bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retained primary teeth in STAT3 hyper-IgE syndrome: Early intervention in childhood is essential
Authors: Meixner Iris , Hagl Beate , Kröner Carolin I. , Spielberger Benedikt D , Paschos Ekaterini , Dückers Gregor , Niehues Tim , Hesse Ronny , Renner Ellen D 
Published: August 2019

Abstract
Objectives: To optimize dental management we evaluated development of the dentition and long-term outcome of dental treatment in STAT3 hyper-IgE syndrome (STAT3-HIES), a rare primary immunodeficiency clinically overlapping with atopic dermatitis. Next to eczema, elevated serum-IgE, and recurrent infections, STAT3-HIES patients present with characteristic facies, midline defects, and retained primary teeth.
Materials and Methods: We assessed dental histories of 13 molecularly defined STAT3-HIES patients by questionnaires, radiographs, and dental investigations.
Results: Primary tooth eruption was unremarkable in all STAT3-HIES patients. Primary tooth exfoliation and permanent tooth eruption was delayed in 83% of patients due to unresorbed tooth roots. Permanent teeth erupted spontaneously in all patients receiving primary teeth extraction of retained primary teeth during average physiologic exfoliation time. A complex orthodontic treatment was needed in one patient receiving delayed extraction of primary molars and canines.
Conclusion: To enable spontaneous eruption of permanent teeth in children with STAT3-HIES, we recommend extracting retained primary incisors not later than 9 years of age and retained primary canines and molars not later than 13 years of age after having confirmed the presence of the successor permanent teeth by radiograph.
Clinical Relevance: The association of STAT3-HIES with retained primary teeth is important knowledge for dentists in any field as timely extraction of retained primary teeth avoids dental complications.
A CROSS SECTIONAL ANALYSIS OF DIETARY PRACTICES AND NUTRITION STATUS OF FEMALE UNDERGRADUATE STUDENTS AT KENYATTA UNIVERSITY, KENYA
Authors: Waweru Grace , Chege Peter , Njogu Eunice 
Published: August 2019

Abstract
Background

The rapid changes in eating habits and lifestyles in Kenya have resulted to the overweight/obesity transition. Students are likely to make poor food choices which may affect their nutrition status during the beginning of college and this may continue throughout their life. This study aimed to establish the dietary practices, assess nutrition status based on body mass index and the relationship between selected dietary practices and nutrition status of female undergraduate students at Kenyatta University, Kenya.

Methods
The study adopted a cross-sectional analytical design involving sample of 422 female undergraduate students randomly selected from Kenyatta University. Food Frequency Questionnaire and the Minimum Dietary Diversity – Women were used to assess dietary practices. Weight and height were measured to assess the nutrition status of the female students.

Results

The results showed that 64.0% of the participants had consumed ≥ 5 food groups while 36% had consumed <5 food groups over a period of 24 hours. In terms of nutrition status, 68.4% of the participants had normal BMI while 23.9% were overweight, 5.55% were underweight and 2.3% were obese. MDDS-W was significantly associated with nutrition status (p=0.044).

Conclusion

The results illustrated unhealthy eating habits and sub-optimal nutrition status among a significant number of the female students. Policy makers should scale up interventions that would help improve dietary practices of women of reproductive age particularly university students.
Staff expectations for the implementation of an electronic patient record system: A qualitative study
Authors: mccrorie carolyn , Benn Jonathan , Johnson Owen , Scantlebury Arabella 
Published: August 2019

Abstract
Background

Global evidence suggests benefits of introducing electronic patient record (EPR) systems to improve patient care. However, implementing EPR into healthcare organisations is complex and in the United Kingdom (UK), uptake has been slow. More research is needed to explore factors influencing successful implementation. This study explored staff expectations for change and outcome following procurement of an EPR system in a large academic acute NHS trust in the UK.

Methods

Qualitative interviews were conducted with 14 members of hospital staff who represented a variety of user groups across different specialities within an NHS hospital in England. The four components of Normalisation Process Theory (Coherence, Cognitive participation, Collective action and Reflexive monitoring) provided a theoretical framework to interpret and report study findings.

