bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary care service use by end-of-life cancer patients: a nationwide retrospective cohort study in the United Kingdom
Authors: Gao Wei , Gulliford Martin , Morgan Myfanwy , Higginson Irene J 
Published: September 2019

Abstract
Background End of life(EoL) care becomes more complex and increasingly takes place in the community but there is little data on the use of general practice (GP) services to guide care improvement. This study aims to determine the trends and factors associated with GP consultation, prescribing and referral to other care services amongst cancer patients in the last year of life.Methods A nationwide, retrospective cohort study using the Clinical Practice Research DataLink(CPRD) in the United Kingdom primary care, 2001-2014. Outcome variables were number of GP consultations(primary), number of prescriptions and referral to other care services (yes vs no) in the last year of life. Explanatory variables included socio-demographics, clinical characteristics and the status of palliative care needs recognised or not. The association between outcome and explanatory variables were evaluated using multiply adjusted risk ratio(aRR).Results Of 68,523 terminal cancer patients, 70% were aged 70+, 75% had comorbidities and 45.5% had palliative care needs recognised. In the last year of life, a typical cancer patient had 43 GP consultations (Standard deviation(SD): 31.7; total=3,031,734), 71.5 prescriptions (SD: 68.0; total=5,074,178), and 21 (SD: 13.0) different drugs; 58% of patients had at least one referral covering all main clinical specialities. More comorbid conditions, prostate cancer and having palliative care needs recognised were associated with more primary care consultations, more prescriptions and a higher chance of referral (aRRs 1.07-2.03). Increasing age was related to fewer consultations (aRRs: 0.77-0.96), less prescriptions(aRR 1.09-1.44), and a higher chance of referral (aRRs 1.08-1.16) but less likely to have palliative care needs recognised(aRRs 0.53-0.89).Conclusions GPs are very involved in the end of life care of cancer patients, most of whom having complex care needs, i.e. older age, comorbidity and polypharmacy. This highlights the importance of enhancing primary palliative care skills among GPs and the imperative of a greater integration of primary care with other healthcare professionals including oncologists, palliative care specialists, geriatricians and pharmacists. Research into the potential of deprescribing is warranted. Older patients have poorer access to both primary care and palliative care need to be addressed in future practices.
A unified nomenclature for vertebrate olfactory receptors
Authors: Olender Tsviya , Jones Tamsin E.M. , Twik Michal , Bruford Elspeth , Lancet Doron 
Published: September 2019

Abstract
Background Olfactory receptors (ORs) are G protein-coupled receptors with a crucial role in odor detection. A typical mammalian genome harbors ~1000 OR genes and pseudogenes; however, different gene duplication/deletion events have occurred in each species, resulting in complex orthology relationships. While the human OR nomenclature is widely accepted and based on phylogenetic classification into 18 families and further into subfamilies, for other mammals different and multiple nomenclature systems are currently in use, thus concealing important evolutionary and functional insights. Results Here we describe the Mutual Maximum Similarity (MMS) algorithm, a systematic classifier for assigning a human-centric nomenclature to any OR gene based on inter-species hierarchical pairwise similarities. MMS was applied to the OR repertoires of seven mammals and zebrafish. Altogether, we assigned symbols to 10,249 ORs. This nomenclature is supported by both phylogenetic and synteny analyses. The availability of a unified nomenclature provides a framework for diverse studies, where textual symbol comparison allows immediate identification of potential ortholog groups as well as species-specific expansions/deletions; for example, Or52e5 and Or52e5b represent a rat-specific duplication of OR52E5 . Another example is the complete absence of OR subfamily OR6Z among primate OR symbols. In other mammals, OR6Z members are located in one genomic cluster, suggesting a large deletion in the great ape lineage. An additional 14 mammalian OR subfamilies are missing from the primate genomes. While in chimpanzee 87% of the symbols were identical to human symbols, this number decreased to ~50% in dog and cow and to ~30% in rodents, reflecting the adaptive changes of the OR gene superfamily across diverse ecological niches. Application of the proposed nomenclature to zebrafish revealed similarity to mammalian ORs that could not be detected from the current zebrafish olfactory receptor gene nomenclature. Conclusions We have consolidated a unified standard nomenclature system for the vertebrate OR superfamily. The new nomenclature system will be applied to cow, horse, dog and chimpanzee by the Vertebrate Gene Nomenclature Committee and its implementation is currently under consideration by other relevant species-specific nomenclature committees.
Characterization of the Interleukin-17 Effect on Articular Cartilage in a Translational Model. An Explorative Study
Authors: Sinkeviciute Dovile , Aspberg Anders , He Yi , Bay-Jensen Anne-Christine , Önnerfjord Patrik 
Published: September 2019

