bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comprehensive 5P Framework for Active Aging Using the Ecological Approach: An Iterative Systematic Review
Authors: Lak Azadeh , Rashidghalam Parichehr , Myint Phyo K , Bradaran Hamid R 
Published: December 2019

Abstract
Background: "Active aging" is an inclusive term and has been defined from a variety of aspects in different domains throughout the literature. The aim of this review was to identify those aspects that play significant roles in building this concept using an ecological approach. Methods: In this study, seven online databases, including JSTOR, Pub-Med, Web of Science, Google Scholar, ProQuest, EBSCO, and Scopus, were searched from 2002 to 2018 for both qualitative and quantitative articles published in English. Two reviewers independently found the related articles using the search terms “active aging” and “built environment” and included both “ageing” and “aging”. Results: Of 1500 records which passed the screening stage, 92 were eligible for inclusion in the review. A total of 15 subthemes were derived: (1) personal characteristics, (2) behavioral attitude, (3) land use, (4) access, (5) physical form, (6) cityscape/city image, (7) public open spaces, (8) housing, (9) social environment, (10) cultural Environment, (11) economic environment, (12) good governance, (13) physical health, (14) mental health, and (15) social health. Ecological themes of active aging can be defined as the 5P model: person, processes, place, prime, and policymaking. Conclusions: The results of this study can shed light on different aspects of active aging. Also, the results emphasized the significance of the multidimensional nature of active aging, micro (person), meso (process), and macro systems (place and policymaking), based on health (prime) environments. Moreover, the results were based on the relationships between the person and the environment at the individual, interpersonal, and environmental levels, which can be used to conduct future studies and develop policies on aging populations.
Promoting parent-child relationships and preventing violence via home-visiting: A pre-post cluster randomised trial among Rwandan families linked to social protection programmes
Authors: Betancourt Theresa S. , Jensen Sarah K.G. , Barnhart Dale A. , Brennan Robert T. , Murray Shauna M. , Yousafzai Aisha K. , Farrar Jordan , Godfroid Kalisa , Bazubagira Stephanie M. , Rawlings Laura B. , Wilson Briana , Sezibera Vincent , Kamurase Alex 
Published: December 2019

Abstract
Background: Sugira Muryango ​ is a father-engaged early child development and violence-prevention home-visiting programme delivered by trained lay workers. This cluster-randomised trial evaluates whether families living in extreme poverty ( Ubudehe 1, the poorest category in the Government of Rwanda’s wealth ranking) who receive Sugira Muryango in combination with a government-provided social protection programme demonstrate greater responsive, positive caregiving, nutrition, care seeking, hygiene, and father involvement compared with control families receiving usual care (UC). Methods: Using detailed maps, we grouped closely spaced villages into 284 geographic clusters stratified by the type of social protection programs operating in the village clusters; 198 clusters met all enrolment criteria. Sugira Muryango was delivered to n=541 families in 100 treatment clusters with children aged 6–36 months living in extreme poverty. We assessed changes in outcomes in intervention and 508 UC control families using structured surveys and observation. Analyses were intent to treat using mixed models to accommodate the clustering. Results: Families receiving Sugira Muryango improved on core outcomes of parent-child relationships assessed using the Home Observation for Measurement of the Environment (Cohen’s d =0.87, 95% CI: 0.74, 0.99) and the Observation of Mother-Child Interaction (Cohen’s d =0.29, 95% CI: 0.17, 0.41). We also saw reductions in harsh discipline on items from the UNICEF MICS (OR=0.30: 95% CI: 0.22, 0.51) and violent victimization of female caregivers by their partners (OR=0.49, 95% CI: 0.24, 1.00) compared with UC. Moreover, children in families receiving SM had a 0.45 higher increase in food groups consumed in the past 24 hours (Cohen’s d =0.35, 95% CI: 0.22, 0.47), increased care seeking for diarrhoea (OR=4.43, 95% CI: 1.95, 10.10) and fever (OR=3.28, 95% CI: 1.82, 5.89), and improved hygiene behaviours such as proper treatment of water (OR=3.39, 95% CI: 2.16, 3.69) compared with UC. Finally, Sugira Muryango was associated with decreased caregiver depression and anxiety (OR=0.58, 95% CI: 0.38, 0.88). Conclusions: Sugira Muryango led to improvements in caregiver behaviours linked to child development and health as well as reductions in violence. Trial registration: ClinicalTrials.gov number NCT02510313.
Surgical Workflow Simulation for the Design and Assessment of Operating Room Setups in Orthopedic Surgery
Authors: Neumann Juliane , Angrick Christine , Höhn Celina , Zajonz Dirk , Ghanem Mohamed , Roth Andreas , Neumuth Thomas 
Published: December 2019

