bluuebunny/crossref_metadata_2025_split huggingface dataset:
Duration of antibiotic therapy in critically ill patients: a randomized controlled trial of a clinical and C-reactive protein-based protocol versus an evidence-based best practice strategy without biomarkers
Authors:   on behalf of NIIMI – Núcleo Interdisciplinar de Investigação em Medicina Intensiva, Borges Isabela , Carneiro Rafael , Bergo Rafael , Martins Larissa , Colosimo Enrico , Oliveira Carolina , Saturnino Saulo , Andrade Marcus Vinícius , Ravetti Cecilia , Nobre Vandack 
Published: June 2020

Abstract
Background
The rational use of antibiotics is one of the main strategies to limit the development of bacterial resistance. We therefore sought to evaluate the effectiveness of a C-reactive protein-based protocol in reducing antibiotic treatment time in critically ill patients.

Methods
A randomized, open-label, controlled clinical trial conducted in two intensive care units of a university hospital in Brazil. Critically ill infected adult patients were randomly allocated to (i) intervention to receive antibiotics guided by daily monitoring of CRP levels and (ii) control to receive antibiotics according to the best practices for rational use of antibiotics.

Results
One hundred thirty patients were included in the CRP (n = 64) and control (n = 66) groups. In the intention-to-treat analysis, the median duration of antibiotic therapy for the index infectious episode was 7.0 (5.0–8.8) days in the CRP and 7.0 (7.0–11.3) days in the control (p = 0.011) groups. A significant difference in the treatment time between the two groups was identified in the curve of cumulative suspension of antibiotics, with less exposure in the CRP group only for the index infection episode (p = 0.007). In the per protocol analysis, involving 59 patients in each group, the median duration of antibiotic treatment was 6.0 (5.0–8.0) days for the CRP and 7.0 (7.0–10.0) days for the control (p = 0.011) groups. There was no between-group difference regarding the total days of antibiotic exposure and antibiotic-free days.

Conclusions
Daily monitoring of CRP levels may allow early interruption of antibiotic therapy in a higher proportion of patients, without an effect on total antibiotic consumption. The clinical and microbiological relevance of this finding remains to be demonstrated.

Trial registry
ClinicalTrials.gov Identifier: NCT02987790. Registered 09 December 2016.
Comparing the effectiveness of magnesium oxide and naldemedine in preventing opioid-induced constipation: a proof of concept, single institutional, two arm, open-label, phase II, randomized controlled trial: the MAGNET study
Authors: Ozaki Anna , Kessoku Takaomi , Iwaki Michihiro , Kobayashi Takashi , Yoshihara Tsutomu , Kato Takayuki , Honda Yasushi , Ogawa Yuji , Imajo Kento , Higurashi Takuma , Yoneda Masato , Taguri Masataka , Yamanaka Takeharu , Ishiki Hiroto , Kobayashi Noritoshi , Saito Satoru , Ichikawa Yasushi , Nakajima Atsushi 
Published: June 2020

Abstract
Background
Patients taking opioids are known to develop opioid-induced constipation (OIC), which reduces their quality of life. The aim of this study is to compare magnesium oxide with naldemedine and determine which is more effective in preventing OIC.

Methods
This proof-of-concept, prospective, randomized controlled trial commenced in Japan in March 2018. Initially, a questionnaire-based survey will be conducted targeting adult patients with cancer who concomitantly commenced opioid treatment and OIC prevention treatment. Patients will then be randomly allocated to a magnesium oxide group (500 mg thrice daily) or a naldemedine group (0.2 mg once daily). Each drug will be orally administered for 12 weeks. The primary endpoint is defined as any improvement in scores on the Japanese version of Patient Assessment of Constipation Quality of Life questionnaire (JPAC-QOL) from baseline to 2 weeks of treatment.

Discussion
The primary endpoint is change in JPAC-QOL score from baseline to 2 weeks of intervention. The key secondary endpoint will be change in spontaneous bowel movements at 2 and 12 weeks of intervention. This study will determine whether magnesium oxide or naldemedine is more effective for the prevention of OIC.

