bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety and efficacy of glibenclamide combined with rtPA in acute cerebral ischemia with occlusion/stenosis of anterior circulation (SE-GRACE): study protocol for a randomized controlled trial
Authors: Huang Kaibin , Ji Zhong , Wu Yongming , Huang Yunqiang , Li Guangning , Zhou Saijun , Yang Zhi , Huang Wenguo , Yang Guoshuai , Weng Guohu , Chen Pingyan , Pan Suyue
Published: June 2020

Background

Thrombolysis with recombinant tissue plasminogen activator (rtPA) improves outcome for patients with acute ischemic stroke (AIS), but many of them still have substantial disability. Glibenclamide (US adopted name, glyburide), a long-acting sulfonylurea, shows promising result in treating AIS from both preclinical and clinical studies. This study investigates the safety and efficacy of glibenclamide combined with rtPA in treating AIS patients.

Methods

This is a prospective, randomized, double-blind, placebo-controlled, multicenter trial with an estimated sample size of 306 cases, starting in January 2018. Patients aged 18 to 74 years, presented with a symptomatic anterior circulation occlusion with a deficit on the NIHSS of 4 to 25 points and treated with intravenous rtPA within the first 4.5 h of their clinical onsets, are eligible for participation in this study. The target time from the onset of symptoms to receive the study drug is of 10 h. Subjects are randomized 1: 1 to receive glibenclamide or placebo with a loading dose of 1.25 mg, followed by 0.625 mg every 8 h for total 5 days. The primary efficacy endpoint is 90-day good outcome, measured as modified Rankin Scale of 0 to 2. Safety outcomes are all-cause 30-day mortality and early neurological deterioration, with a focus on cardiac- and glucose-related serious adverse events.

Discussion

This study will provide valuable information about the safety and efficacy of oral glibenclamide for AIS patients treated with rtPA. This would bring benefits to a large number of patients if the agent is proved to be effective.

Trial registration

The trial was registered on September 14th 2017 at www.clinicaltrials.gov having identifier NCT03284463. Registration was performed before recruitment was initiated.
Is higher psychotropic medication burden associated with involuntary treatment under the Mental Health Act? A four-year Australian cohort study
Authors: Wheeler Amanda J. , Hu Jie , Profitt Caitlin , McMillan Sara S. , Theodoros Theo
Published: June 2020

Background

Involuntary treatment for individuals who lack sufficient capacity to make informed decisions regarding treatment has been associated with increased rates of injectable antipsychotics, antipsychotic polytherapy, and/or high doses. However, little is known about non-antipsychotic psychotropic prescription, or psychotropic medication burden as a more encompassing approach for people treated involuntarily. The aim of this study was to examine the relationship between Mental Health Act (MHA) status and psychotropic polypharmacy and/or high-dose medication prescribing practices in an Australian inpatient mental health unit.

Methods

A retrospective cohort study of 800 adults discharged from a large metropolitan Queensland mental health unit was undertaken. Data was collected for 200 individuals, discharged on at least one psychotropic medicine, at four time periods; Cohort 1 (on or before 31st January 2014), Cohort 2 (2015), Cohort 3 (2016) and Cohort 4 (2017). The number of prescribed medicines and total daily doses were recorded and reviewed for alignment with current clinical guidelines. Participant demographics and clinical characteristics were compared by individual MHA status using chi-square test for categorical variables and analysis of variance for continuous variables. Associations between MHA status and prescribing practices (psychotropic polypharmacy and/or high-dose prescribing) were assessed using bivariate and multivariate binomial logistic regression models. Age, gender, birth country, year of admission, admissions in previous 12 months, primary diagnosis, ECT/clozapine treatment, and other psychotropic medications were adjusted as covariates.

Results

Regression analysis found that compared to their voluntary counterparts, individuals treated involuntarily were 2.7 times more likely to be prescribed an antipsychotic at discharge, 8.8 times more likely to be prescribed more than one antipsychotic at discharge and 1.65 times more likely to be prescribed high-dose antipsychotic treatment at discharge. The adjusted model also found that they were half as likely to be prescribed an antidepressant at discharge.

Conclusion

Implicit review of justifications for increased psychotropic medication burden (antipsychotic polypharmacy and high-doses) in those treated involuntarily is required to ensure clinical outcomes and overall quality of life are improved in this vulnerable group. Clearly documented medication histories, reconciliation at discharge and directions for medication management after discharge are necessary to ensure quality use of medicines.
Family-centeredness of childhood obesity interventions: psychometrics & outcomes of the family-centered care assessment tool
Authors: Simione Meg , Sharifi Mona , Gerber Monica W. , Marshall Richard , Avalon Earlene , Fiechtner Lauren , Horan Christine , Orav E. John , Skelton Joseph , Taveras Elsie M.
Published: June 2020

Background

Incorporating family-centered care principles into childhood obesity interventions is integral for improved clinical decision making, better follow-through, and more effective communication that leads to better outcomes and greater satisfaction with services. The purpose of this study is to evaluate the psychometric properties of a modified version of the Family Centered-Care Assessment (mFCCA) tool and to assess the family-centeredness of two clinical-community childhood obesity interventions.