Abstract
Background
The design and internal layout of modern operating rooms are influencing the team’s collaboration and communication, ergonomics, as well as intraoperative hygiene substantially. Nevertheless, there is no objective method for the assessment and design of the personnel and table positions for different surgical disciplines and intervention types available. The aim of this work is to establish an improved OR setup for common procedures in arthroplasty.
Methods
With the help of computer simulation techniques, a method for the objective design and assessment of enhanced OR setups was developed. In this work, new OR setups were designed, analyzed in a computer simulation environment and evaluated in the actual intraoperative setting.
Results
The implementation of improved OR setups reduces the instrument handover time between the surgeon and the scrub nurse, the travel paths of the OR team as well as shortens the procedure duration. Additionally, the ergonomics of the OR staff were improved.
Conclusion
The developed simulation method was intraoperatively evaluated and proved its benefit for the design and optimization of OR setups for different surgical intervention types. As a clinical result, enhanced setups for total knee arthroplasty and total hip arthroplasty surgeries were established in daily clinical routine and the OR efficiency was improved.
Clinical Population Pharmacokinetics/Pharmacodynamics Protocol of Alkaloids from Leaf of Alstonia scholaris on Acute Bronchitis Patients
Authors: Li Rui , Zhang Wan-Tong , Zhao Yun-Li , Sun Ming-Yue , Fan Mao-Rong , Luo Xiao-Dong , Gao Rui , Li Xin-Gang 
Published: December 2019

Abstract
Background Acute tracheobronchitis is the acute tracheobronchial mucosal inflammation caused by biological, physical, chemical stimulation, and accompanied by symptoms of cough and expectoration. The capsule of alkaloids from leaf of Alstonia scholaris (CALAS), an effective part riches in alkaloids, has the antiviral, antibacterial, anti-inflammatory, expectorant, anti-tussive, anti-asthmatic, immunoregulation effects. However, whether the clinical indexes could be improved by the same ingredients and pathways after oral administration, and the changes in the relationship between ingredients and pharmacodynamics indexes, still need further clinical verification.Methods/design This is a prospectively planned, blinded, placebo-controlled, parallel-grouped clinical trial with aggregated population pharmacokinetics/pharmacodynamics (PPK/PD) data. 55 subjects will be randomly allocated into four arms, specifically, 10 of the 55 subjects were selected randomly for the placebo arm who will be orally administered with placebo (Tid), and 45 subjects were randomly assigned to CALAS treatment group (20 mg, 40 mg, 80 mg Tid, 15 subjects per group). The medication, cough and phlegm, body temperature of every subject should be recorded daily during treatment. Each subject will be collected 3-4 blood samples at the following points for PPK/PPD parameters analysis. Blood samples will be acquired pre-dose (0 h) and post-dose at 15 min, 40 min, 1 h, 1.5 h, 2 h, 3 h, 4 h, 6 h, 8 h, 12 h, 24 h, 30 h, 48 h after last dosing. All subjects will receive a laboratory examination and efficacy evaluation on day 8.Discussion A new integrating strategy to explore relationship among drug ingredients, action pathway and clinical efficacy will be established through this study. We aim to explore the mechanism of CALAS in treatment of acute bronchitis on the premise of definite active ingredients and reliable clinical efficacy. It is difficult to be accepted by patients since classical pharmacokinetics (PK) research adopts intensive sampling method, meanwhile, it cannot quantify the variability of PK parameters (Intra-individual variation, interindividual variation and weekly variation). Moreover, extrapolation and prediction of dosage regimen between different species and populations cannot be realized. Therefore, PPK/PPD method, usually taking advantage of sparse data (3-5 time points sampling per patient), which be selected to find out the measurable factors of pathology and physiology that lead to the change of dose-concentration, and guide reasonable dose adjustment to achieve the optimal clinical effects.
Barriers for teaching communication skills in Spanish Medical Schools: a qualitative study with academic leaders
Authors: Ruiz-Moral Roger , de Leonardo Cristina García , Pérez Alvaro Cerro , Martínez Fernando Caballero , Martín Diana Monge 
Published: December 2019

