bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sustainment of Lean Redesigns for Primary Care Teams
Authors: Hung Dorothy Y. , Gray Caroline P. , Truong Quan A. , Harrison Michael I. 
Published: August 2019

Background:
Quality improvements are notoriously followed by “backsliding” or relapse to the status quo. This mixed-methods study examined the sustainment of Lean workflow redesigns for primary care teams several years after being implemented in a large, ambulatory care delivery system.

Methods:
We conducted qualitative interviews of 57 leaders and frontline providers, and fielded post-Lean implementation surveys to 1164 physicians and staff in 17 primary care clinics across the system. We analyzed interviews and conducted independent sample t tests to identify key factors that facilitated the sustainment of new workflows among primary care teams. All analyses were conducted after Lean redesigns were implemented and scaled across the system in 3 consecutive phases.

Results:
Adherence to Lean redesigns was highest in the pilot clinic, despite having the longest postdesign measurement period. Members of the pilot clinic reported greatest participation in designing workflows, were most highly engaged in quality improvement efforts, and held most favorable beliefs about Lean changes. Adherence to redesigns was lowest among clinic members in the second phase of implementation; these members also reported highest levels of burnout.

Conclusions:
Staff participation in Lean redesign is a key to facilitating buy-in and adherence to changes. Change ownership and continued availability of time for improvement activities are also critical to the long-term success of Lean implementation in primary care.
Can Nurse-Based Management Screening Ensure Adequate Outcomes in Patients With Gestational Diabetes? A Comparison of 2 Organizational Models
Authors: Nollino Laura , Marcon Maria Lisa , Kiwanuka Edward , Merlotto-Cazziola Michela , Sambataro Maria , Sambado Luisa , Trevisiol Enrica , Scantamburlo Antonella , Mauri Alessandra , Busato Enrico , Pirolo Roberta , Boaretto Massimo , Turolla Licia , Faronato Pietro Paolo , Cadamuro-Morgante Marco , Migot Roberta , Paccagnella Agostino 
Published: August 2019

Background:
Gestational diabetes mellitus (GDM) is an impaired glucose tolerance with onset or first recognition during pregnancy. The purpose of this study is to evaluate the clinical outcomes of a blood glucose monitoring protocol implemented by nurses and dietitians in a diabetes team to the previously established protocol of direct monitoring of GDM patients by a diabetologist.

Methods:
Two groups of patients were formed: The first group was based on a traditional protocol (P1: 230 patients) with patients' blood glucose constantly checked by a diabetologist. In the second structured group (P2: 220 patients) patients were referred to a diabetologist only if they required insulin therapy.

Results:
The number of medical visits (P2: 1.28 ± 0.70 vs P1: 3.27 ± 1.44; P < .001) and the percentage of patients with hypoglycemia (P2: 6.8% vs P1: 15.2%; P < .006) were found to be lower in group P2 than in group P1. In both groups, a direct relationship was found between a parental history of diabetes and the risk of GDM (odds ratio [OR]: P1 = 2.2 [1.17-4.12]; P2 = 2.5 [1.26-5.12]). In group P1, it was observed that hyperweight gain in patients who were already overweight before becoming pregnant significantly increased the risk of macrosomia (OR: 3.11 [1.39-25.7]), whereas this was not detected in patients in group P2. In group P2, a correlation was found between macrosomia and insulin therapy (OR: 0.066 vs 0.34). In group P1 and group P2, a correlation was observed between insulin therapy and a family history of diabetes (OR: 2.20 vs 2.27), and a body mass index of greater than 30 kg/m2 in group P2 (OR: 3.0 vs 1.47).

Conclusions:
The data we collected show that creating a structured protocol for GDM management reduces the number of medical visits required by patients without increasing the risk of hypoglycemia, macrosomia, or hyperweight gain during pregnancy.
Hyperparathyroidism Due to Concurrent Parathyroid Carcinoma and Parathyroid Adenoma
Authors: Yang Jiqin , Li Yanmei , Li Juan , Yang Pengfei , Huang Lingyan 
Published: August 2019