Methods

Connect for Healthwas a randomized trial testing the comparative effectiveness of two interventions that enrolled 721 children, ages 2–12 years, with a body mass index (BMI) ≥ 85th percentile. The two arms were (1) enhanced primary care; and (2) enhanced primary carepluscontextually-tailored, health coaching. At the end of the one-year intervention, the mFCCA was administered. We used Rasch analyses to assess the tool’s psychometrics and examined differences between the groups using multiple linear regression.

Results

629 parents completed the mFCCA resulting in an 87% response rate. The mean (SD) age of children was 8.0 (3.0) years. The exploratory factor analysis with 24 items all loaded onto a single factor. The Rasch modeling demonstrated good reliability as evidenced by the person separation reliability coefficient (0.99), and strong validity as evidenced by the range of item difficulty and overall model fit. The mean (SD, range) mFCCA score was 4.14 (0.85, 1–5). Compared to parents of children in the enhanced primary care arm, those whose children were in the enhanced primary careplushealth coaching arm had higher mFCCA scores indicating greater perception of family-centeredness (β = 0.61 units [95% CI: 0.49, 0.73]).

Conclusions

Using the mFCCA which demonstrated good psychometric properties for the assessment of family-centered care among parents of children with obesity, we found that individualized health coaching is a family-centered approach to pediatric weight management.

Trial registration

Clinicaltrials.govNCT02124460.
Association between maternal lifestyle factors and low birth weight in preterm and term births: a case-control study
Authors: Xi Chuhao , Luo Min , Wang Tian , Wang Yingxiang , Wang Songbai , Guo Lan , Lu Ciyong
Published: June 2020

Background

It has been reported that lifestyle factors may affect birth weight; however, few studies have explored the association between lifestyle factors and low birth weight in preterm and term births in China. The objective of this study was to explore the effect of lifestyle on low birth weight in preterm and term births.

Methods

This case-control study was conducted in fourteen hospitals in Jiangmen, Guangdong Province. Data were collected from August 2015 to May 2016 using a standard questionnaire. Data were analysed using logistic regression.

Results

Women who delivered preterm and were physically active (1–3 times per week and ≥ 4 times per week) had reduced odds of having low birth weight babies (aOR = 0.584, 95%CI = 0.394–0.867 and, aOR = 0.516, 95%CI = 0.355–0.752, respectively). Pregnant women who had insufficient gestational weight gain had increased odds of having low birth weight babies (aOR = 2.272, 95%CI = 1.626–3.176). Women exposed to passive smoking had an increased risk of delivering low birth weight infants (aOR = 1.404, 95%CI = 1.057–1.864). Insufficient gestational weight gain and excessive gestational weight gain were both significantly associated with low birth weight (aOR = 1.484, 95%CI = 1.103–1.998 and aOR = 0.369, 95%CI = 0.236–0.577, respectively) for term deliveries. In addition, parity, history of low birth weight, antenatal care and gestational hypertension were significantly associated with the likelihood of low birth weight.

Conclusion

Pregnant women without exercise contraindications should remain physically active. Pregnant women should be aware of the negative effects of smoke and be aware of strategies to protect themselves from passive smoke exposure. Hospitals should inform pregnant women of the importance appropriate gestational weight gain. These recommendations should be put into practice to decrease the prevalence of low birth weight infants.
Vitalism in contemporary chiropractic: a help or a hinderance?
Authors: Simpson J. Keith , Young Kenneth J.
Published: June 2020

Background

Chiropractic emerged in 1895 and was promoted as a viable health care substitute in direct competition with the medical profession. This was an era when there was a belief that one cause and one cure for all disease would be discovered. The chiropractic version was a theory that most diseases were caused by subluxated (slightly displaced) vertebrae interfering with “nerve vibrations” (a supernatural, vital force) and could be cured by adjusting (repositioning) vertebrae, thereby removing the interference with the body’s inherent capacity to heal. DD Palmer, the originator of chiropractic, established chiropractic based on vitalistic principles. Anecdotally, the authors have observed that many chiropractors who overtly claim to be “vitalists” cannot define the term. Therefore, we sought the origins of vitalism and to examine its effects on chiropractic today.

Discussion

Vitalism arose out of human curiosity around the biggest questions: Where do we come from? What is life? For some, life was derived from an unknown and unknowable vital force. For others, a vital force was a placeholder, a piece of knowledge not yet grasped but attainable. Developments in science have demonstrated there is no longer a need to invoke vitalistic entities as either explanations or hypotheses for biological phenomena. Nevertheless, vitalism remains within chiropractic. In this examination of vitalism within chiropractic we explore the history of vitalism, vitalism within chiropractic and whether a vitalistic ideology is compatible with the legal and ethical requirements for registered health care professionals such as chiropractors.

Conclusion

Vitalism has had many meanings throughout the centuries of recorded history. Though only vaguely defined by chiropractors, vitalism, as a representation of supernatural force and therefore an untestable hypothesis, sits at the heart of the divisions within chiropractic and acts as an impediment to chiropractic legitimacy, cultural authority and integration into mainstream health care.
The effect of total glucoside of paeony on gut microbiota in NOD mice with Sjögren’s syndrome based on high-throughput sequencing of 16SrRNA gene
Authors: Lu Wen-Wen , Fu Tian-Xiao , Wang Qing , Chen Yi-Lian , Li Tian-Yi , Wu Guo-Lin
Published: June 2020

Purpose

To investigate the effect of total glucoside of paeony (TGP) on gut microbiota in NOD mice with Sjögren’s syndrome (SS), using high-throughput sequencing of 16SrRNA gene.

