bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genomic analysis of avian-pathogenic Escherichia coli (APEC) isolated from diseased chicken
Authors: Papoušková Aneta , Masaříková Martina , Valček Adam , Šenk David , Čejková Darina , Jahodářová Eva , Čížek Alois 
Published: September 2019

Abstract
Background Avian pathogenic Escherichia coli (APEC) can cause various extraintestinal infections in chicken, resulting in massive economic losses in poultry industry. Apart from that, some avian E. coli strains may have zoonotic potential, making poultry a possible source of infection for humans. Due to its extreme genetic diversity, this pathotype remains poorly defined. This study aimed to investigate the diversity of colibacillosis-associated E. coli isolates from Central European countries with a focus on the Czech Republic.Results Out of 95 preliminarily characterized clinical isolates 32 isolates were selected for whole-genome sequencing. A multiresistant phenotype was detected in a majority of them and the predominant resistance to lactams and quinolones was widely associated with TEM-type beta-lactamase genes and chromosomal gyrA mutations, respectively. The phylogenetic analysis confirmed a great diversity of isolates, that were derived from nearly all phylogenetic groups, with predominace of B2, B1 and C phylogroups. Clusters of closely related isolates within ST23 (phylogroup C) and ST429 (phylogroup B2) indicated a long-term local spread of these clones. Besides, the ST429 cluster carried bla CMY-2, -59 genes for AmpC beta-lactamase and isolates of both clusters were generally well-equipped with virulence-associated genes, with considerable differences in distribution of certain virulence-associated genes between phylogenetically distant lineages. Other important and potentially zoonotic APEC STs were detected, incl. ST117, ST354 and ST95, showing several molecular features typical for human ExPEC.Conclusions The results support the concept of local spread of virulent APEC clones, as well as of zoonotic potential of specific poultry-associated lineages, and highlight the need to investigate the possible source of these pathogenic strains.
The Correlation Analysis between the Oxford Classification of Chinese IgA Nephropathy Children and Renal Outcome -A retrospective cohort study
Authors: Wu Heyan , Xia Zhengkun , Gao Chunlin , Zhang Pei , Yang Xiao , Wang Ren , Wang Meiqiu , Peng Yingchao 
Published: September 2019

Abstract
Background The 2016 Oxford Classification's MEST-C scoring system predicts outcomes in adults with IgA nephropathy, but it lacks large cohort validation in children with IgAN in China. We would like to verify that the MEST-C score can be used to predict the renal outcome of children with IgAN.Methods A retrospective cohort analysis of data from 1243 Chinese children with IgAN who underwent renal biopsy in Jinling Hospital from 2000 to 2017 was performed and investigated with glomerular filtration rate (eGFR),24h urine proteinuria(24h-UP)and blood pressure(BP) at biopsy and during follow-up.The renal pathology was based on Oxford Classification of IgAN.Results We confirm that BP was significantly correlated with mesangial hypercellullarity(M), endocapillary hypercellularity(E), tubular atrophy/ interstitial fibrosis(T) and crescents (C) .There was a significant correlation between eGFR and segmental glomerulosclerosis(S), T and C .24h-UP and all pathological indexes were significantly correlated. S and T were shown to be independent risk factors associated with renal outcomes in our group. Kaplan-Meier revealed that M [log-rank, chi-squared(χ2)=14.679, P=0.000 ], S(χ2=31.508,P=0.000),T (χ2=78.893, P=0.000),C(χ2=16.603, P=0.000) were associated with renal outcome.In univariate analyses, M(HR 2.167, 95% CI, 1.445~3.251, P = 0.000),S(HR 3.081, 95% CI, 2.038~4.658, P = 0.000), T(HR 7.911, 95% CI, 4.670~13.400,P = 0.000) and C(HR3.346, 95% CI, 1.818~6.156,P = 0.000) lesions were significant predictors of renal outcome. In a multivariate analysis, only S(HR 2.742, 95% CI, 1.805~4.164,P = 0.000) and T(HR 6.633, 95% CI, 3.897~11.289,P = 0.000)were shown to be independent risk factors .Conclusions We found that S and T lesions were valid in predicting a poor outcome in our group.E, S, T and C lesion were important basis for doctors to choose glucocorticoids and immunosuppressive agents in the treatment of IgAN, while T and C lesion were often the basis for doctors to use RAS blockers cautiously.
Modified percutaneous Kirschner wire with mutual linking technique in proximal humeral fracture: a technique note and preliminary results
Authors: Chang Hao-Ming , Lee Pei-Yuan , Su Wei-Ren , Lin Cheng-Li 
Published: September 2019