Abstract
Parathyroid carcinoma is uncommon, and its coexistence with parathyroid adenoma is extremely rare. A 28-year-old woman with hyperparathyroidism underwent dual-phase 99mTc-sestamibi SPECT/CT scan for presurgical evaluation. The images showed intense activity inside the left side thyroid and mild activity inside the right side of the thyroid. The histopathologic findings showed intrathyroidal parathyroid carcinoma on the left side and intrathyroid parathyroid adenoma on the right side.
Association of Single Nucleotide Polymorphisms with Dyslipidemia in Antiretroviral Exposed HIV Patients in a Ghanaian population
Authors: Obirikorang Christian , Acheampong Emmanuel , Quaye Lawrence , Yorke Joseph , Amos-Abanyie Ernestine Kubi , Akyaw Priscilla Abena , Anto Enoch Odame , Bani Simon Bannison , Asamoah Evans Adu , Batu Emmanuella Nsenbah 
Published: August 2019

AbstractDyslipidemia is a potential complication of long-term usage of antiretroviral therapy (ART) and also known to be associated with genetic factors. The host genetic variants associated with dyslipidemia in HIV patients on ART in Ghana have not been fully explored. The study constituted a total of 289 HIV-infected patients on stable ART for at least a year and 85 aged matched apparently healthy control subjects with no history of HIV and dyslipidemia. Fasting blood was collected into EDTA tube for lipids measurements. Lipid profiles were determined as a measure of dyslipidemia. HIV-infected patients were categorized into two groups; those with dyslipidemia(HIV-Dys+) (n=90; 31.1%) and without dyslipidemia (n=199; 68.9%) based on the NCEP-ATP III criteria. Four candidate single nucleotide polymorphisms (SNPs) genes (ABCA1-rs2066714, LDLR-rs6511720, APOA5-rs662799 and DSCAML1-rs10892151) were determined. Genotyping was performed on isolated genomic DNA of study participants using PCR followed by a multiplex Ligation Detection Reaction (LDR). The percentage of the population who had the rare homozygote alleles for rs6511720 (T/T), rs2066714 (G/G), and rs10892151 (T/T) and rs662799 (G/G) among HIV+Dys+subjects were 5.5%, 14.4%, 6.6% and 10.0%; 2.0% 9.1%, 6.5% and 4.0% among HIV+Dys-subjects while 3.5%, 4.7%, 4.7% and 2.4% were observed in HIV-Dys-subjects. Statistically significant difference in genotypic prevalence of APOA5 polymorphisms was observed among different groups (p=0.0196). Compared to the AA genotype of the APOA5 polymorphisms, individuals with the rare homozygote genotype [aOR =4.01, 95%CI(1.57-22.39), p=0.004] were significantly more likely to develop dyslipidemia after controlling for age, gender, treatment duration and CD4 counts among the HIV+Dys+subjects. There was also a significant associated between GG genotype of ABCA1 and dyslipidemia [aOR =3.29, 95% (1.08 −12.43); p=0.042]. Individuals with the rare homozygote variant (GG) of APOA5 (rs662799) were significantly associated with increased likelihood of developing dyslipidemia [OR =2.24, 95% CI (1.20 −6.83); p=0.0370] holding other variables constant in the HIV+Dys-subjects. Our data accentuate the presence of SNPs in four candidate genes and its association with dyslipidemia among HIV patients exposed to ART in the Ghanaian population especially variants in APOA5-rs662799 ABCA1-rs2066714 respectively. These findings provide baseline information that necessitates a pre-symptomatic strategy for monitoring dyslipidemia in ART-treated HIV patients. There is a need for longitudinal studies to validate a comprehensive number of SNPs and its association with dyslipidemia.
Impairment of dual-task gait dynamics in older adults with mild cognitive impairment: Relationships to neuropsychological status, fitness and brain morphology
Authors: Hawkins Tess C , Samuel Rebecca , Fiatarone Singh Maria A , Gates Nicola , Wilson Guy C , Jain Nidhi , Meiklejohn Jacinda , Brodaty Henry , Wen Wei , Singh Nalin , Baune Bernhard T , Suo Chao , Baker Michael K , Foroughi Nasim , Wang Yi , Sachdev Perminder S , Valenzuela Michael J , Hausdorff Jeffrey M , Mavros Yorgi 
Published: August 2019