Methods

Twenty-four NOD mice were randomly assigned to 4 groups (n = 6 per group): sham group receiving deionized water (0.4 ml), hydroxychloroquin group receiving hydroxychloroquin (0.4 ml), TGP group receiving TGP (0.4 ml), and TGP + hydroxychloroquin group receiving 0.4 ml TGP and 0.4 ml hydroxychloroquin. Balb/c mice (n = 6) receiving 0.4 ml deionized water were used as a control group. After intragastric injection of drugs for 8 weeks, feces were collected for high-throughput sequencing of 16SrRNA gene.

Results

The sequencing of 16SrRNA gene resulted in 3686 OTUs, and 10 phyla and 69 genera were identified. Compared with the control group, the indices of Chao, Ace and Shannon in the other 4 groups were significantly lower (P < 0.05), and the Simpson index were significantly higher in the TGP, hydroxychloroquine, and sham groups (P < 0.05). Compared with the sham group, the indices of Chao, Ace and Shannon were significantly higher (P < 0.05), whereas the Simpson index was significantly lower (P < 0.05) in the TGP and TGP + hydroxychloroquine groups. At phylum level, Bacteroidetes was least abundant (36.1%), and Firmicutes was most abundant (56.28%) in the TGP + hydroxychloroquine group. Compared with the other 4 groups, Bacteroidetes was significantly less abundant (P < 0.05) and Firmicutes was significantly more abundant (P < 0.05) in the TGP + hydroxychloroquine group. Verrucomicrobia was most abundant (12.26%) in the hydroxychloroquine, and was significantly more abundant compared with the other 3 groups (P < 0.05). At genus level, compared with the control group, the abundance of Lactobacillus and Incertae of Phylum Firmicutes and Desulfovibrio of Phylum Proteobacteria was significantly increased, and the abundance of Bacteroides and Alloprevotella of Phylum Bacteroidetes and Pseudoflavonifractor of Phylum Firmicutes was significantly decreased in the TGP + hydroxychloroquine group (P < 0.05). Compared with the hydroxychloroquine group, the abundance of Akkermansia of Phylum Verrucomicrobia was significantly decreased in the TGP and TGP + hydroxychloroquine groups (P < 0.05). The abundance of Alistipes of Phylum Bacteroidetes and Desulfovibrio of Phylum Proteobacteria was significantly increased in the TGP + hydroxychloroquine group (P < 0.05).

Conclusions

TGP increases the growth of many key beneficial bacteria, inhibits the growth of dominant pathogenic bacteria, and increases the diversity and abundance of gut microorganisms, especially when combined with hydroxychloroquine. Our findings suggest that TGP may be effective to treat SS by improving the microecological structure of the gut.
Standardisation of lymphatic filariasis microfilaraemia prevalence estimates based on different diagnostic methods: a systematic review and meta-analysis
Authors: Vinkeles Melchers Natalie V. S. , Coffeng Luc E. , de Vlas Sake J. , Stolk Wilma A.
Published: June 2020

Background

Lymphatic filariasis (LF) infection is generally diagnosed through parasitological identification of microfilariae (mf) in the blood. Although historically the most commonly used technique for counting mf is the thick blood smear based on 20 µl blood (TBS20), various other techniques and blood volumes have been applied. It is therefore a challenge to compare mf prevalence estimates from different LF-survey data. Our objective was to standardise microfilaraemia (mf) prevalence estimates to TBS20 as the reference diagnostic technique.

Methods

We first performed a systematic review to identify studies reporting on comparative mf prevalence data as measured by more than one diagnostic test, including TBS20, on the same study population. Associations between mf prevalences based on different diagnostic techniques were quantified in terms of odds ratios (OR, with TBS20 blood as reference), using a meta-regression model.

Results

We identified 606 articles matching our search strategy and included 14 in our analyses. The OR of the mf prevalences as measured by the more sensitive counting chamber technique (≥ 50 µl blood) was 2.90 (95% confidence interval (CI): 1.60–5.28). For membrane filtration (1 ml blood) the OR was 2.39 (95% CI: 1.62–3.53), Knott’s technique it was 1.54 (95% CI: 0.72–3.29), and for TBS in ≥ 40 µl blood it was 1.37 (95% CI: 0.81–2.30).

Conclusions

We provided transformation factors to standardise mf prevalence estimates as detected by different diagnostic techniques to mf prevalence estimates as measured by TBS20. This will facilitate the use and comparison of more datasets in meta-analyses and geographic mapping initiatives across countries and over time.
A European field assessment of the efficacy of fluralaner (Bravecto®) chewable and spot-on formulations for treatment of dogs with generalized demodicosis
Authors: Petersen Ivo , Chiummo Rafael , Zschiesche Eva , Karas-Tecza Joanna , Rapti Dhimiter , Roepke Rainer , Thomas Emmanuel
Published: June 2020

Background

Recent reports indicate that the isoxazoline compounds have the potential to provide safe and effective treatment of canine generalized demodicosis, a condition that has been traditionally difficult to cure. Controlled field studies are needed to confirm this potential. A study was therefore initiated to investigate the efficacy of a single oral or spot-on treatment with fluralaner, an isoxazoline, compared with multiple topical treatments with imidacloprid-moxidectin, in dogs naturally affected by generalized demodicosis.