Abstract
Background: In recent years, Spanish medical schools (MSs) have been incorporating training in communication skills (CS), although how this is being carried out has not yet been evaluated. Objective: to identify the barriers to the introduction and development of CS teaching in Spanish MSs.
Methods: Based on participation in a previous study, 34 (83%) MSs (34) were invited to participate in a previous study that explored factual aspects of teaching CS in these schools. Person responsible for the teaching this domain were contacted at each school and asked to respond to a single open ended question. Two researchers independently conducted a thematic analysis of the responses.
Results: We received responses from 30 MSs, (85.7% of those contacted and 73% of all MSs in Spain). Five main thematic areas were identified, each with different sub-areas: negative attitudes of teachers and academic leaders, type of organisation, structure and presence in the CS curriculum, negative attitudes of students, lack of trained teachers and problems linked to teaching methods and necessary educational logistics.
Conclusions: The barriers and problems identified indicate there are areas for improvement in the teaching CS in most Spanish MSs. There seem to be a vicious circle in the dynamic relationship and interdependence of all these problems, that should be faced with different strategies but, at the same time, requiring a significant cultural shift as well as decisive institutional support at the local and national level. This represents a major challenge that must be addressed in order for students to learn these skills more effectively and avoided negative attitudes toward learning CS.
Absorbable suture can be effectively and safely used to close the mesenteric defect in a Gastric bypass Sprague-Dawley Rat Model
Authors: Yao Libin , Dolo Ponnie Robertlee , Shao Yong , Li Chao , Widjaja Jason , Hong Jian , Zhu Xiaocheng 
Published: December 2019

Abstract
Background: To observe if closing the mesenteric defect with absorbable sutures creates a safe adhesion compared to non-absorbable suture after Roux-en-Y gastric bypass.
Methods: Rats were randomly assigned to 5 experimental groups according to the different suture materials used in closing the mesenteric defects (Peterson’s space) after Roux-en-Y gastric bypass. Group A (control group), Group B (non-absorbable suture, Prolene suture), Group C (biological glue), Group D (non-absorbable suture, polyester suture) and Group E (absorbable suture). All rats were followed up for 8 weeks postoperatively and underwent laparotomy to observe the degree of adhesion and closure of the mesenteric defect.
Results: No significant difference was found in the decrease in food intake and body weight among all groups. No internal hernia (IH) occurred in any group. The mesenteric defects of Group A remained completely visible without any closure or adhesion. Multiple gaps were found between the Prolene suture and the mesentery along the suture line in Group B. The mesenteric defects of Group C were complete closed with multiple adhesions of the small intestine and the greater omentum. The mesenteric defects in both Group D and Group E closed completely. The average adhesion scores in Group A and Group B were 0 and 0.33±0.52 respectively. The average adhesion score in group C (3.83±0.41) was higher than the other groups (p ＜ 0.05). The average adhesion scores in Group D and E were similar (3.17±0.41 and 3.00±0.00 respectively).
Conclusion: Absorbable suture created a safe adhesion score between the mesentery which was not inferior to non-absorbable sutures.
Near-infrared auto-fluorescence spectroscopy combining with Fisher’s linear discriminant analysis improves intraoperative real-time identification of normal parathyroid in thyroidectomy
Authors: Liu Junsong , Wang Xiaoxia , Wang Rui , Xu Chongwen , Zhao Ruimin , Li Honghui , Zhang Shaoqiang , Yao Xiaobao 
Published: December 2019