ABSTRACTBackgroundIndividuals with Mild Cognitive Impairment (MCI) have more gait variability under dual-task conditions than cognitively healthy adults. However, characteristics associated with this susceptibility of gait to dual-task stress are unknown.MethodsTesting was performed at baseline in the Study of Mental And Resistance Training (SMART). Ninety-three adults with MCI (age 70±6.8 years; 66.6% female) performed a single- and dual-task walk (cognitive distractor=letter fluency), in random order. Linear and non-linear gait variability were measured using force-sensitive insoles. Cognitive performance during dual-tasking was assessed by the number of correct words vocalized. Cognitive function, brain Magnetic Resonance Imaging (MRI), muscle strength, aerobic capacity, body composition, physical and psychosocial function were also assessed as potential correlates of gait dynamics.ResultsGait dynamics worsened during dual-tasking, with decrements in both stride time variability (p<0.001) and detrended fluctuation analysis (DFA) (p=0.001). Lower aerobic capacity and thinner posterior cingulate cortex were associated with greater decrements in DFA (p<0.05). Smaller hippocampal volume, worse psychological well-being and poorer static balance were associated with greater decrements in stride time variability (p<0.05). By contrast, cognitive performance did not change under dual-task conditions compared to seated testing (p=0.13).ConclusionsUnder dual-task conditions, participants with MCI preserved their cognitive performance at the expense of gait stability. Decrements in dual-tasking gait were associated with lower aerobic fitness, balance, psychological well-being, and brain volume in cognitively-relevant areas of the posterior cingulate and hippocampus, all potentially modifiable characteristics. Trials of targeted interventions are needed to determine the potential plasticity of gait variability in high-risk cohorts.
Efficient CRISPR/Cas9 genome editing in a salmonid fish cell line using a lentivirus delivery system
Authors: Gratacap Remi L. , Regan Tim , Dehler Carola E. , Martin Samuel A.M. , Boudinot Pierre , Collet Bertrand , Houston Ross D. 
Published: August 2019

1AbstractGenome editing is transforming bioscience research, but its application to non-model organisms, such as farmed animal species, requires optimisation. Salmonids are the most important aquaculture species by value, and improving genetic resistance to infectious disease is a major goal. However, use of genome editing to evaluate putative disease resistance genes in cell lines, and the use of genome-wide CRISPR screens is currently limited by a lack of available tools and techniques. In the current study, an optimised protocol using lentivirus transduction for efficient integration of constructs into the genome of a Chinook salmon (Oncorhynchus tshwaytcha) cell line (CHSE-214) was developed. As proof-of-principle, two target genes were edited with high efficiency in an EGFP-Cas9 stable CHSE cell line; specifically, the exogenous, integrated EGFP and the endogenous RIG-I locus. Finally, the effective use of antibiotic selection to enrich the successfully edited targeted population was demonstrated. The optimised lentiviral-mediated CRISPR method reported here increases possibilities for efficient genome editing in salmonid cells, in particular for future applications of genome-wide CRISPR screens for disease resistance.
Immunotherapy prevents long-term disability in relapsing multiple sclerosis over 15 years
Authors: Kalincik Tomas , Sharmin Sifat , Malpas Charles , Spelman Tim , Horakova Dana , Havrdova Eva Kubala , Trojano Maria , Izquierdo Guillermo , Lugaresi Alessandra , Prat Alexandre , Girard Marc , Duquette Pierre , Grammond Pierre , Jokubaitis Vilija , van der Walt Anneke , Grand’Maison Francois , Sola Patrizia , Ferraro Diana , Shaygannejad Vahid , Alroughani Raed , Hupperts Raymond , Terzi Murat , Boz Cavit , Lechner-Scott Jeannette , Pucci Eugenio , Van Pesch Vincent , Granella Franco , Bergamaschi Roberto , Spitaleri Daniele , Slee Mark , Vucic Steve , Ampapa Radek , McCombe Pamela , Ramo-Tello Cristina , Prevost Julie , Olascoaga Javier , Cristiano Edgardo , Barnett Michael , Saladino Maria Laura , Sanchez-Menoyo Jose Luis , Hodgkinson Suzanne , Rozsa Csilla , Hughes Stella , Moore Fraser , Shaw Cameron , Butler Ernest , Skibina Olga , Gray Orla , Kermode Allan , Csepany Tunde , Singhal Bhim , Shuey Neil , Piroska Imre , Taylor Bruce , Simo Magdolna , Sirbu Carmen-Adella , Sas Attila , Butzkueven Helmut ,   on behalf of the MSBase Study group
Published: August 2019