Methods

Veterinary clinics in 5 European countries enrolled 134 dogs diagnosed with generalized demodicosis. Dogs were randomized to treatment with either fluralaner chewables, fluralaner spot-on, or topical imidacloprid-moxidectin in a 2:2:1 ratio. Both fluralaner formulations were administered once, at the approved dose rate, on Day 0. Imidacloprid-moxidectin was administered per label on Day 0, and every 4 weeks, more frequently if necessary. At each visit (Days 0, 28, 56, 84), dogs were monitored for demodectic mites using deep skin scrapings and observed for health and for severity of skin lesions. Treatment was considered efficacious if more than 90% of the dogs were free of live mites at both Days 56 and 84.

Results

Of 124 dogs completing the study, 57 were diagnosed with juvenile-onset demodicosis and 67 with the adult-onset form. A single treatment with oral or spot-on fluralaner was efficacious, each eliminating mites from at least 98.0% of treated dogs on Days 56 and 84. Against juvenile-onset demodicosis, efficacy of the oral and spot-on formulations was 96.0% and 100%, respectively, and against adult-onset demodicosis 100% and 96.7%. Multiple administrations of imidacloprid-moxidectin were not efficacious, eliminating mites from 87.5% of dogs (92.0% with juvenile-onset demodicosis cured; 81.8% with adult-onset demodicosis). All groups showed a marked reduction in skin lesions by Day 28, with continuing clinical improvement at each subsequent visit through Day 84. There were no treatment-related adverse events.

Conclusions

A single administration of fluralaner chewables or fluralaner spot-on is highly effective against with juvenile-onset and adult-onset forms of generalized canine demodicosis. Topically applied imidacloprid-moxidectin at weekly to monthly intervals over the 84-day study did not achieve the proportion of mite-free dogs required to demonstrate efficacy.
Physical activity and blood gene expression profiles: the Norwegian Women and Cancer (NOWAC) Post-genome cohort
Authors: Olsen Karina Standahl , Lukic Marko , Borch Kristin Benjaminsen
Published: June 2020

Objectives

The influence of physical activity (PA) on the immune system has emerged as a new field of research. Regular PA may promote an anti-inflammatory state in the body, thus contributing to the down-regulation of pro-inflammatory processes related to the onset and progression of multiple diseases. We aimed to assess whether overall PA levels were associated with differences in blood gene expression profiles, in a cohort of middle-aged Norwegian women. We used information from 977 women included in the Norwegian Women and Cancer (NOWAC) Post-genome cohort. Information on PA and covariates was extracted from the NOWAC database. Blood samples were collected using the PAXgene Blood RNA collection system, and gene expression profiles were measured using Illumina microarrays. The R-package limma was used for the single-gene level analysis. For a target gene set analysis, we used the global test R-package with 48 gene sets, manually curated from the literature and relevant molecular databases.

Results

We found no associations between overall PA levels and gene expression profiles at the single-gene level. Similarly, no gene sets reached statistical significance at adjusted p < 0.05. In our analysis of healthy, middle-aged Norwegian women, self-reported overall PA was not associated with differences in blood gene expression profiles.
Anti-Ri-associated paraneoplastic ophthalmoplegia-ataxia syndrome in a woman with breast cancer: a case report and review of the literature
Authors: Sena Giuseppe , Gallo Gaetano , Vescio Giuseppina , Gambardella Denise , de Franciscis Stefano , Renne Mariuccia
Published: June 2020

Background

Breast cancer is the most common cancer in women. However, in the management of breast cancer, paraneoplastic neurological syndromes represent a diagnostic and therapeutic challenge. The diagnosis of paraneoplastic neurological syndromes is difficult due to the heterogeneity of symptoms, the timing of presentation, and the absence of antibodies, and it generally occurs before the diagnosis of breast cancer in 80% of patients who develop paraneoplastic neurological syndromes. We describe a 72-year-old woman with subacute ophthalmoplegia-ataxia syndrome who was subsequently diagnosed as having breast cancer and anti-Ri antibodies.

Case presentation

A 72-year-old post-menopausal Caucasian woman, with a positive medical history for diabetes mellitus and hypertension, presented with a 3-month onset of blurred vision, diplopia, and progressive gait disturbance. Serological tests were positive for well-characterized onconeural antibodies (anti-Ri). A whole-body computed tomography scan revealed a nodular opacity under her left nipple and axillary adenopathy. A biopsy of her left breast was performed, and histological examination showed ductal carcinoma. She underwent a superoexternal quadrantectomy with left axillary dissection. The final diagnosis showed infiltrating ductal carcinoma of the breast (T1c N1 M0, stage IIA) associated with paraneoplastic ophthalmoplegia-ataxia syndrome. At a 6-month follow-up, she showed no clinical or instrumental evidence of neoplastic recurrence with partial clinical improvement of neurological symptoms, such as ataxia and diplopia.