Abstract
Background
Osteoarthritis (OA) is a progressive, chronic disease characterized by articular cartilage destruction. The pro-inflammatory cytokine IL-17 levels have been reported elevated in serum and synovial fluid of OA patients and correlated with increased cartilage defects and bone remodeling. The aim of this study was to characterize an IL-17-mediated articular cartilage degradation ex-vivo model and to investigate IL-17 effect on cartilage extracellular matrix protein turnover.
Methods
Full-depth bovine femoral condyle articular cartilage explants were cultured in serum-free medium for three weeks in the absence, or presence of cytokines: IL-17A (100 ng/ml or 25 ng/ml), or 10 ng OSM combined with 20 ng/ml TNFα (O+T). RNA isolation and PCR analysis were performed on tissue lysates to confirm IL-17 receptor expression. GAG and ECM-turnover biomarker release into conditioned media was assessed with dimethyl methylene blue and ELISA assays, respectively. Gelatin zymography was used for matrix metalloproteinase (MMP) 2 and MMP9 activity assessment in conditioned media, and shotgun LC-MS/MS for identification and label-free quantification of proteins and protein fragments in conditioned media.
Results
IL-17RA mRNA was expressed in bovine full-depth articular cartilage and the treatment with IL-17A did not interfere with metabolic activity of the model. IL-17A induced cartilage breakdown; conditioned media GAG levels were 3.6-fold-elevated compared to untreated. IL-17A [100 ng/ml] induced ADAMTS-mediated aggrecan degradation fragment release (14-fold increase compared to untreated) and MMP-mediated type II collagen fragment release (6-fold-change compared to untreated). MS data analysis revealed 16 differentially expressed proteins in IL-17A conditioned media compared to untreated.
Conclusions
We showed that IL-17A has cartilage modulating potential. It induces collagen and aggrecan degradation indicating an upregulation of MMPs. This was confirmed by zymography and mass spectrometry data. We also showed that the expression of other cytokines is induced by IL-17A, which provide further insight to the pathways that are active in response to IL-17A. This exploratory study confirms that IL-17A may play a role in cartilage pathology and that the applied model may be a good tool to further investigate it.
Diagnostic capability of a linear discriminant function applied to a novel Spectralis OCT glaucoma-detection protocol
Authors: Bambo Maria Pilar , Fuentemilla Enrique , Cameo Beatriz , Fuertes Isabel , Ferrandez Blanca , Güerri Noemi , Polo Vicente , Larrosa Jose M. , Pablo Luis E. , Garcia-Martin Elena 
Published: September 2019