ABSTRACTObjectiveWhether immunotherapy improves long-term disability in multiple sclerosis has not been satisfactorily demonstrated. This study examined the effect of immunotherapy on long-term disability outcomes in relapsing-remitting multiple sclerosis.MethodsWe studied patients from MSBase followed for ≥1 year, with ≥3 visits, ≥1 visit per year and exposed to a multiple sclerosis therapy, and a subset of patients with ≥15-year follow-up. Marginal structural models were used to compare the hazard of 12-month confirmed increase and decrease in disability, EDSS step 6 and the incidence of relapses between treated and untreated periods. Marginal structural models were continuously re-adjusted for patient age, sex, pregnancy, date, disease course, time from first symptom, prior relapse history, disability and MRI activity.Results14,717 patients were studied. During the treated periods, patients were less likely to experience relapses (hazard ratio 0.60, 95% confidence interval 0.43–0.82, p=0.0016), worsening of disability (0.56, 0.38-0.82, p=0.0026) and progress to EDSS step 6 (0.33, 0.19-0.59, p=0.00019). Among 1085 patients with ≥15-year follow-up, the treated patients were less likely to experience relapses (0.59, 0.50–0.70, p=10-9) and worsening of disability (0.81, 0.67-0.99, p=0.043).ConclusionsContinued treatment with multiple sclerosis immunotherapies reduces disability accrual (by 19-44%), the risk of need of a walking aid by 67% and the frequency of relapses (by 40-41%) over 15 years. A proof of long-term effect of immunomodulation on disability outcomes is the key to establishing its disease modifying properties.
Genome sequence and comparative analysis of reindeer (Rangifer tarandus) in northern Eurasia
Authors: Weldenegodguad Melak , Pokharel Kisun , Ming Yao , Honkatukia Mervi , Peippo Jaana , Reilas Tiina , Røed Knut H. , Kantanen Juha 
Published: August 2019

AbstractReindeer are semi-domesticated ruminants that have adapted to the challenging northern Eurasian environment characterized by long winters and marked annual fluctuations in daylight. We explored the genetic makeup behind their unique characteristics by de novo sequencing the genome of a male reindeer and conducted gene family analyses with nine other mammalian species. We performed a population genomics study of 23 additional reindeer representing both domestic and wild populations and several ecotypes from various geographic locations. We assembled 2.66 Gb (N50 scaffold of 5 Mb) of the estimated 2.92 Gb reindeer genome, comprising 27,332 genes. The results from the demographic history analysis suggested marked changes in the effective population size of reindeer during the Pleistocene period. We detected 160 reindeer-specific and expanded genes, of which zinc finger proteins (n=42) and olfactory receptors (n=13) were the most abundant. Comparative genome analyses revealed several genes that may have promoted the adaptation of reindeer, such as those involved in recombination and speciation (PRDM9), vitamin D metabolism (TRPV5, TRPV6), retinal development (PRDM1, OPN4B), circadian rhythm (GRIA1), immunity (CXCR1, CXCR2, CXCR4, IFNW1), tolerance to cold-triggered pain (SCN11A) and antler development (SILT2). The majority of these characteristic reindeer genes have been reported for the first time here. Moreover, our population genomics analysis suggested at least two independent reindeer domestication events with genetic lineages originating from different refugial regions after the Last Glacial Maximum. Taken together, our study has provided new insights into the domestication, evolution and adaptation of reindeer and has promoted novel genomic research of reindeer.
Phase-amplitude markers of synchrony and noise: A resting-state and TMS-EEG study of schizophrenia
Authors: Freche D , Naim-Feil J , Hess S , Peled A , Grinshpoon A , Moses E , Levit-Binnun N 
Published: August 2019

AbstractThe electroencephalogram (EEG) of schizophrenia patients is known to exhibit a reduction of signal-to-noise ratio and of phase locking, as well as a facilitation of excitability, in response to a variety of external stimuli. Here we demonstrate these effects in transcranial magnetic stimulation (TMS)-evoked potentials and in the resting-state EEG. To ensure veracity we used three weekly sessions and analyzed both resting state and TMS-EEG data. For the TMS responses our analysis verifies known results. For the resting state we introduce the methodology of mean-normalized variation to the EEG analysis (quartile-based coefficient of variation), which allows for a comparison of narrow-band EEG amplitude fluctuations to narrow-band Gaussian noise. This reveals that amplitude fluctuations in the delta, alpha and beta bands of healthy controls are different from those in schizophrenia patients, on time scales of tens of seconds. We conclude that the EEG-measured cortical activity patterns of schizophrenia patients are more similar to noise, both in alpha and beta resting state and in TMS responses. Our results suggest that the ability of neuronal populations to form stable, locally and temporally correlated activity is reduced in schizophrenia, a conclusion that is in accord with previous experiments on TMS-EEG and on resting-state EEG.
Core Fermentation (CoFe) granules focus coordinated glycolytic mRNA localization and translation to fuel glucose fermentation
Authors: Morales-Polanco Fabian , Bates Christian , Lui Jennifer , Casson Joseph , Solari Clara A. , Pizzinga Mariavittoria , Forte Gabriela , Griffin Claire , Burt Harriet E. , Dixon Hannah L. , Hubbard Simon , Portela Paula , Ashe Mark P. 
Published: August 2019