Conclusion

The diagnosis of paraneoplastic neurological syndromes is often late, as in this patient, but treatment at an early stage may provide a good prognosis. Furthermore, this is one of several cases of an anti-Ri paraneoplastic neurological syndrome not associated with myoclonus, which reinforces the belief that opsoclonus myoclonus syndrome is not pathognomonic of the associated anti-Ri paraneoplastic neurological syndromes.
Proinflammatory cytokines regulate epidermal stem cells in wound epithelialization
Authors: Xiao Tong , Yan Zhu , Xiao Shengxiang , Xia Yumin
Published: June 2020

The skin, which serves as the first barrier of the human body, is particularly susceptible to exogenous injuries. Skin wounds, including acute burns and chronic non-healing ulcers, are commonly observed in clinics. Healing of skin wounds is a complex process, consisting of infiltration of inflammatory cells, cellular proliferation, and tissue remodeling phases, which restore the integrity and functions of the skin. Epithelialization is involved in wound healing through re-establishing an intact keratinocyte layer. Epidermal stem cells are indispensable for epithelialization, and they are regulated by multiple proinflammatory cytokines or growth factors. In this review, we summarize recent advances in the effect of these cytokines on migration, proliferation, and differentiation processes of epidermal stem cells. We also introduce promising therapeutic strategies targeting epidermal stem cells or related proinflammatory cytokines for patients with skin wounds.
Identification of hub genes associated with RNAi-induced silencing of XIAP through targeted proteomics approach in MCF7 cells
Authors: Gholizadeh Mehdi Agha , Shamsabadi Fatemeh T. , Yamchi Ahad , Golalipour Masoud , Jhingan Gagan Deep , Shahbazi Majid
Published: June 2020

Background

The X-linked inhibitor of apoptosis protein (XIAP) is the most potent caspase inhibitor of the IAP family in apoptosis pathway. This study aims to identify the molecular targets of XIAP in human breast cancer cells exposed to XIAP siRNA by proteomics screening. The expression of XIAP was reduced in MCF-7 breast cancer cells by siRNA. Cell viability and the mRNA expression level of this gene were evaluated by MTS and quantitative real-time PCR procedures, respectively. Subsequently, the XIAP protein level was visualized by Western blotting and analyzed by two-dimensional (2D) electrophoresis and LC–ESI–MS/MS.

Results

Following XIAP silencing, cell proliferation was reduced in XIAP siRNA transfected cells. The mRNA transcription and protein expression of XIAP were decreased in cells exposed to XIAP siRNA than si-NEG. We identified 30 proteins that were regulated by XIAP, of which 27 down-regulated and 3 up-regulated. The most down-regulated proteins belonged to the Heat Shock Proteins family. They participate in cancer related processes including apoptosis and MAPK signaling pathway. Reduced expression of HSP90B1 was associated with apoptosis induction by androgen receptor and prostate specific antigen. Suppression of XIAP resulted in the enhancement of GDIB, ENO1, and CH60 proteins expression. The network analysis of XIAP-regulated proteins identified HSPA8, HSP90AA1, ENO1, and HSPA9 as key nodes in terms of degree and betweenness centrality methods.

Conclusions

These results suggested that XIAP may have a number of biological functions in a diverse set of non-apoptotic signaling pathways and may provide an insight into the biomedical significance of XIAP over-expression in MCF-7 cells.
Physicians’ adherence to management guidelines for H. pylori infection and gastroesophageal reflux disease: a cross-sectional study
Authors: Na’amnih Wasef , Ben Tov Amir , Bdair-Amsha Amna , Cohen Shlomi , Tsamir Judith , Chodick Gabriel , Muhsen Khitam
Published: June 2020

Background

Primary care physicians (PCPs) play a pivotal role in the management of illnesses of the digestive tract. The study aim was to assess the adherence of PCPs to the guidelines on the management ofHelicobacter pylori(H. pylori) infection and gastroesophageal reflux disease (GERD) in adults.

Methods

We conducted a cross-sectional study during March–July 2017 using the survey platform of Maccabi Healthcare Services in Israel. The study questionnaire assessed adherence to the Maastricht/Florence guidelines onH. pyloriinfection and the American College of Gastroenterology guidelines on the management of GERD. We sent the study questionnaires to a random sample of 610 PCPs via electronic mails. We contacted those who did not respond by telephone; eventually 180 physicians completed the survey.

Results

Ninety (50%) and 60 (36%) of the responders reported using professional guidelines for the diagnosis and management ofH. pyloriinfection and GERD, respectively. Of the 180 participants, 153 (85%) reported referring patients with suspected peptic ulcer disease toH. pyloritesting, 109 (61%) reported referring patients with unexplained iron deficiency anemia and 83 (46%) refer relatives of gastric cancer patients. In caring for young patients who have dyspepsia without alarm symptoms, 127 (74%) reported referral to a urea breath test for the diagnosis ofH. pyloriinfection, and 136 (81%) referral to a specialist in gastroenterology if alarm symptoms present. Triple therapy with proton pump inhibitors/clarithromycin/amoxicillin or metronidazole was reported as first-line therapy by 141 (83%) participants. For GERD, 94–98% of the participants followed the appropriate recommendations.