Abstract
Background: Bruch membrane opening–minimum rim width (BMO–MRW) assessment offers a new diagnostic use in glaucoma patients of the Glaucoma Module Premium Edition (GMPE) available for the Spectralis optical coherence tomography (OCT) system. The objective of our research was to evaluate the diagnostic benefits of examining BMO–MRW and peripapillary retinal nerve fibre layer (pRNFL) readings acquired with Spectralis OCT to distinguish between healthy and early-onset glaucoma patients, comparing those readings with the standard pRNFL application. Moreover, we investigated whether using a particular combination of BMO–MRW and pRNFL parameters with a linear discriminant function (LDF) could further enhance glaucoma diagnosis. Methods: 136 eyes from 136 individuals were incorporated into this observational, prospective cross-sectional study: 68 healthy control subjects and 68 early-onset primary open-angle glaucoma (POAG) patients. MRW and pRNFL thickness around the disc (diameters: 3.5 mm, 4.1 mm, and 4.7 mm) were obtained using the BMO–MRW protocol, and pRNFL thickness at 3.5 mm was obtained with the standard glaucoma application. The group data were contrasted. One sample was chosen at random to develop the LDF (teaching set: 34 healthy subjects and 34 POAG patients) using a combination of MRW and pRNFL parameters (acquired with the BMO–MRW protocol); the other sample provided a test of how the LDF performed on an independent group (validating set: 34 healthy subjects and 34 POAG patients). The receiver operating curves (ROCs) were plotted for every measurement and contrasted with the proposed LDF. The OCT parameters with the best area under the receiver operating characteristic curve (AUC) were determined. Results: Global MRW and pRNFL thicknesses were significantly thinner in the POAG group (p < 0.001). The BMO–MRW parameters showed good diagnostic accuracy; the largest AUCs reached 0.875 for the LDF and 0.879 for global RNFL thickness using the standard glaucoma application. There were no statistical differences between the AUCs calculated. Conclusions: BMO–MRW parameters show a strong capability to differentiate between early-onset glaucoma and control eyes. Our LDF based on the new BMO–MRW OCT protocol did not perform better than isolated parameters.
Community level socioeconomic inequality in ischemic heart disease incidence: A nationwide, Cohort Study
Authors: Gwon Jun Gyo , Choi Jimi , Han Young Jin 
Published: September 2019

Abstract
BackgroundThe purpose of this study is to confirm that the inequalities of community level social economic status (SES) actually affect ischemic heart disease (IHD) incidence, using the analysis of the Korean population-based cohort study of the National Health Insurance Service–National Sample Cohort (NHIS-NSC) database.MethodsThis study used the National Health Insurance Service–National Sample Cohort database, a population-based cohort database established by the NHIS in South Korea. The regional income level was classified in three categories, i.e. low, moderate, and high, according to the rank. The outcome measure of interest was IHD which was defined as according to the International Classification of Disease, 10th Revision (ICD-10) codes. ResultsIn the low community level SES group, the incidence of IHD was 3.56 per 1,000 person years (cumulative incidence rate, 1.78%). In the high community level SES group, the incidence of IHD was 3.13 per 1,000 person years (cumulative incidence rate, 1.57%). the cumulative incidence of IHD according to the community level SES cohort during the follow-up period using the Kaplan-Meier. The log-rank test showed that the cumulative incidence of IHD was higher in the low community level SES group compared with the high community level SES group (adjusted hazard ratio, 1.16; 95% CI, 1.01-1.32)ConclusionDifferences in SES levels at the local level may also differ in the incidence of IHD, as well as individual SES differences. Therefore, intervention in active, health-related behaviors at the local level will be required in order to reduce the IHD incidence.
Nontuberculous mycobacteria isolated from specimens of pulmonary tuberculosis suspects, Northern Tunisia: 2002-2016
Authors: Gharbi Reem , Mhenni Besma , Fraj Saloua Ben , Mardassi Helmi 
Published: September 2019