Trial registration
University Hospital Medical Information Network (UMIN) Clinical Trials Registry, UMIN000031891. Registered March 25, 2018.
Biochemical characteristics and molecular mechanism of an exo-type alginate lyase VxAly7D and its use for the preparation of unsaturated monosaccharides
Authors: Tang Luyao , Wang Ying , Gao Shan , Wu Hao , Wang Danni , Yu Wengong , Han Feng 
Published: June 2020

Abstract
Background
As the most abundant polysaccharide in brown algae, alginate has become a promising economical material for bioethanol production. Recently, exo-type alginate lyases have received extensive attention because the unsaturated monosaccharides produced by their degradation of alginate can be easily converted into 4-deoxy-l-erythro-5-hexoseulose uronate (DEH), a promising material for bioethanol production and biorefinery systems.

Results
In this study, we cloned and characterized an exo-type polysaccharide lyase family 7 (PL7) alginate lyase VxAly7D from the marine bacterium Vibrio xiamenensis QY104. Recombinant VxAly7D was most active at 30 °C and exhibited 21%, 46% and 90% of its highest activity at 0, 10 and 20 °C, respectively. Compared with other exo-type alginate lyases, recombinant VxAly7D was shown to be a bifunctional alginate lyase with higher specific activity towards sodium alginate, polyG and polyM (462.4 ± 0.64, 357.37 ± 0.53 and 441.94 ± 2.46 U/mg, respectively). A total of 13 μg recombinant VxAly7D could convert 3 mg sodium alginate to unsaturated monosaccharides in 1 min with a yield of 37.6%, and the yield reached 95% in 1 h. In addition, the three-dimensional structure of VxAly7D was modelled using the crystal structure of AlyA5 from Zobellia galactanivorans DsijT as the template. The action mode and the end products of the W295A mutant revealed that Trp295 is a key amino acid residue responsible for the exolytic action mode of VxAly7D.

Conclusion
Overall, our results show that VxAly7D is a PL7 exo-type alginate lyase with high activity and a high conversion rate at low/moderate temperatures, which provides a useful enzymatic tool for the development of biofuel production from brown algae and enriches the understanding of the structure and functional relationships of polysaccharide lyases.
Evaluation of a pan-Leishmania SL RNA qPCR assay for parasite detection in laboratory-reared and field-collected sand flies and reservoir hosts
Authors: Pareyn Myrthe , Hendrickx Rik , Girma Nigatu , Hendrickx Sarah , Van Bockstal Lieselotte , Van Houtte Natalie , Shibru Simon , Maes Louis , Leirs Herwig , Caljon Guy 
Published: June 2020

AbstractBackgroundIn eco-epidemiological studies,Leishmaniadetection in vectors and reservoirs is frequently accomplished by high-throughput and sensitive molecular methods that target minicircle kinetoplast DNA (kDNA). A pan-LeishmaniaSYBR green quantitative PCR (qPCR) assay which detects the conserved spliced-leader RNA (SL RNA) sequence was developed recently. This study assessed the SL RNA assay performance combined with a crude extraction method for the detection ofLeishmaniain field-collected and laboratory-reared sand flies and in tissue samples from hyraxes as reservoir hosts.MethodsField-collected and laboratory-infected sand fly and hyrax extracts were subjected to three different qPCR approaches to assess the suitability of the SL RNA target forLeishmaniadetection. Nucleic acids of experimentally infected sand flies were isolated with a crude extraction buffer with ethanol precipitation and a commercial kit and tested for downstream DNA and RNA detection. Promastigotes were isolated from culture and sand fly midguts to assess whether there was difference in SL RNA and kDNA copy numbers. Naive sand flies were spiked with a serial dilution of promastigotes to make a standard curve.ResultsThe qPCR targeting SL RNA performed well on infected sand fly samples, despite preservation and extraction under presumed unfavorable conditions for downstream RNA detection. Nucleic acid extraction by a crude extraction buffer combined with a precipitation step was highly compatible with downstream SL RNA and kDNA detection. Copy numbers of kDNA were found to be identical in culture-derived parasites and promastigotes isolated from sand fly midguts. SL RNA levels were slightly lower in sand fly promastigotes (ΔCq 1.7). The theoretical limit of detection and quantification of the SL RNA qPCR respectively reached down to 10−3and 10 parasite equivalents. SL RNA detection in stored hyrax samples was less efficient with some false-negative assay results, most likely due to the long-term tissue storage in absence of RNA stabilizing reagents.ConclusionsThis study shows that a crude extraction method in combination with the SL RNA qPCR assay is suitable for the detection and quantification ofLeishmaniain sand flies. The assay is inexpensive, sensitive and pan-Leishmaniaspecific, and accordingly an excellent assay for high-throughput screening in entomological research.
Assessment of knowledge, attitude and practices and the analysis of risk factors regarding schistosomiasis among fishermen and boatmen in the Dongting Lake Basin, the People’s Republic of China
Authors: Guan Zhou , Dai Si-Min , Zhou Jie , Ren Xiao-Bing , Qin Zhi-Qiang , Li Yin-Long , Lv Shan , Li Shi-Zhu , Zhou Xiao-Nong , Xu Jing 
Published: June 2020