Conclusions

We identified gaps between the practices of PCPs and the guidelines onH. pyloriinfection management,while guidelines on GERD management are well adopted. Simplification of the guidelines and exploring barriers towards their implementation by PCPs is warranted.
On the distance α-spectral radius of a connected graph
Authors: Guo Haiyan , Zhou Bo
Published: June 2020

For a connected graph G and $\alpha \in [0,1)$α∈[0,1), the distance α-spectral radius of G is the spectral radius of the matrix $D_{\alpha }(G)$Dα(G) defined as $D_{\alpha }(G)=\alpha T(G)+(1-\alpha )D(G)$Dα(G)=αT(G)+(1−α)D(G), where $T(G)$T(G) is a diagonal matrix of vertex transmissions of G and $D(G)$D(G) is the distance matrix of G. We give bounds for the distance α-spectral radius, especially for graphs that are not transmission regular, propose local graft transformations that decrease or increase the distance α-spectral radius, and determine the graphs that minimize and maximize the distance α-spectral radius among several families of graphs.
A new Hermite–Hadamard type inequality for coordinate convex function
Authors: Cao Haisong
Published: June 2020

In the article, we establish a new Hermite–Hadamard type inequality for the coordinate convex function by constructing two monotonic sequences. The given result is the generalization and improvement of some previously obtained results.
A subdivision-based approach for singularly perturbed boundary value problem
Authors: Mustafa Ghulam , Ejaz Syeda Tehmina , Baleanu Dumitru , Ghaffar Abdul , Nisar Kottakkaran Sooppy
Published: June 2020

A numerical approach for solving second order singularly perturbed boundary value problems (SPBVPs) is introduced in this paper. This approach is based on the basis function of a 6-point interpolatory subdivision scheme. The numerical results along with the convergence, comparison and error estimation of the proposed approach are also presented.
Will healthcare workers improve infection prevention and control behaviors as COVID-19 risk emerges and increases, in China?
Authors: Lai Xiaoquan , Wang Xuemei , Yang Qiuxia , Xu Xiaojun , Tang Yuqing , Liu Chenxi , Tan Li , Lai Ruying , Wang He , Zhang Xinping , Zhou Qian , Chen Hao
Published: June 2020

Background

COVID-19 arise global attention since their first public reporting. Infection prevention and control (IPC) is critical to combat COVID-19, especially at the early stage of pandemic outbreak. This study aimed to measure level of healthcare workers’ (HCW’) self-reported IPC behaviors with the risk of COVID-19 emerges and increases.

Methods

A cross-sectional study was conducted in two tertiary hospitals. A structured self-administered questionnaire was delivered to HCWs in selected hospitals. The dependent variables were self-reported IPC behavior compliance; and independent variables were outbreak risk and three intent of infection risk (risk of contact with suspected patients, high-risk department, risk of affected area). Chi-square tests and multivariable negative binomial regression models were employed.

Results

A total of 1386 participants were surveyed. The risk of outbreak increased self-reported IPC behavior on each item (coefficient varied from 0.029 to 0.151). Considering different extent of risk, HCWs from high-risk department had better self-reported practice in most IPC behavior (coefficient ranged from 0.027 to 0.149). HCWs in risk-affected area had higher self-reported compliance in several IPC behavior (coefficient ranged from 0.028 to 0.113). However, HCWs contacting with suspected patients had lower self-reported compliance in several IPC behavior (coefficient varied from − 0.159 to − 0.087).

Conclusions

With the risk of COVID-19 emerges, HCWs improve IPC behaviors comprehensively, which benefits for better combat COVID-19. With the risk (high-risk department and affected area) further increases, majority of IPC behaviors achieved improvement. Nevertheless, under the risk of contact with suspected patients, HCWs show worse IPC behaviors. Which may result from higher work load and insufficient supplies and resources among these HCWs. The preparedness system should be improved and medical assistance is urgently needed.
Eggshell and environmental bacteria contribute to the intestinal microbiota of growing chickens
Authors: Maki Joel J. , Bobeck Elizabeth A. , Sylte Matthew J. , Looft Torey
Published: June 2020

Background

The initial intestinal microbiota acquired from different sources has profound impacts on animal health and productivity. In modern poultry production practices, the source(s) of the establishing microbes and their overall contribution during development of gastrointestinal tract communities are still unclear. Using fertilized eggs from two independent sources, we assessed the impact of eggshell- and environmental-associated microbial communities on the successional processes and bacterial community structure throughout the intestinal tract of chickens for up to 6 weeks post-hatch.

Results

Culturing and sequencing techniques identified a viable, highly diverse population of anaerobic bacteria on the eggshell. The jejunal, ileal, and cecal microbial communities for the egg-only, environment-only, and conventionally raised birds generally displayed similar successional patterns characterized by increasing community richness and evenness over time, with strains of Enterococcus, Romboutsia, and unclassified Lachnospiraceae abundant for all three input groups in both trials. Bacterial community structures differed significantly based on trial and microbiota input with the exception of the egg-exposed and conventional birds in the jejunum at week 1 and the ileum at week 6. Cecal community structures were different based on trial and microbiota input source, and cecal short-chain fatty acid profiles at week 6 highlighted functional differences as well.