Abstract
Background
Reports on the worldwide ascending trend of pulmonary nontuberculous mycobacteria (NTM) isolation rates and their effective role in respiratory tract infections are compelling. However, as yet, there are no such data relating to Tunisia.
Methods
Here we carried out a retrospective review of mycobacterial cultures originating from Northern Tunisia, which have been processed in the laboratory of mycobacteria of the Institut Pasteur de Tunis, during the time period 2002-2016. All pulmonary NTM (PNTM) isolates available for culture were characterized phenotypically and their taxonomic status was further established based on polymorphisms in rpoB, 16S rRNA, hsp65, and sodA DNA gene sequences.
Results
Of the 10,466 specimens collected from HIV-negative Tunisian patients with presumptive clinical pulmonary TB, 60 (0.6%) yielded PNTM isolates. An overall annual PNTM isolation prevalence of 0.2/100,000 was estimated. As far as could be ascertained, this isolation rate accounts amongst the lowest reported hitherto throughout the world. Among the 30 NTM isolates that were available for culture, 27 (90.0%) have been identified to the species level. The most commonly encountered species was Mycobacterium kansasii (23.3%) subtype 1. Strikingly, all M. kansasii cases were male patients originating from Bizerte, an industrialized region particularly known for iron industry. The remaining NTM species were M. fortuitum (16.6%), M. novocastrense (16.6%), M. chelonae (10.0%), M. gordonae (6.6%), M. gadium (6.6%), M. peregrinum (3.3%), M. porcinum (3.3%), and M. flavescens (3.3%). There were no bacteria of the M. avium complex, the most frequently isolated NTM globally, and the main driver of the rise of NTM-lung diseases.
Conclusions
This study uncovered an exceptional low prevalence of PNTM isolation among HIV-negative TB suspects in Northern Tunisia, suggesting a very low burden of NTM pulmonary disease. However, the frequent isolation of M. kansasii subtype 1, the most pathogenic subtype, particularly from the industrialized region of Bizerte, strongly suggests its effective involvement in a typical pulmonary disease.
Patient Engagement in Medical Research Among Older Adults: Analysis of the Health Information National Trends Survey
Authors: Gerido Lynette Hammond , Tang Xiang , Ernst Brittany , Langford Aisha , He Zhe 
Published: September 2019

Background
By 2035, it is expected that older adults (aged 65 years and older) will outnumber children and will represent 78 million people in the US population. As the aging population continues to grow, it is critical to reduce disparities in their representation in medical research.

Objective
This study aimed to describe sociodemographic characteristics and health and information behaviors as factors that influence US adults’ interest in engaging in medical research, beyond participation as study subjects.

Methods
Nationally representative cross-sectional data from the 2014 Health Information National Trends Survey (N=3677) were analyzed. Descriptive statistics and weighted multivariable logistic regression analyses were performed to assess predictors of one’s interest in patient engagement in medical research. The independent variables included age, general health, income, race and ethnicity, education level, insurance status, marital status, and health information behaviors.

Results
We examined the association between the independent variables and patient interest in engaging in medical research (PTEngage_Interested). Patient interest in engaging in medical research has a statistically significant association with age (adjusted P<.01). Younger adults (aged 18-34 years), lower middle-aged adults (aged 35-49 years), and higher middle-aged adults (aged 50-64 years) indicated interest at relatively the same frequency (29.08%, 29.56%, and 25.12%, respectively), but older adults (aged ≥65 years) expressed less interest (17.10%) than the other age groups. After the multivariate model was run, older adults (odds ratio 0.738, 95% CI 0.500-1.088) were found to be significantly less likely to be interested in engaging in medical research than adults aged 50 to 64 years. Regardless of age, the strongest correlation was found between interest in engaging in medical research and actively looking for health information (P<.001). Respondents who did not seek health information were significantly less likely than those who did seek health information to be interested in engaging in medical research.

Conclusions
Patients’ interest in engaging in medical research vary by age and information-seeking behaviors. As the aging population continues to grow, it is critical to reduce disparities in their representation in medical research. Interest in participatory research methods may reflect an opportunity for consumer health informatics technologies to improve the representation of older adults in future medical research.
DETERMINANT FACTORS ASSOCIATED WITH PATIENT SAFETY CULTURE IN DHARMA YADNYA GENERAL HOSPITAL, BALI
Authors: Darmawan Ede Surya , Darmika Putu 
Published: September 2019

Patient safety is a global issue where the achievement is low, so that it needs to implement a patient safety culture. The patient safety culture is measured based on 12 elements of the patient's safety culture according to AHRQ and the application of 6 patient safety goals. Perceived causes of the problem is the work environment, team work, leadership, job satisfaction and job stress. At RSU Dharma Yadnya Denpasar, the staff's perception about patient safety culture is not known yet, but the incident rate is still high. The purpose of this research is to know the relation of determinant of factor which is related to patient safety culture. This research method is quantitative research with cross sectional design which analyzed by PLS, with sample of nurses and midwife implementer which is 72 respondent. The results of this study indicate that there is a significant correlation between work team, leadership, and work stress with the patient safety culture, respectively 3.707, 12.647, and 3.135> T Statistics 1.96. While there is no significant relation between work environment and job satisfaction with patient safety culture equal to 1,336 and 0,328 <T Statistic 1,96. This study concludes that teamwork, decreased levels of work stress and the application of transformational leadership models need to be applied in an effort to improve the patient safety culture in the hospital.
Keywords: Determinants factors, patient safety culture
Study of attitudes to own health patients of multiprofile institution: instruments and main results
Authors: Gandzyuk V.А. 
Published: September 2019