Abstract
Background: The percutaneous pinning technique (PPT) with multiple Kirschner wires (K-wires) is one of common surgical options in proximal humeral fractures. However, complications including pin migration and loss of reduction have been re-ported. We aimed to describe a novel technique employing modified percutaneous pin-ning with mutual linking for the treatment of proximal humerus fractures, which may decrease such complications. Methods: 6 patients (5 female, 1male ; mean age 60.1 years) received close reduction and the modified percutaneous Kirschner wire fixation with mutual linking technique. All wires were removed about 6 weeks postoperatively followed by progressive reha-bilitation. We used following radiograph to evaluate bony union, wires migration, and fragment displacement. Clinical outcomes were evaluated using range of motion of af-fected glenohumeral joint, a 1-10 visual analog score (VAS), UCLA shoulder rating score (UCLA), and the American Shoulder and Elbow Surgeons Shoulder Score (ASES). Outcomes were evaluated during the 2-month follow up and at the final follow up. Results: All cases were followed-up after an average of 12.6 months (range, 12-13.5 months). The mean of anterior forward flexion of the injured shoulder were 152.5 degrees (range, 145-160 degrees) during the 2-month follow up and 166.7 degrees (range, 150-180 degree) at the final follow up respectively. The means of the VAS, UCLA score, and the ASES of the injured shoulders were 0.3 (range, 0-1), 31.8 (range, 27-34), and 92.4 (range, 82-100) respectively. No wire migrations or fracture displacements were noted in our cases. There were also no deep infection, nonunion, implant failure, or avascular necrosis of the humeral head observed during the follow-ups. Conclusions:With this modified percutaneous Kirschner wire mutual linking technique, minimal invasive approach could be achieved and additional stability was provided by mutually linking the wires to reduce pin migration and fracture displacement in proximal humeral fracture.
Combination of ultrasonic elastography and Ki-67 index as a novel predictive modality for the prognosis in clinic stage III breast cancer
Authors: Du Rui , Shu Weiwei , Chen Baoding , Zhang Xin , Wu Xincai , Shang Mengyuan , Zhang Zheng , Wang Zhongqun , Zhang Hao , Li Yuefeng 
Published: September 2019

Abstract
Background To investigate the feasibility of combination of ultrasonic elastography (UE) and Ki-67 index as a novel predictive modality for the prognosis of clinic stage Ⅲ breast cancer. Methods Of 112 patients, Multi-parameter of UE were obtained after analyzing elastograms of 112 lesions which were recorded classification of Ki-67 by histopathologic diagnosis. Multivariate Survival analysis was performed by using multivariate Cox model. The nomograms was established to predict the probability of clinic stage Ⅲ breast cancer according to the selected independently significant variables in the multivariate Cox model. The model was internally validated using Harrell’s concordance index. Results ⅢC had significant difference in all ultrasonic elastography (UE) parameters (P < 0.05) and were statistically different from ⅢA and ⅢB (P < 0.01). The Cox model was RR (t)= Exp(1.104* X1+0.901*X4+0.972*X5) (X1: classification of Ki-67, X4: classification of strain ratio, X5: classification of Young's modulus). The nomogram showed that Ki-67 had the greatest influence on survival prediction, followed by Young's modulus and strain ratio. Internal validation revealed a concordance index of 0.76. Conclusions Our study explored a novel modality in predicting the prognosis of clinic stage Ⅲ breast cancer combining a tumor marker with breast UE imaging. A nomogram was developed to prove that the model was helpful to estimate the 5-year survival of the patients.
Comparison of mood disorder screening scales in geriatric oncology: THYMOG study results
Authors: Boudin Guillaume , Laviec Heidi Solem , Ghewy Lauriane , Machavoine Jean Luc , Denhaerynck Julie , Morello Remy , Beauplet Bérengère 
Published: September 2019