Results

Health professionals had a common understanding for the rationale for EPR implementation (Coherence). There was variation in willingness to engage with and invest time into EPR (Cognitive participation) at an individual, professional and organisational level. Collective action (whether staff feel able to use EPR) was influenced by context and perceived user-involvement in EPR design and planning of the implementation strategy. When appraising EPR (Reflexive monitoring), staff anticipated short and long-term benefits. Staff perceived that quality and safety of patient care would be improved with EPR implementation, but that these benefits may not be immediate. Some staff perceived use of the system during early implementation to negatively impact patient care. The findings indicate that preparedness for EPR use could mitigate perceived threats to the quality and safety of care.

Conclusions

Health professionals looked forward to reaping the benefits from EPR use. Variations in level of engagement suggest early components of the implementation strategy were effective, and that more work was needed to involve users in preparing them for use. A clearer understanding as to how staff groups and services differentially interact with EPR as they go about their daily work was required. The findings may inform other hospitals and healthcare systems on actions that can be taken prior to EPR implementation to reduce concerns for quality and safety of patient care and improve the chance of successful implementation.
Predicting Hospitalization following Psychiatric Crisis Care using Machine Learning
Authors: Blankers Matthijs , Post Louk F. M. van der , Dekker Jack J. M. 
Published: August 2019

Abstract
Background: It is difficult to accurately predict whether a patient on the verge of a potential psychiatric crisis will need to be hospitalized. Machine learning may be helpful to improve the accuracy of psychiatric hospitalization prediction models. In this paper we evaluate and compare the accuracy of ten machine learning algorithms including the commonly used generalized linear model (GLM/logistic regression) to predict psychiatric hospitalization in the first 12 months after a psychiatric crisis care contact, and explore the most important predictor variables of hospitalization.

Methods: Data from 2,084 patients with at least one reported psychiatric crisis care contact included in the longitudinal Amsterdam Study of Acute Psychiatry were used. The accuracy and area under the receiver operating characteristic curve (AUC) of the machine learning algorithms were compared. We also estimated the relative importance of each predictor variable. The best and least performing algorithms were compared with GLM/logistic regression using net reclassification improvement analysis. Target variable for the prediction models was whether or not the patient was hospitalized in the 12 months following inclusion in the study. The 39 predictor variables were related to patients’ socio-demographics, clinical characteristics and previous mental health care contacts.

Results: We found Gradient Boosting to perform the best (AUC=0.774) and K-Nearest Neighbors performing the least (AUC=0.702). The performance of GLM/logistic regression (AUC=0.76) was above average among the tested algorithms. Gradient Boosting outperformed GLM/logistic regression and K-Nearest Neighbors, and GLM outperformed K-Nearest Neighbors in a Net Reclassification Improvement analysis, although the differences between Gradient Boosting and GLM/logistic regression were small. Nine of the top-10 most important predictor variables were related to previous mental health care use.

Conclusions: Gradient Boosting led to the highest predictive accuracy and AUC while GLM/logistic regression performed average among the tested algorithms. Although statistically significant, the magnitude of the differences between the machine learning algorithms was modest. Future studies may consider to combine multiple algorithms in an ensemble model for optimal performance and to mitigate the risk of choosing suboptimal performing algorithms.
Genetic characterization of highly pathogenic avian influenza A (H5N8) virus isolated from domestic geese in Iraq, 2018
Authors: Saeed Nahla M. , Rashid Peshnyar M.A. , Dyary Hiewa Othman 
Published: August 2019

Abstract
After the circulation of H5N1 in 2006, 2015 and 2016 in Iraq, a new H5N8 influenza virus emerged in Iraq in 2018. In this study, a HPAI virus subtype H5N8 was identified from backyard domestic geese in Kurdistan region, Iraq. Phylogenic analyses of the hemagglutinin (HA) and neuraminidase (NA) genes indicated that Iraq H5N8 viruses belonged to clade 2.3.4.4 group B and clustered with isolates from Iran, Israel and Belgium. Genetic analysis of HA of the Iraq H5N8 indicated molecular markers for avian-type receptors. Characterization of the NA gene showed that the virus had sensitive molecular markers for antiviral drugs. This is the first study ever on H5N8 in Iraq and it is crucial to understand the epidemiology of the viruses in Iraq and the Middle East. The results are suggestive of a possible role of migratory birds in the introduction of HPAI subtype H5N8 into Iraq.
Carbapenems-resistant Pseudomonas aeruginosa bloodstream infection in Hematopoietic stem cell transplant patients: in vitro synergy and clinical outcome
Authors: Ramos Jessica Fernandes , Leite Gleice Cristina , Martins Roberta Cristina Ruedas , Rizek Camila , Sanabani Sabri Saeed Al , Guimarães Thais , Levin Anna Sara , Rocha Vanderson , Costa Silvia 
Published: August 2019