Abstract
Background To evaluate the efficacy of a sensitive, real-time tool for identification and protection of parathyroid glands during thyroidectomy.
Methods Near-infrared (NIR) auto-fluorescence was measured intraoperatively from 20 patients undergoing thyroidectomy. To determine the accuracy of NIR identification furtherly, intraoperative fast frozen pathological examination and postoperative immunohistochemical staining were performed on the suspicious parathyroid glands and other neck tissues. Data were extracted for Fisher’s linear discriminant analysis.
Results The auto-fluorescence intensity of parathyroid was significantly higher than that of thyroid, fat and lymph node. The peak intensity of auto-fluorescence from parathyroid was 5.55 times as much as that from thyroid at the corresponding wave number. Of the 20 patients, the parathyroid was accurately detected and identified in 19 patients by NIR system, compared with their histopathological results. One suspicious parathyroid tissue did not exhibit characteristic spectra, and finally was proved to be fat tissue by histopathological examination. The NIR auto-fluorescence method had a 100% (19/19) sensitivity of parathyroid glands identification and a high accuracy of 95% (19/20). The positive predictive value was 95%. The parathyroid gland has specific auto-fluorescence spectrum and can be separated from the other three types of tissues through the Fisher’s linear discriminant analysis with the average accuracy rate around 90%.
Conclusions NIR auto-fluorescence spectoscopy can accurately identify normal parathyroid glands during thyroidectomy. The Fisher’s linear discriminant analysis demonstrated the specificity of the NIR auto-fluorescence of parathyroid tissue and its efficacy in parathyroid discrimination.
Genome-wide identification of expansin gene family reveals expansin genes are involved in fibre cells growth in cotton
Authors: Lv Limin , Zuo Dongyun , Wang Xingfen , Cheng Hailiang , Zhang Youping , Wang Qiaolian , Song Guoli , Ma Zhiying 
Published: December 2019

Abstract
Background : Expansins ( EXPs ), a group of proteins that loosen plant cell walls and cellulosic materials, are involved in regulating cell growth and diverse developmental processes in plants. However, the biological functions of this gene family are still unknown in cotton.
Results: In this paper, we identified a total of 93 expansin genes in Gossypium hirsutum . These genes were classified into four subfamilies, including 67 GhEXPAs , 8 GhEXPBs , 6 GhEXLAs , and 12 GhEXLBs , and divided into 15 subgroups. All 93 expansin genes are distributed over 24 chromosomes excluding Ghir_A02 and Ghir_D06. All GhEXP genes contain multiple exons and each GhEXP protein has multiple conserved motifs. Transcript profiling and qPCR analysis revealed that the expansin genes have distinct expression patterns in different stages of cotton fibre development. Among them, 3 genes ( GhEXPA4o , GhEXPA1A , and GhEXPA8h ) were highly expressed in the initiation stage, 9 genes ( GhEXPA4a , GhEXPA13a , GhEXPA4f , GhEXPA4q , GhEXPA8f , GhEXPA2 , GhEXPA8g , GhEXPA8a , and GhEXPA4n ) had high expression during the fast elongation stage, while GhEXLA1c and GhEXLA1f were preferentially expressed in the transition stage of fibre development.
Conclusions: Our results provide a solid basis for further elucidation of biological functions of expansin genes in cotton fibre development and valuable genetic resources used for crop improvement in the future.
Lonely places or lonely people? Investigating the relationship between loneliness and place of residence
Authors: Victor Christina R , Pikhartova Jitka 
Published: December 2019

Abstract
Background: Loneliness in later life is largely presented as a problem of the individual focusing upon antecedents such as demographic or health factors. Research examining the role of the broader living environments is much rarer. We examined the relationship between loneliness and three dimensions of the lived environment: geographical region, deprivation, and area classification (urban or rural). Methods: Our sample consisted of 4,663 core members (44% males) aged 50+ (wave 7 mean age 72.8, S.D.= 7.1) present both in waves 3 (2006) and 7 (2014) of the English Longitudinal Study of Ageing (ELSA). Loneliness was measured using two approaches, individual and area-based, and both waves included these questions. Individual-based (self-reported) loneliness was assessed using the three item University of California Los Angeles (UCLA) scale (ranging from 3 =not lonely to 9= lonely with a score of 6+ defining loneliness. We also used a novel question which asked participants to evaluate how often they felt lonely in their area of residence (area-based; ranging from 1=often to 7=never, using cut off 4+ to define loneliness). The lived environment was classified in three different ways: the Index of Multiple Deprivation (IMD), Government Office Regions (GOR), and area classification (urban or rural). Covariates with established relationship with loneliness including demographic factors, social engagement and health, were included in the analyses. Results: In wave 7, the prevalence of individual-based loneliness was 18% and area-based was 25%. There was limited congruence between measures: 68% participants reported no individual- or area-based loneliness and 9% reported loneliness for both measures. After adjusting for individual co-variates only one significant relationship was observed between loneliness and area -based characteristics. A significant association was observed between area-based loneliness and deprivation score, with higher levels of loneliness in more deprived areas (OR=1.4 for highest quintile of deprivation). Conclusions: Our results indicate that loneliness in older adults is higher in the most deprived areas independent of individual-level factors. In order to develop appropriate interventions further research is required to investigate how area-level factors combine with individual-level loneliness vulnerability measures to generate increased levels of loneliness in deprived areas.
Formulation of Improved Traditional Drugs against virulent species of Salmonella spp in Benin: assessment of the properties from Uvaria chamae, Lantana camara and Phyllantus amarus in Benin, West Africa
Authors: LEGBA Boris , DOUGNON Victorien , GBAGUIDI Carène , ANIAMBOSSOU Alidah , DEGUENON Esther , DOUGNON Jacques , BABA-MOUSSA Lamine 
Published: December 2019