Abstract
Background: Early and systematic depression screening is recommended for older patients with cancer. The objective of this study is to evaluate the performance of three different mood disorder screening scales for detection of Major Depressive Disorder (MDD) in older patients with cancer. Methods: A prospective multicentric study was conducted in patients with cancer over 70 years of age, comparing three self-administered questionnaires: the 15-item Geriatric Depression Scale (GDS-15), the Hospital Anxiety and Depression Scale - Depression (HADS-D) and the Distress Thermometer (DT). Three weeks after initial assessment, in case of score above the standard cut-off, a reassessment of the patient’s mood was performed by the primary care physician, using the DSM-V MDD diagnostic criteria and the DT. Potential differences between an abnormal mood screening test and a confirmed MDD was assessed using variance analysis for each screening scale. Results: 93 patients with an average age of 81 years [70 - 95 years] were included. 66 patients had at least one abnormal score on one of the screening scales. A MDD was confirmed for 10 of the 36 reassessed patients (28%). Abnormal screening by the GDS-15 (p=0.021), the HADS-D (p=0.018) and the DT (p=0.045) was significantly associated with MDD diagnosis. Conclusions: The three screening scales enabled detection of MDD in older patients with cancer. Among the tested scales, the HADS-D could perform best in detecting MDD. However, these screening scales may not be sufficiently reliable for MDD screening in this population. Further studies are needed to confirm the results.
Women’s knowledge and attitudes toward cervical cancer and cervical cancer screening in Zanzibar, Tanzania: a cross- sectional study
Authors: Weng Qiao , Jiang Jie , Haji Fatma Mrisho , Nondo Lamlet Hassan , Zhou Huaijun 
Published: September 2019

Abstract
Background: Cervical cancer is the most common cancer and the leading cause of cancer death among women in Tanzania. Knowledge and willingness of cervical cancer screening are important determinants of prevention services. This study aimed to describe women's awareness about cervical cancer and to explore the attitudes, acceptability and barriers toward cervical cancer screening in Zanzibar, Tanzania, in order to help organizing the forthcoming China-Zanzibar cervical cancer screening program. Methods: A cross-sectional study was conducted from March to June 2018, involving 1483 women who responded to questionnaires concerning general demographic characteristics, screening willingness and awareness of cervical cancer from 10 districts in Zanzibar. Chi-square tests, analysis of variance, rank sum tests and stepwise multiple regression were conducted using STATA 15.0 software. Results : The average Total Knowledge Scores(TKS) was 7.83±5.32 on a 23 scale. Education level and family income were positively correlated with TKS (Coef=1.075, 95% CI=0.687-1.462 and Coef=0.810, 95% CI=0.262-1.358 respectively). Previous schistosomiasis history (OR = 24.140, 95% CI= 3.306-176.266) and family genetic disease history (OR = 3.140, 95% CI= 1.644-5.997) were strong predictors of free screening. Women were less likely to be screened freely if they had 7 or more deliveries (OR = 0.300, 95% CI= 0.150-0.598) and were unknown about previous family tumor history (OR = 0.381, 95% CI= 0.218-0.665). As for non-free screening, age and education level were negatively associated while family income was positively associated with willingness to uptake non-free screening; divorced or widowed marriage and unawareness about previous family tumor history were predictors of reluctance to screening while previous disease history was the strong predictor of non-free screening uptake. Among 129 women who were reluctant and 50 who were uncertain to participate in the free screening, 51.4% thought it was unnecessary, 18.44% showed obvious fear and 20.67% were worrying about extra infection. Conclusions: The findings revealed that the knowledge of cervical cancer was poor. Education level, family income and awareness of previous disease history were the significant influencing factors of screening uptake. Specific awareness programs to increase knowledge and willingness to uptake screening should be designed and implemented in the public without delay.
The IBER study: study protocol for a feasibility randomised controlled trial of Imagery Based Emotion Regulation for the treatment of anxiety in bipolar disorder.
Authors: steel Craig , Wright Kim , Goodwin Guy , Simon Judit , Morant Nicola , Taylor Rod , Brown Michael , Jennings Susie , Hales Susie , Holmes Emily 
Published: September 2019