Abstract
Summary

Bloodstream infection (BSI) caused by Pseudomonas aeruginosa has high mortality in hematopoietic stem cell transplant (HSCT) recipients. Objectives: To evaluate clinical, in vitro synergy and molecular features of 30 BSI caused by carbapenems-resistant P. aeruginosa (CRPA) in HSCT patients. Methods: Demographic and clinical data including treatment were collected and a database was built using EPIINFO, bivariate and multivariate analysis were run to assess outcome using SPSS. In vitro synergy using time-kill assays, pulsed-field electrophoresis (PFGE) and PCR for carbapenemases and virulence genes were performed for all isolates. Whole genome sequence (WGS) of main clones was done by Nextera XT, using Illumina MiSeq technology. Results: Mortality was 71%; most patients who died were allogeneic HSCT (78%) (p=0.02). Clinical isolates showed a high resistance level to meropenem: 50% had a MIC of 512 µg/mL; two thirds were susceptible to amikacin (MIC 2-512 µg/mL) and 100% to colistin. Many (17/30) isolates achieved synergistic effect with meropenem plus colistin but not with amikacin. None antagonism was observed. The presence of synergy by time-kill between colistin and meropenem showed a tendency towards a better outcome (HR 0.68 95%CI 0.02-1.02; p=0.06). The most frequent carbapenemase gene identified was blaSPM, and six co-harboured both blaKPC and blaSPM. Isolates presented genes related with virulence factors such as toxA, exoS and more patients with BSI caused by P. aeruginosa harbouring gene lasB evolved to death. The WGS showed that all five clones harboured SPM-1, Tn4371 and belonged to ST277; however, the resistance and virulence genes differ among the clones. Conclusion: CRPA BSI showed high mortality in HSCT patients. All clones carried SPM-1, Tn4371 and belonged to ST277. Synergy by time-kill between colistin and meropenem showed a tendency towards a better outcome
Exploring the success of Brazilian endemic clone Pseudomonas aeruginosa ST277 and its association with the CRISPR-Cas system type I-C
Authors: Silveira Melise Chaves , Rocha-de-Souza Cláudio Marcos , Albano Rodolpho Mattos , Santos Ivson Cassiano de Oliveira , Carvalho-Assef Ana Paula D'Alincourt 
Published: August 2019

Abstract
Background

The Brazilian endemic clone Pseudomonas aeruginosa ST277 carry important antibiotic resistance determinants, highlighting the gene coding for SPM-1 carbapenamase. However, the resistance and persistence of this clone is apparently restricted to Brazilian territory. To completely understand the differences between strains from Brazil from the ones isolated in other countries, we phylogenetically examined 43 P. aeruginosa ST277 genomes as well as analyzed virulence and resistance genes, evaluated the distribution of genomic islands and assessed in detail the characteristics of the CRISPR-Cas immunity system in these isolates.

Results

The Brazilian genomes presented a typical set of resistance and virulence determinants, genomic islands and a high frequency of the CRISPR-Cas system type I-C. Upon phylogeny results, even if ST277 genomes are closely related we can see important differences among the strains isolated from China, Mexico and United States when compared to others, most of them from Brazil. We also observed a standard CRISPR spacers content for ST277, confirming a strong link between phylogeny and spacer acquisition.

Conclusions

Based on our findings, Pseudomonas aeruginosa ST277 strains circulating in Brazil have acquired a few distinctive genetic elements that contributing to their resistance, pathogenicity and success when compared to strains from other countries.
Acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa: A Knowledge, Attitudes and Practices Survey
Authors: Lourens Andrit , Hodkinson Peter , Parker Romy 
Published: August 2019

Abstract
Background:
Acute pain is frequently encountered in the prehospital setting, and therefore, is known to be a fundamental aspect of quality emergency care. Research has shown a positive association between pain management practices and health care providers’ knowledge of, and attitudes towards pain. This study aimed to describe the knowledge, attitudes, and practices of emergency care providers in relation to acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa.