Abstract
Background
Fishermen and boatmen are a population at-risk for contracting schistosomiasis due to their high frequency of water contact in endemic areas of schistosomiasis in the People’s Republic of China (P. R. China). To develop specific interventions towards this population, the present study was designed to assess the knowledge, attitudes and practices (KAPs) towards schistosomiasis of fishermen and boatmen, and to identify the risk factors associated with schistosome infection using a molecular technique in a selected area of Hunan Province in P. R. China.

Methods
A cross sectional survey was conducted in the Dongting Lake Basin of Yueyang County, Hunan Province. A total of 601 fishermen and boatmen were interviewed between October and November 2017. Information regarding sociodemographic details and KAPs towards schistosomiasis were collected using a standardized questionnaire. Fecal samples of participants were collected and tested by polymerase chain reaction (PCR). Logistic regression analysis was conducted to explore the risk factors related to the positive results of PCR.

Results
Of the 601 respondents, over 90% knew schistosomiasis and how the disease was contracted, the intermediate host of schistosomes and preventive methods. The majority of respondents had a positive attitude towards schistosomiasis prevention. However, only 6.66% (40/601) of respondents had installed a latrine on their boats, while 32.61% (196/601) of respondents defecated in the public toilets on shore. In addition, only 4.99% (30/601) respondents protected themselves while exposed to freshwater. The prevalence of schistosomiasis, as determined by PCR, among fishermen and boatmen in Yueyang County was 13.81% (83/601). Age, years of performing the current job, number of times receiving treatment, and whether they were treated in past three years were the main influencing factors of PCR results among this population.

Conclusions
Fishermen and boatmen are still at high risk of infection in P. R. China and gaps exist in KAPs towards schistosomiasis in this population group. Chemotherapy, and health education encouraging behavior change in combination with other integrated approaches to decrease the transmission risk in environments should be improved.
Care transition from hospital to home: cancer patients’ perspective
Authors: Lorenzini Elisiane , Boell Julia Estela Willrich , Oelke Nelly D. , Rodrigues Caroline Donini , Trindade Letícia Flores , Winter Vanessa Dalsasso Batista , Malkiewiez Michelle Mariah , Flôres Gabriela Ceretta , Pluta Pâmella , Kolankiewicz Adriane Cristina Bernat 
Published: June 2020

Abstract
Objectives
The present database contains information on sociodemographic and clinical data as well as data from the Care Transition Measure (CTM 15-Brazil) of cancer patients undergoing clinical or surgical treatment. Data collection was carried out 7 to 30 days after patients’ hospital discharge from June to August 2019. Understanding these data can contribute to improving quality of care transitions and avoiding hospital readmissions.

Data description
This data set encompasses 213 cancer patients characterized by the follow variables: gender, age range, place of residence, race, marital status, schooling, paid work activity, type of treatment, cancer staging, metastasis, comorbidities, main complaint, main complaint grouped as, continuing medication, diagnosis, diagnosis grouped as, cancer type, year of diagnosis, oncology treatment, first hospitalization, readmission in the last 30 days, number of hospitalizations in the last 30 days, readmission in the last 6 months, number of hospitalizations in the last 6 months, readmission in the last year, number of hospitalizations in the last year and the questions 1–15 from CTM 15-Brazil.
The Efficiency of self-employed general practitioners and factors affecting it: a study in Iran
Authors: Hajibagheri Razie , Lotfi Farhad , Bayati Mohsen 
Published: June 2020

Abstract
Objective
Physicians as an economic firm make use of available resources such as time, human forces and space to provide healthcare services. The current study aimed at estimating the technical efficiency of Iranian self-employed general practitioners (GPs) and its effective factors using data envelopment analysis and regression analysis.