Abstract
Background Uvaria chamae (Annonaceae), Phyllantus amarus (Phyllantaceae) and Lantana camara (Verbenaceae) are empirically alleged to be used as Beninese medicinal plants in the treatment of salmonellosis. This study aimed to produce scientific data on in vitro and in vivo efficacy of Uvaria chamae, Lantana camara and Phyllantus amarus on multiresistant Salmonella spp isolated in Benin.Results After in vitro tests on aqueous and ethanolic extracts of Uvaria chamae, Lantana camara and Phyllantus amarus , only the aqueous extract of Uvaria chamae (leaves) showed the best anti- Salmonella ’s activity. It has been used for the following experiments. The induction of salmonellosis revealed 9.0 10 8 CFU/ml was optimal concentration for triggering and maintaining the symptoms in chicks. This infective concentration has been used for in vivo assessment. 24 hours post inoculation later, the symptoms of salmonellosis (wet cloaca, diarrhea stool and somnolence) were observed in infected groups. After seven days of treatment, the rate of reduction of bacterial load at 100 mg / L, 200 mg / L, 400 mg / L of this extract was 85%, 52.38% and 98% respectively in the chicks groups infected with Salmonella Typhimurium ATCC 14028. About the groups infected with Salmonella spp (virulent strain), the rate of reduction of bacterial load at 100 mg / L, 200 mg / L, 400 mg / L of this extract was 0%, 98.66% and 99.33%. The toxicity tests did not show any significant effect of the Uvaria chamae ’s extract on the biochemical and hematological parameters of the chicks.Conclusion The aqueous extract of Uvaria chamae is active in vitro and in vivo on multiresistant strains of Salmonella spp . This plant is a good candidate for the development of an improved traditional medicine for the management of salmonellosis.
Evaluation of oral care protocols practice by dentists in Rio de Janeiro towards HIV/AIDS individuals
Authors: Silva-Boghossian Carina Maciel , Boscardini Brenda Azzariti Berrondo , Pereira Claudia Maria , Moreira Edson Jorge Lima 
Published: December 2019

Abstract
Background The aim of this study was to evaluate the dentists’ knowledge and practice regarding HIV positive individuals’ oral care in Rio de Janeiro State. Methods Dentists from Rio de Janeiro State (n = 242) answered an electronic questionnaire on biosafety procedures, oral manifestations of AIDS, and knowledge of HIV infection. Collected information was stratified by gender, and data were analyzed using Chi-square and t tests. Results From the 14 oral manifestations investigated, oral candidiasis, necrotizing ulcerative gingivitis, and hairy leucoplakia were more associated with HIV, with no differences between the responses from men and women. Above 85% of the participants would be concerned about becoming infected with HIV after a needle/ sharp object injury and more than 80% of them were willing to be tested for HIV. However, significantly more women (98.8%), compared to men (91.3%), said they knew that HIV/ AIDS patients can contaminate dental care professionals, p = 0.007. There was a significant difference in the answers for the questions: “Are there special dental clinics for treatment of HIV/AIDS patients in Brazil?” (p = 0.044), and “Do the negative HIV tests surely indicate that the persons are free of viruses?” (p = 0.005). Significant differences between men and women were also observed regarding use of disposable mask (p = 0.01), and cap (p < 0.0001). Conclusion Most dentists who participated in the study presented a good knowledge on the care of HIV/ AIDS individuals, including biosafety protocols and in terms of the oral manifestations commonly associated to AIDS.