SummaryGlycolysis is a fundamental metabolic pathway for glucose catabolism across biology, and glycolytic enzymes are amongst the most abundant proteins in cells. Their expression at such levels provides a particular challenge. Here we demonstrate that the glycolytic mRNAs are localized to granules in yeast and human cells. Detailed live cell and smFISH studies in yeast show that the mRNAs are actively translated in granules, and this translation appears critical for the localization. Furthermore, this arrangement is likely to facilitate the higher level organisation and control of the glycolytic pathway. Indeed, the degree of fermentation required by cells is intrinsically connected to the extent of mRNA localization to granules. On this basis, we term these granules, Core Fermentation (CoFe) granules; they appear to represent translation factories allowing high-level co-ordinated enzyme synthesis for a critical metabolic pathway.
Investigating Confidence Judgments using Reviews in Human and Monkeys
Authors: Stoll Frederic M. , Procyk Emmanuel 
Published: August 2019

AbstractConfidence judgments are self-assessments of the quality of one’s own performance, and are a crucial aspect of metacognitive abilities. The underlying neurobiological mechanisms are poorly understood. One approach to understanding these mechanisms would be to take advantage of putative metacognitive abilities in non-human models. However, many discrepancies exist between human and non-human studies on metacognition due to the mode of reporting judgements. We here present an attempt to directly compare human and non-human primates’ metacognitive abilities using a protocol assessing confidence judgments. After performing a categorization test, subjects could either validate their choice or review the test. We could assess whether subjects detected their errors and how they corrected them according to their confidence, and importantly did so in both human and non-human primates. 14 humans and 2 macaque monkeys were tested. Humans showed a well-adapted use of the review option by reviewing more after incorrect choices or difficult stimuli. Non-human primates did not demonstrate a convincing use of the review or validate opportunity. In both species, reviewing did not improve performance. This study shows that decisions to review under uncertainty are not naturally beneficial to performance and is rather perturbed by biases and alternative low-cognitive cost strategies.
Inflammation in Alzheimer’s disease: do sex and APOE matter?
Authors: Duarte-Guterman Paula , Albert Arianne Y. , Inkster Amy M. , Barha Cindy K. , Galea Liisa A.M. ,   on behalf of the Alzheimer’s Disease Neuroimaging Initiative
Published: August 2019

ABSTRACTAlzheimer’s disease (AD) disproportionately affects females with steeper cognitive decline and more neuropathology compared to males, which is exacerbated in females carrying the APOEε4 allele. The risk of developing AD is also higher in female APOEε4 carriers in earlier age groups (aged 65-75), and the progression from cognitively normal to mild cognitive impairment (MCI) and to AD may be influenced by sex. Inflammation is observed in AD and is related to aging, stress, and neuroplasticity, and although studies are scarce, sex differences are noted in inflammation. The objective of this study was to investigate underlying physiological inflammatory mechanisms that may help explain why there are sex differences in AD and APOEε4 carriers. We investigated, using the ADNI database, the effect of sex and APOE genotype (non-carriers or carriers of 1 and 2 APOEε4 alleles) and sex and diagnosis (cognitively normal (CN), MCI, AD) on CSF (N= 279) and plasma (N= 527) markers of stress and inflammation. We found CSF IL-16 and IL-8 levels were significantly lower in female non-carriers of APOEε4 alleles compared to males, whereas levels were similar between the sexes among carriers of APOEε4 alleles. Furthermore, females had on average higher levels of plasma CRP and ICAM1 but lower levels of CSF ICAM1, IL-8, IL-16, and IgA than males. Carrying APOEε4 alleles and diagnosis (MCI and AD) decreased plasma CRP in both sexes. Sex differences in inflammatory biomarkers support that the underlying physiological changes during aging differ by sex and tissue origin.