Methods:
A web-based descriptive cross-sectional survey was conducted among emergency care providers of all qualifications, using a face-validated Knowledge, Attitudes and Practices of Pain survey.

Results:
A hundred (n=100) respondents, with a mean age of 34.74 (SD 8.13) years and mean of 10.02 (SD 6.47) years of experience participated. Most respondents were male (69%), employed in the public/government sector (93%) as operational emergency care providers (85%) with 54% (n=54) of respondents having attended medical education on pain assessment and management in the last two years.
The overall mean percentage of correct answers for knowledge and attitudes regarding pain among emergency care providers was 58.01% (SD 15.66) with gaps identified in various aspects of pain and pain management including: basic knowledge of pain physiology; pain assessment; indicators of severe pain; pharmacological and non-pharmacological pain management; culture and spiritual influences; and pain expression. Practitioners with a higher qualification, more years’ experience and those who did not attend medical education on pain, achieved higher overall scores. Pain scores were not assigned to patients’ as self-reported while overall, limited pain relief was provided.

Conclusion:
Our results suggest that there is suboptimal knowledge and attitudes regarding pain among most levels of emergency care qualifications. Pain education is essential, it should occur regularly, and specific educational initiatives aimed at addressing pain knowledge and attitudes have been indicated. Future work should focus on the additional description of the gaps in pain knowledge and attitudes among emergency care providers and exploring the decline over time. Description of barriers to and enablers of pain care in the South African prehospital setting is imperative. Organisational culture should endorse and monitor prehospital pain care.
The interactome of porcine epidemic diarrhea virus nucleocapsid protein
Authors: Tan Min , Ding Guofei , Cai Xinna , Cao Shengliang , Cong Fangyuan , Liu Jiaqi , Zhao Yuzhong , Liu Sidang , Liu Guangliang , Xiao Yihong 
Published: August 2019

Abstract
Background

Many viral proteins specifically interact with cellular proteins to facilitate virus replication. Understanding these interactions can decipher the viral infection mechanism and provide potential targets for antiviral therapy. Porcine epidemic diarrhea virus (PEDV), the agent of PED, causes numerous economic losses for the swine industry each year. Till now, no effective vaccine or drugs are available to contain this disease. As a result, it is critical urgent to elucidate the PEDV interactome. The nucleocapsid (N) of PEDV plays an important role in viral replication.

Results

In this study, the N gene was cloned into pEGFP-C1 and transfected into 293T cells. The interactome of N was elucidated by label-free mass spectrometry. A total of 125 cellular proteins interacting with PEDV N protein were discovered, of which 4 cellular proteins, DHX9, NCL, KAP1, TCEA1, were confirmed by pull down, immunoprecipitation, and co-localization.

Conclusions

The interactome of N protein supplied a powerful tool to explore the role of N in PEDV infection and therapeutic targets.
What is the advantage of rectal amputation with an initial perineal approach for primary anorectal carcinoma?
Authors: Funahashi Kimihiko , Goto Mayu , Kaneko Tomoaki , Ushigome Mitsunori , Kagami Satoru , Koda Takamaru , Nagashima Yasuo , Yoshida Kimihiko , Miura Yasuyuki 
Published: August 2019