Conclusion

We identified distinct intestinal microbial communities and differing cecal short-chain fatty acid profiles between birds exposed to the microbiota associated with either the eggshell or environment, and those of conventionally hatched birds. Our data suggest the eggshell plays an appreciable role in the development of the chicken intestinal microbiota, especially in the jejunum and ileum where the community structure of the eggshell-only birds was similar to the structure of conventionally hatched birds. Our data identify a complex interplay between the eggshell and environmental microbiota during establishment and succession within the chicken gut. Further studies should explore the ability of eggshell- and environment-derived microbes to shape the dynamics of succession and how these communities can be targeted through interventions to promote gut health and mitigate food-borne pathogen colonization in poultry.
Reactive-oxygen-species-mediated mechanism for photoinduced antibacterial and antiviral activities of Ag3PO4
Authors: Seo Youngsik , Park Keunchun , Hong Yonggun , Lee Eun Sik , Kim Sang-Soon , Jung Yong-Tae , Park Heonyong , Kwon Chian , Cho Young-Sik , Huh Young-Duk
Published: June 2020

Cubic-shaped Ag3PO4 crystals with a mean size of 1 μm were synthesized by a precipitation method from a mixed solution of AgNO3, Na2HPO4, and triethanolamine. The antibacterial activities against Escherichia coli, Listeria innocua, and Pseudomonas syringae DC3000 in both the absence and presence of Ag3PO4 under dark conditions and in the presence of Ag3PO4 under red-light (625 nm) and blue-light (460 nm) irradiation were examined. The concentrations of reactive oxygen species (ROS) were also measured in the antibacterial action of the Ag3PO4 against Escherichia coli. The photoinduced enhancement of the Ag3PO4 antibacterial activity under blue-light irradiation is explained by the formation of ROS during the antibacterial action of the Ag3PO4. Moreover, the antiviral activity of Ag3PO4 against amphotropic 10A1 murine leukemia virus enhanced under blue-light irradiation via ROS production. These results provide an insight into extended bio-applications of Ag3PO4.
Improvement on spatial resolution of a coseismic slip distribution using postseismic geodetic data through a viscoelastic inversion
Authors: Tomita Fumiaki , Iinuma Takeshi , Ohta Yusaku , Hino Ryota , Kido Motoyuki , Uchida Naoki
Published: June 2020

Obvious crustal deformation is observed during a postseismic period as well as a coseismic period associated with a large earthquake. Major mechanisms of transient postseismic deformation are known as afterslip and viscoelastic relaxation. Since the viscoelastic relaxation occurs as a response to a coseismic slip, postseismic deformation provides information on coseismic deformation through the viscoelastic response. However, most previous studies have not thoroughly utilized postseismic geodetic observational data for revealing coseismic slip behaviors. In this study, we developed a slip inversion method that simultaneously estimates coseismic slip and postseismic slip distributions from coseismic and postseismic geodetic observational data using viscoelastic Green’s function (viscoelastic inversion method). We investigated the performance of the viscoelastic inversion method via two synthetic tests: one assumed a strike–slip event along an inland fault, while the other assumed a dip–slip event along a plate interface in a subduction zone. Both synthetic tests demonstrated that when extensive postseismic observational data were given, the viscoelastic inversion method provided a superior spatial resolution of coseismic slip distributions compared to conventional elastic inversion distributions. We also applied the viscoelastic inversion method to co- and post-seismic deformations associated with the 2011 Tohoku-oki earthquake. The seafloor geodetic observational network of the off-Tohoku region has been widely extended after the occurrence of the mainshock. Using this extended seafloor geodetic observational data, we successfully improved the spatial resolution of the coseismic slip distribution through the viscoelastic inversion method. Furthermore, using the seafloor observational data during the postseismic period, our inversion method enables us to obtain high spatial resolution of the coseismic slip in the offshore area and a reasonable coseismic slip distribution even if seafloor observational data during the coseismic period are unavailable. These results clarify the importance of deploying a geodetic observational network even after large coseismic events to assess past coseismic slip behaviors by considering the viscoelasticity of the Earth.
Ocean carbon pump decomposition and its application to CMIP5 earth system model simulations
Authors: Oka Akira
Published: June 2020

The ocean stores 60 times as much carbon as the atmosphere, and the ocean carbon cycle has a critical role in controlling atmospheric CO2 concentration. The concept of ocean carbon pump is widely used for describing the ocean carbon cycle, but the term “ocean carbon pump” is not necessarily strictly defined and has been differently referred in previous studies. Here, using three dimensional distributions of dissolved inorganic carbon concentration, total alkalinity, phosphate, and salinity, four types of ocean carbon pump (organic matter, calcium carbonate, gas exchange, and freshwater flux pumps) were formulated. Although previously proposed decomposition emphasizes the enrichment in the deep ocean, my decomposition focuses on surface depletion which directly affects air-sea CO2 exchanges. Based on this decomposition, vector diagram for quantifying the individual roles of the pumps in controlling the ocean surface pCO2, which is in balance with atmospheric CO2 concentration, was demonstrated in this study. The method was applied to the observational climatology, and the contributions of the four carbon pump components to atmospheric CO2 were visualized in a single figure (the vector diagram); each carbon pump component was represented by one vector, and its contribution to CO2 concentration was measured from the difference in the contour values between the beginning and end of the vector. The same analysis was also applied to the CMIP5 earth system model simulations. All the models reproduced the same level of atmospheric CO2 concentration as the observation; however, the contributions from the four carbon pumps varied. The vector diagram was shown to quantify the differences in the contributions from the pumps between the models and against the observation. This study demonstrated that the proposed vector diagram analysis is a useful tool for quantifying the individual contributions of the ocean carbon pumps to atmospheric CO2 concentration and is helpful for evaluating the reproducibility of ocean carbon cycle models.
Context matters: the psychoneurobiological determinants of placebo, nocebo and context-related effects in physiotherapy
Authors: Rossettini Giacomo , Camerone Eleonora Maria , Carlino Elisa , Benedetti Fabrizio , Testa Marco
Published: June 2020