Results
About 2% of the GPs were fully efficient and the remaining (98%) were inefficient. Almost, 2.09% of the physicians had constant returns to scale, and 31.41% and 66.49% of them had increasing and decreasing returns to scale, respectively. According to the regression estimates, gender (female) (β = 3.776, P = 0.072), age (β = 0.475, P = 0.013), practice experience (β = − 0.477, P = 0.015), contract with the insurer (β = − 6.475, P = 0.005) and economic expectations (β = 1.939, P = 0.014) showed significant effect on GPs inefficiency. Most of the GPs surveyed did not optimally allocate their time and physical and human resources to provide their services. Female GPs, older ones, those with fewer practice experience, those with higher economic expectations, and the GPs with no insurance contract were more inefficient. Increasing the insurance coverage of self-employed GPs and providing them with training in office economic management can reduce their inefficiency.
Estrogen-related mechanisms in sex differences of hypertension and target organ damage
Authors: Sabbatini Andrea Rodrigues , Kararigas Georgios 
Published: June 2020

AbstractHypertension (HTN) is a primary risk factor for cardiovascular (CV) events, target organ damage (TOD), premature death and disability worldwide. The pathophysiology of HTN is complex and influenced by many factors including biological sex. Studies show that the prevalence of HTN is higher among adults aged 60 and over, highlighting the increase of HTN after menopause in women. Estrogen (E2) plays an important role in the development of systemic HTN and TOD, exerting several modulatory effects. The influence of E2 leads to alterations in mechanisms regulating the sympathetic nervous system, renin-angiotensin-aldosterone system, body mass, oxidative stress, endothelial function and salt sensitivity; all associated with a crucial inflammatory state and influenced by genetic factors, ultimately resulting in cardiac, vascular and renal damage in HTN. In the present article, we discuss the role of E2 in mechanisms accounting for the development of HTN and TOD in a sex-specific manner. The identification of targets with therapeutic potential would contribute to the development of more efficient treatments according to individual needs.
A dynamic model of viruses with the effect of removable media on a computer network with heterogeneous immunity
Authors: Al-Tuwairqi Salma M. , Bahashwan Walaa 
Published: June 2020

AbstractIn this paper, we build a mathematical model to study the impact of external removable devices on a network with weakly- and strongly-protected computers. The model describes the dynamics between weak, strong, infected computers and susceptible, infected removable media. Analytical investigations of the model produce two equilibrium points: virus-free and endemic. Moreover, we investigate the local and global stability of both equilibria. The existence and stability conditions of the equilibrium points depend primarily on the basic reproduction number ($R_{0}$R0) of the model. Furthermore, we perform numerical simulations to substantiate the analytical results. Also, a sensitivity analysis is carried out to examine the critical parameters that lead to strategies to control the dissipation of viruses.
Identifying the space source term problem for a generalization of the fractional diffusion equation with hyper-Bessel operator
Authors: Luc Nguyen Hoang , Huynh Le Nhat , Baleanu Dumitru , Can Nguyen Huu 
Published: June 2020

AbstractIn this paper, we consider an inverse problem of identifying the source term for a generalization of the time-fractional diffusion equation, where regularized hyper-Bessel operator is used instead of the time derivative. First, we investigate the existence of our source term; the conditional stability for the inverse source problem is also investigated. Then, we show that the backward problem is ill-posed; the fractional Landweber method and the fractional Tikhonov method are used to deal with this inverse problem, and the regularized solution is also obtained. We present convergence rates for the regularized solution to the exact solution by using an a priori regularization parameter choice rule and an a posteriori parameter choice rule. Finally, we present a numerical example to illustrate the proposed method.
Social media use disorder and loneliness: any association between the two? Results of a cross-sectional study among Lebanese adults
Authors: Youssef Lara , Hallit Rabih , Kheir Nelly , Obeid Sahar , Hallit Souheil 
Published: June 2020

Abstract
Background
In Lebanon, it is already established that mental disorders are prevalent among the population. Lebanese people are active users of social media platforms. To date, no study has previously explored the relationship between mental health and social media use disorder in Lebanon. The present study aims to learn more about the link between social media use disorder and loneliness among Lebanese people.

Methods
This cross-sectional study was carried out between January and December 2018. It enrolled 456 residents of the community randomly selected from Lebanon’s governorates in a proportionate rate.