Abstract
Background: Rectal amputation (RA) remains an important surgical procedure for salvage despite advances in sphincter-preserving resection, including intersphincteric resection. The aim of this study was to compare short- and long-term outcomes of RA with an initial perineal approach to those of RA with an initial abdominal approach (conventional abdominoperineal resection (APR)) for primary anorectal cancer.
Methods: We retrospectively analyzed the short- and long-term outcomes of 48 patients who underwent RA with an initial perineal approach (perineal group) and 21 patients who underwent RA with an initial abdominal approach (conventional group).
Results: For the perineal group, the operation time was shorter than that for the conventional group (313 vs. 388 minutes, p = 0.027). The postoperative complication rate was similar between the two groups (43.8 vs. 47.6%, p = 0.766). Perineal wound complications (PWCs) were significantly fewer in the perineal group than in the conventional group (22.9 vs. 57.1%, p = 0.006). All 69 patients underwent complete TME, but positive CRM was significantly higher in the conventional group than in the perineal group (0 vs. 19.0%, p = 0.011). There were no significant differences in the recurrence (43.8 vs. 47.6%, p = 0.689), 5-year disease-free survival (63.7% vs. 56.7%, p = 0.665) and 5-year overall survival rates (82.5% vs. 66.2%, p = 0.323) between the two groups.
Conclusion: These data suggest that RA with an initial perineal approach for selective primary anorectal carcinoma is advantageous in minimizing PWCs and positive CRMs. Further investigations on the advantages of this approach are necessary.
Two Novel Mutations in the ALPL gene of Unrelated Chinese Children with Hypophosphatasia: Case Reports and Literature Review
Authors: Mao Xiaojian , Liu Sichi , Lin Yunting , Chen Zhen , Shao Yongxian , Yu Qiaoli , Liu Haiying , Lu Zhikun , Sheng Huiyin , Lu Xinshuo , Huang Yonglan , Liu Li , Zeng Chunhua 
Published: August 2019

Abstract
Objective: Hypophosphatasia (HPP) is an inherited disorder of defective skeletal mineralization caused by mutations in the ALPL gene that encodes the Tissue Non-specific Alkaline Phosphatase (TNSALP). It is subdivided into six forms depending on the age of onset: perinatal lethal, prenatal benign, infantile, childhood, adult, and odonto HPP. Among these, infantile HPP is characterized by early onset and high frequency of lethal outcome. Few studies have reported the phenotype and genetic characteristics of HPP in Chinese children.

Case presentation: Three forms of HPP were identified in four unrelated patients from four different Chinese families, including one lethal infantile (patient 1), two childhood (patient 2 and 3) and one odonto HPP (patient 4). Six variants in the ALPL gene were identified, including five missense mutations and one frameshift mutation. Of which, none were reported previously in the Chinese population, and two were novel (c.359G>C: p.G120A and c.1017dupG: p.H340AfsX3). Patient 1 carrying a novel homozygous (c.359G>C) mutation showed respiratory distress and pneumonia at first day of his life. He presented nearly negligible level of serum ALP activity, overall skeletal hypominaralization and died at 3 months old. Patient 2, 3 and 4 were compound heterozygotes with decreased serum ALP activity. Patient 2 and 3 presented premature loss of deciduous teeth, muscle weakness and bone pain, whereas patient 4 had early loss of deciduous teeth only. All four pedigrees exhibited autosomal recessive pattern of inheritance.

Conclusions: In this study, six mutations in the ALPL gene were found in four Chinese HPP patients. Two of which were novel: c.359G>C in exon 5 and c.1017dupG in exon 10. Our results show that the novel mutation c.359G>C is strongly indicated to be disease-causing and associated with severe infantile form of HPP.
Efficacy of an electrochemical flow cell introduced into the electrochemical Fenton-type process using a Cu(I)/HOCl system
Authors: Kishimoto Naoyuki , Ito Saki , Kato Masaaki , Otsu Hideo 
Published: August 2019

Abstract
An electrochemical flow cell was introduced into the electrochemical Fenton-type process using a Cu(I)/HOCl system. The effects of the current density and the initial cupric ion (Cu2+) concentration on the process performance were discussed. The current efficiency of the process improved from 6.1% for an electrolytic tank system to 33% for the electrochemical flow cell system at a current density of 5.0 mA/cm2 and an initial Cu2+ concentration of 1.0 mM. The current efficiency increased to 58% for Cu2+ concentrations of 2.0 mM and beyond. The cathodic reduction of Cu2+ to the cuprous ion (Cu+) emerged as the rate-determining step in comparison to the anodic production of free chlorine. The introduction of the electrochemical flow cell enhanced the cathodic production of Cu+ by reinforcing the mass transfer of the Cu2+ to the cathode, and the detachment of micro bubbles generated electrochemically at the cathode surface. A decrease in the current density and an increase in the initial Cu2+ concentration also improved the current efficiency by promoting the cathodic production of Cu+. This involved the prevention of the cathodic reduction of protons to hydrogen gas and the elevation of the electrode potential of the cathodic reaction from Cu2+ to Cu+.