Background

Placebo and nocebo effects embody psychoneurobiological phenomena where behavioural, neurophysiological, perceptive and cognitive changes occur during the therapeutic encounter in the healthcare context. Placebo effects are produced by a positive healthcare context; while nocebo effects are consequences of negative healthcare context. Historically, placebo, nocebo and context-related effects were considered as confounding elements for clinicians and researchers. In the last two decades this attitude started to change, and the understanding of the value of these effects has increased. Despite the growing interest, the knowledge and the awareness of using the healthcare context to trigger placebo and nocebo effects is currently limited and heterogeneous among physiotherapists, reducing their translational value in the physiotherapy field.

Objectives

To introduce the placebo, nocebo and context-related effects by: (1) presenting their psychological models; (2) describing their neurophysiological mechanisms; (3) underlining their impact for the physiotherapy profession; and (4) tracing lines for future researches.

Conclusion

Several psychological mechanisms are involved in placebo, nocebo and context-related effects; including expectation, learning processes (classical conditioning and observational learning), reinforced expectations, mindset and personality traits. The neurophysiological mechanisms mainly include the endogenous opioid, the endocannabinoid and the dopaminergic systems. Neuroimaging studies have identified different brain regions involved such as the dorsolateral prefrontal cortex, the rostral anterior cingulate cortex, the periaqueductal gray and the dorsal horn of spine. From a clinical perspective, the manipulation of the healthcare context with the best evidence-based therapy represents an opportunity to trigger placebo effects and to avoid nocebo effects respecting the ethical code of conduct. From a managerial perspective, stakeholders, organizations and governments should encourage the assessment of the healthcare context aimed to improve the quality of physiotherapy services. From an educational perspective, placebo and nocebo effects are professional topics that should be integrated in the university program of health and medical professions. From a research perspective, the control of placebo, nocebo and context-related effects offers to the scientific community the chance to better measure the impact of physiotherapy on different outcomes and in different conditions through primary studies.
The use of learning dashboards to support complex in-class pedagogical scenarios in medical training: how do they influence students’ cognitive engagement?
Authors: de Leng Bas , Pawelka Friedrich
Published: June 2020

This study aims to contribute to empirical and interdisciplinary knowledge on how visual learning analytics tools can support students’ cognitive engagement in complex in-class scenarios. Taking a holistic approach, instructional design, learning analytics, and students’ perceptions were examined together. The teaching of systematic viewing and image interpretation in radiology education was used to exemplify a complex in-class scenario, and a specific learning dashboard was designed as a support tool. The design was based on both educational and visualization theories and aligned with a pedagogical scenario integrating individual and class-wide activities. The quantity and quality of the cognitive engagement of a group of 26 students were explored. A mixed method approach was used, including computer log file analyses of individual work, analysis of video recordings of in-class small group discussions, and a focus group discussion with the students involved. The in-class scenario with the learning dashboard resulted in a good balance between individual tasks and group discussions and a high degree of active cognitive engagement. Constructive and interactive forms of cognitive engagement were, however, less evident. In addition, the products of these constructive (description of findings) and interactive (type of dialogue) cognitive engagements were of mediocre quality and therefore not optimal for knowledge transfer. The study also showed that the way the students and teacher understood their respective tasks and used the available interaction techniques of the learning dashboard highly influenced the students’ cognitive engagement. Finally, several ideas emerged that could help to overcome the deficits found in the training of participants and to improve the tasks set and the learning dashboard itself.
Preoperative vitamin D level does not affect the short-term functional outcome after total knee arthroplasty in elderly women
Authors: Hwang Il Yeong , Park Ki Bong , Chang Sung Who , Cho Sung Do , Youm Yoon Seok
Published: June 2020

Background

We aimed to evaluate the effect of vitamin D levels on the functional outcome of elderly women who underwent total knee arthroplasty (TKA).

Methods

Seven hundred and four patients (1013 knees) who underwent primary TKA were included in our retrospective study. Preoperative vitamin D levels were measured and the relationship analyzed between these and age, weight, height, body mass index, and bone mineral density. Two hundred and twenty patients (220 knees) who received unilateral TKA and were followed up for more than 1 year after operation were divided into two groups: Group 1, serum 25-hydroxyvitamin D3 (25(OH)D3) level < 20 ng/ml; and Group 2, 25(OH)D3 level ≥ 20 ng/ml. Both groups were evaluated for the relationship between vitamin D levels and postoperative Visual Analogue Scale (VAS) score, Knee Society Knee Score (KSKS), Knee Society Function Score (KSFS), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) score.

Results

The number of vitamin D-deficient patients (< 20 ng/ml of serum 25(OH)D3 level) was 556 (79.0%). In the correlation analysis, the vitamin D level was negatively correlated with weight only (p = 0.033). No significant differences were observed between the groups in terms of postoperative VAS score, KSKS, KSFS, and WOMAC score.

Conclusions

Vitamin D deficiency was highly prevalent in patients who underwent TKA. Vitamin D levels negatively correlated with weight. Low vitamin D level was not a risk factor for unsatisfactory TKA outcome in elderly women.