Results
The results showed that 107 (23.7%) participants were classified as having social media use disorder. The results of a stepwise linear regression, taking the loneliness score as the dependent variable, showed that female gender compared to males (Beta = 0.42), having a secondary level of education compared to illiteracy (Beta = 0.65), higher social media use disorder (Beta = 0.03) and higher insomnia (Beta = 0.02) and alexithymia (Beta = 0.02) were significantly associated with higher loneliness.

Conclusion
The present study was able to contribute to the literature and showed the association between social media use disorder and loneliness. These findings can benefit psychologists and public health practitioners in their future prevention and intervention plans.
What influences antibiotic sales in rural Bangladesh? A drug dispensers’ perspective
Authors: Matin Mohammad Abdul , Khan Wasif Ali , Karim Mohammad Mahbubul , Ahmed Sabeena , John-Langba Johannes , Sankoh Osman A. , Gyapong Margaret , Kinsman John , Wertheim Heiman 
Published: June 2020

AbstractBackgroundAntibiotic resistance poses a great threat to global health, especially in low- and middle-income countries with a high infectious disease burden and limited resources. In spite of regulations, antibiotics are sold in many settings as non-prescription medicines, resulting in inappropriate use and resistance.ObjectiveThis study aimed to investigate the current status of access and use of antibiotics in rural Bangladesh, by exploring the perspectives and sales practices of antibiotic drug dispensers.MethodsWe used a mixed methods approach (qualitative and quantitative). We mapped and characterized antibiotic purchasing and dispensing sites in the Matlab Health and Demographic Surveillance System catchment area. Furthermore, we investigated the volume of provision of systemic antibiotics in 10 drug outlets. We held 16 in-depth interviews with randomly selected antibiotics dispensers. Interviews explored factors associated with antibiotic selling. Responses were transcribed, coded for themes, and summarized. We used ATLAS.ti 5.2 for conducting a thematic analysis.ResultsA total of 301 antibiotic dispensers were identified, of whom 92% (n = 278) were private and 8% (n = 23) public. 52% (n = 155) operated informally (i.e. without legal authorization). In order to promote and survive in their business, dispensers sell antibiotics for a range of conditions without a qualified physician’s prescription. Factors that facilitate these inappropriate sales include lack of access to healthcare in the rural community, inadequate doctor: population ratio, limited dispenser knowledge, poor pharmacovigilance concerning safety of self medication, lack of enforcement of policies, financial benefits for both customers and dispensers, and high dependency on pharmaceutical companies’ information.ConclusionDispensers in rural Bangladesh sell antibiotics inappropriately by ignoring existing national regulations. They operate the antibiotic sales without facing any legal barriers and primarily with a view to sustain their business, resulting in inappropriate sales of antibiotics to the rural community. The influence of the drug industry needs to be replaced with evidence-based, not commercially driven information. Awareness programs for antibiotic providers that promote understanding of antibiotics and antibiotic resistance through tailored interventions may be helpful in changing current antibiotic sales practices.
Impact of truncal vagotomy on complicated peptic ulcer after distal gastrectomy with reconstruction by jejunal pouch interposition
Authors: Yamashita Reika , Takahashi Naoto , Tsuboi Kazuto , Mitsumori Norio , Kashiwagi Hideyuki , Yanaga Katsuhiko 
Published: June 2020

Abstract
Background
We encountered a case of marginal ulcer in the jejunum after distal gastrectomy with jejunal pouch interposition. However, it has not been reported and not confirmed the treatment. We chose truncal vagotomy, considering reduced morbidity and postoperative complications.

Case presentation
A case was a 69-year-old woman who was admitted to our hospital with melena. She had received curative distal gastrectomy with a 15-cm jejunal pouch reconstruction for early gastric cancer. Marginal ulcer in the jejunal pouch was detected by upper gastrointestinal endoscopy. She was given medication; however, she repeated hospitalization for melena and abdominal pain. Therefore, we decided to perform surgery, and truncal vagotomy was performed. The patient’s postoperative course was uneventful and was discharged on the 22nd postoperative day. Symptoms such as abdominal pain and melena were improved after truncal vagotomy.

Conclusion
We presented a case with a complicated peptic ulcer after distal gastrectomy with reconstruction by jejunal pouch interposition, which was successfully treated by truncal vagotomy, a surgical acid-reducing procedure which does not require resection of remnant stomach.