Abstract
Background Anxiety is highly prevalent in people diagnosed with bipolar disorder (BD), and can persist between acute episodes of mania and depression. Recent studies indicate that people with BD are prone to experiencing frequent, intrusive and emotional mental images which further fuel their levels of anxiety and mood instability. These intrusive emotional mental images represent a specific target for treatment for this disorder with the potential to reduce anxiety and improve mood stability. A new brief structured psychological intervention for BD called Imagery Based Emotion Regulation (IBER) has been developed, which translates experimental work in the area of imagery and emotion into a skills training programme to improve the regulation of intrusive and distressing emotional mental images in BD. A feasibility trial is required in order to assess whether a full randomized controlled trial is indicated in order to evaluate this approach.Methods The design is a two-arm feasibility randomised controlled trial (RCT), with 1:1 randomisation stratified by trial site and minimised on medication status and anxiety severity. Participants are 60 individuals diagnosed with bipolar disorder and experiencing at least a mild level of anxiety. Sites are defined by the geographical boundaries of two NHS Trusts, with recruitment from NHS teams, GP surgeries and self-referral. The intervention is up to 12 sessions within 16 weeks of Imagery Based Emotion Regulation. The comparator is NHS standard care. The primary aim is to assess the feasibility of conducting a powered multi-site RCT to evaluate effectiveness. Measures of anxiety, depression, mania, mood stability and health care use will be conducted at baseline, end of treatment and at 16-weeks follow-up.Discussion This is the first feasibility trial of an imagery based intervention for the treatment of anxiety in bipolar disorder. If the trial proves feasible, a large multi-site trial will be required.
Discontinuing statins or not in the elderly? Study protocol for a randomized controlled trial
Authors: Bonnet Fabrice , Bénard Antoine , Poulizac Pierre , Afonso Mélanie , Maillard Aline , Salvo Francesco , Berdaï Driss , Salles Nathalie , Rousselot Nicolas , Marchi Sébastien , Hayes Nathalie , Joseph Jean-Philippe 
Published: September 2019

Abstract
Background The risk/benefit ratio of using statins for cardiovascular (CV) primary prevention in elderly people has not been established. The main objectives of the present study are to assess the cost-effectiveness of statin cessation and to examine the non-inferiority of statin cessation in terms of mortality in patients aged 75 and over treated with statins for primary prevention.Methods The Statins In The Elderly (SITE) Study is an ongoing 3-year follow-up, open-label comparative multi-centre randomised clinical trial that is being conducted in two parallel groups in outpatient primary care offices. Participants meeting the following criteria are being included: people aged 75 years and older being treated with statins as primary prevention for CV events who provide informed consent. After randomisation, patients in the statin-cessation strategy are instructed to withdraw their treatment. In the comparison strategy, patients continue their statin treatment at the usual dosage. The cost-effectiveness of the statin-cessation strategy compared to continuing statins will be estimated through the incremental cost per quality-adjusted life years (QALY) gained at 36 months based on the perspective of the French healthcare system. Overall mortality will be the primary clinical endpoint. We assumed that the mortality rate at 3 years will be 15%. The sample size was computed to achieve 90% power in showing the non-inferiority of statin cessation, assuming a non-inferiority margin of 5% of the between-group difference in overall mortality. In total, the SITE study will include 2,430 individuals. Discussion There is some debate regarding the value of statins in people over 75 years old, especially for primary prevention, due to a lack of evidence of their efficacy in this population, potential compliance-related events, drug-drug interactions and side effects that could impair quality of life. Data from clinical trials guide the initiation of medication therapy for primary or secondary prevention of CV disease but do not define the timing, safety, or risks of discontinuing the agents. The SITE study is one of the first to examine whether treatment cessation is a cost-effective strategy that has no adverse effects on the prognosis of people over 75 years old formerly treated with statins. Trial registration This research has been registered at clinicaltrials.gov under number NCT02547883, 11 September 2015, https://clinicaltrials.gov/ct2/show/NCT02547883
A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: A Randomized Controlled Trial
Authors: Knefel Matthias , Kantor Viktoria , Nicholson Andrew A. , Schieß-Jokanovic Jennifer , Weindl Dina , Schäfer Ingo , Lueger-Schuster Brigitte 
Published: September 2019

