workforce. While exhibiting many workforce strengths, the sector faces significant challenges in building and maintaining a strong and stable workforce. Drawing on data from one Aboriginal Community Controlled Health Service (ACCHS), this study reports what is working well and what could be improved to strengthen the Indigenous PHC sector workforce.

Methods: Using grounded theory methods, interviews with 17 ACCHS staff from a range of organisational positions were transcribed, coded and analysed. This paper focuses on the strategies identified that contribute towards strengthening the Indigenous PHC workforce.

Results: Four overarching strategies for Indigenous PHC workforce strengthening were identified. These were Strengthening Workforce Stability, Having Strong Leadership, Growing Capacity, and Working Well Together. A range of enabling factors at the macro, community, organisational and individual levels were also identified.

Conclusion: Indigenous PHC services are already implementing many important workforce-development strategies that are having a positive impact on the sector. There are also several persistent challenges which need to be addressed through action at organisational and structural levels. Approaches to workforce strengthening in Indigenous PHC should be tailored to local needs to ensure they address the unique workforce challenges experienced in different contexts.
Integration of mental health care in private not-for-profit health centres in Guinea, West Africa: a systemic entry point towards the delivery of more patient-centred care?
Authors: Sow Abdoulaye , De Man Jeroen , De Spiegelaere Myriam , Vanlerberghe Veerle , Criel Bart 
Published: August 2019

Abstract
Abstract

Background

Patient-centred care is an essential component of quality of health care. We hypothesize that integration of a mental health care package into versatile first-line health care services can strengthen patient participation, an important dimension of patient-centred care. The objective of this study is to analyse whether consultations conducted by providers in facilities that integrated mental health care score higher in terms of patient participation.

Methods

This study was conducted in Guinea in 12 not-for-profit health centres, 4 of which had integrated a mental health care package (MH+) and 8 had not (MH-). The study involved 450 general curative consultations (175 in MH+ and 275 in MH- centres), conducted by 18 care providers (7 in MH+ and 11 in MH- centres). Patients were interviewed after the consultation on how they perceived their involvement in the consultation, using the Patient Participation Scale (PPS). The providers completed a self-administered questionnaire on their perception of patient’s involvement in the consultation. We compared scores of the PPS between MH+ and MH- facilities and between patients and providers.

Results

The mean PPS score was 24.21 and 22.54 in MH+ and MH- health centres, respectively. Participation scores depended on both care providers and the health centres they work in and ranged from 19.12 to 26.96 (p <0.001) for providers and from 20.49 to 26.96 (p <0.001) for the health centres. When adjusting for health providers and the duration of consultation, the patients consulting an MH+ centre were scoring higher on patient participation score than the ones of an MH- centre (adjusted odds ratio of 4.06 with a 95% CI of 1.17-14.10, p = 0.03). All care providers agreed they understood the patients' concerns, and patients shared this view. All patients agreed they wanted to be involved in the decision-making concerning their treatment; providers, however, were reluctant to do so.

Conclusion

Integrating a mental health care package into versatile first-line health services can promote more positive attitudes of care provider-patient interactions, even though this process by its own is not sufficient.
REASONS WHY PATIENTS BYPASS LOWER LEVEL PUBLIC FACILITIES: A CROSS SECTIONAL STUDY FROM UGANDA
Authors: OKORI SAMUEL , BESIGYE INNOCENT , NAMATOVU JANE FRANCIS 
Published: August 2019

Abstract
Background

The quality of services in Uganda at higher level health facilities are usually affected negatively by congestion when patients bypass care from their primary care health facilities (PCHF). The reason behind this bypass phenomenon in Uganda is limited. This study was conducted among patients receiving care at Lira Regional Referral Hospital in northern Uganda to identify reasons why patients bypass their PCHF.

Methods

We performed a descriptive cross-sectional study between 29/12/2014 & 30/1/2015, 484 respondents attending the outpatient department were recruited by systematic random sampling. Four focus group discussions (FGDs) each involving 10 participants were conducted. Quantitative data was collected using a validated questionnaire, entered, analysed by Epidata Entry 3.1 and SPSS 18 versions respectively. Descriptive statistics and chi square test for differences in the study population were used. For qualitative data, thematic analysis of transcripts was done. Codes and categories were developed and interrogated following an iterative process based on grounded theory.

Results

The majority (80.4%) of respondents (71.7% females, mean age 18-35 years, SD 0.85) bypassed their PCHF. Factors associated with bypass were: marital status, distance travelled of >10 km and tertiary education. FGDs reported lack of trust in the health care providers, lack of medicines and diagnostic equipment.

Conclusions

Poor quality of health services at PCHF encourages seeking care from higher-level facilities. Utilization of PCHF is limited due to poor infrastructure, shortage of medicines and human resource. Improvement of these issues will support PCHF which in turn can help reverse bypass phenomenon.