Among the main determinants that form a holistic view of the health of the population are the following: lifestyle, influence of genetic factors, state of health care delivery system and socio-economic status of the country. In the article, we proposed a self-administered questionnaire on self-assessment of self-esteem, the importance of prevention and risk-taking behavior at primary level, and analyzed the main results that help characterize patients' perceptions of healthy lifestyles and health.
Purpose – to study attitudes towards one's own health, to undergo periodic preventive examinations, to be responsible for one's own health among the contingent assigned to the service of the SIS “RPC PCM” SAD, and to identify the main factors of influence.
Material and methods. Analysis of literary sources, sociological and system analysis. The survey was conducted at the pre-doctoral counseling stage on equal terms for all patients by way of active interviewing by the same interviewer.
Results of the study and their discussion. 349 patients participated in the survey, including 159 (45.6%) men and 190 (54.4%) women. The average age of the respondents is 40.8±9.8 year (min 19 years, max 83 years). The survey questionnaires have 7 main blocks of questions, which are designed to determine the patient's level of awareness and identify him or her as accurately as possible.
Conclusions. Analyzing the results of a sociological survey conducted among a contingent attached to the service of the State Institution of Science "Research and Practical Centre of Preventive and Clinical Medicine" State Administration Department, it was found that more than 95% of the respondents are aware of the concepts of "healthy lifestyle", "risk factors for chronic diseases", "foul" preventive medical checkup», etc. With regard to the assessment of one's own health, it should be noted that more than half (62.8%) of the respondents consider it satisfactory, while noting that they have one or more chronic diseases (mainly in the stage of persistent remission).
The prospects for further research are to analyze the results of the questionnaire and to correlate it with the data of the objective study, which will allow to determine, besides the attitude to the medical prophylaxis and psychological type of person, the level of patient's commitment to the doctor's appointments.
Obesity and overweight among children, diagnostic criteria and statistics of prevalence
Authors: Zabolotna I.E. , Yaschenko L.V. 
Published: September 2019

Objective: to conduct an analysis and synthesis of scientific literature and modern recommendations regarding the criteria for diagnosing overweight and obesity in children, international and national statistical databaseson the prevalence of overweight among children,legalactson the diagnosis of obesity and the detection of overweight in children in Ukraine.
Methods. bibliosemantic, epidemiological, contentanalysis.
Results. The international statistical data bases,results of the cross-national studies of WHO, current recommendations and strategies of prevention of obesity of children have been studied. According to the data of the official branch statistics the current scope of spreading of obesity among children’s population of Ukraine. The analysis of the normative documents regulating the order of organization and main components of the obligatory preventive medical examinations of children in Ukraine, the scheme of their periodicity, criteria of evaluation of physical development of children and record of results of medical examination of a child with evaluation of his/ her physical condition have been conducted. Figured out the disadvantages of the existing system of prevention of obesity of children: discrepancies between branchstandardsthatregulateapproachestotheevaluationofharmonyofphysicaldevelopmentofachildanddocumentsthatregulatestoringofresultsofthepreventivemedicalexaminations of children which is the reason for absence of statistics of obesity of children in Ukraine; lowlevel of diagnostics of obesity of children and identification of the excessbody weight that is conditioned by the lowlevel of knowledge a mongprimary medical caredoctors, providing medical careto children,of indicators of excess body weight of children.
Conclusions. A conceptual solution to this problem can be achieved by organizing a continuous, systematic process of detection and registration of children with overweight and obesity, analysis of the environment where the child is from the standpoint of social characteristics and behavioral characteristics.