Abstract
Background Asylum seekers and refugees are at great risk for developing mental disorders. Afghan refugees are a particularly vulnerable group with a low average educational and mental health literacy level. Traumatic experiences and hardship pre- and during migration are predictive of mental health problems. However, post-migration living difficulties (PMLDs) also account for a large proportion of mental distress in such populations, which critically are not sufficiently considered in treatment protocols and research investigations. Indeed, the evidence base for the treatment of refugees and asylum seekers is sparse and mainly limited to trauma-specific treatments, where refugees may likely suffer from other mental health problems such as depression or anxiety as well. Methods/design This trial is the first evaluation of the efficacy of a short-term, transdiagnostic treatment protocol adapted to address mental health problems and PMLDs for treatment seeking Afghan refugees using an adapted version of the Problem Management Plus (PM+) protocol. We investigate the efficacy of an intervention manual with a prospective, single-center, randomized, assessor blind, two-group trial. Furthermore we investigate participants’ subjective experiences with the intervention manual with in-depth interviews. One-hundred-twenty people will be assessed and randomly allocated to either the intervention arm or a TAU arm. Clinical psychologists will conduct the treatment and the sessions will take place with a Dari interpreter. The protocol includes six 90-minute sessions. The primary endpoint is the general symptom distress measure, assessed with the General Health Questionnaire 28 (GHQ-28). Secondary endpoints include the Post-Migration Living Difficulties Checklist (PMLDC), the International Trauma Questionnaire (ITQ), the WHO Quality of Life Questionnaire (WHOQOL-BREF), the Psychological Outcome Profile (PSYCHLOPS), service and health care use (assessed with several items), and the Immigrant Integration Index (IPL-12). Discussion This trial may provide substantial evidence for a brief transdiagnostic psychological intervention. Here, we intend to contribute to the treatment of mental health problems among Afghan refugees. The assessment of subjective experience with this treatment manual, as well as the evaluation of its clinical applicability, may optimize treatment acceptance and outcomes across a wide range of mental health problems among refugees.
Russian education faults
Authors: Voronova Tatyana A. , Gretchenko Anatoliy I. , Kulapov Mikhail N. , Zuev Valeriy M. , Kalinina Irina A. 
Published: September 2019

Despite the efforts made, various and progressive innovations in the education system remain a number of national problems, referred to as the “faults” of Russian education, which do not allow to achieve the strategic goals.The purpose of the study: to analyze the evolution of the reform of the domestic education system for a long historical period, analyzes the content of legal acts relating to Russian education, in particular the Law of the Russian Federation “On education in the Russian Federation”. The formation of education goals and the problems currently facing the Ministry of science and higher education of the Russian Federation, the Ministry of education of the Russian Federation and the independent Federal authority – Rosobrnadzor are analyzed.Two concepts of basic models of education, European and Anglo-American, are considered. It is noted that the Russian education in the present period of time, as well as other public institutions, in many respects are at the crossroads between the two models of management systems.Materials and method: comparative analysis of approaches to education management, as well as methods of scenario modeling and structural and functional analysis were chosen as research methods.The results of the comparative analysis allow us to state that the Russian education now, are at the crossroads of the choice of management system, the choice of which is hidden in the “rivalry” of the two concepts of the main models of education: European or Anglo-American.The European model assumes orientation of education on formation of the personality, the statement about need of orientation of formation of the personality in the mode of pragmatism is the basis of the Anglo-American model.The analysis allows us to conclude that the choice of management system largely depends on the socio-economic environment and the processes taking place in the country.