bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Systematic Review of the Evidence for Deprescribing Interventions Among Older People Living With Frailty
Authors: Ibrahim Kinda , Cox Natalie , Stevenson Jennifer M , Lim Stephen , Fraser Simon , Roberts Helen C 
Published: November 2020

Abstract
Background: Older people living with frailty are often exposed to polypharmacy and potential harm from medications. Targeted deprescribing in this population represents an important component of optimizing medication. This systematic review aims to summarise the current evidence for deprescribing among older people living with frailty.Methods: The literature was searched using Medline, Embase, CINAHL, PsycInfo, Web of Science, and the Cochrane library up to May 2020. Studies with any design or setting were included if they reported deprescribing interventions among people aged 65+ who live with frailty identified using reliable measures. The primary outcome was safety of deprescribing; whereas secondary outcomes included clinical outcomes, medication-related outcomes, feasibility, acceptability and cost-related outcomes. Narrative synthesis was used to summarise findings and study quality was assessed using Joanna Briggs Institute checklists.Results: 2322 articles were identified and six (two randomised controlled trials) were included with 53 participants in total (mean age range 79–87 years). Studies were heterogenous in their designs, settings and outcomes. Deprescribing interventions were pharmacist-led (n=3) or multidisciplinary team-led (n=3). Frailty was identified using several measures and deprescribing was implemented using either explicit or implicit tools or both. Three studies reported safety outcomes and showed no significant changes in adverse events, hospitalisation or mortality rates. Three studies reported positive impact on clinical outcomes including depression, mental health status, function and frailty; with mixed findings on falls and cognition; and no significant impact on quality of life. All studies described medication-related outcomes and reported a reduction in potentially inappropriate medications and total number of medications per-patient. Feasibility of deprescribing was reported in four studies which showed that 72-91% of recommendations made were implemented. Two studies evaluated and reported the acceptability of their interventions and further two described cost saving. Conclusion: There is a paucity of research about the impact of deprescribing in older people living with frailty. However, included studies suggest that deprescribing could safe, feasible, well tolerated and can lead to important benefits. Research should now focus on understanding the impact of deprescribing on frailty status in high risk populations. Trial registration: the review was registered on the international prospective register of systematic reviews (PROSPERO) ID number: CRD42019153367.
External axial Stress Induces&nbsp;Rabbit Tibia Fracture Healing via&nbsp;Stimulating&nbsp;the Expression of VEGF, CD34, BMP-2 and TGF-β1
Authors: Huang Lianshui , Zhang Xiaoshan , Huang Zemao , Wang Lei , Xie Wei , Ding Zhenqi , Cheng Weike 
Published: November 2020

Abstract
BackgroundIt is well acknowledged that stress stimulation can promote the healing rate of fracture. However, there were few literature that described the relationship between stress stimulation at the fracture site and the molecular mechanism in fracture healing process. The aim of this study was to investigate whether external axial stress, provided by the stimulator, postoperatively, can accelerate the union of rabbit tibial fracture, and to reveal the possible mechanism.MethodsSeventy-two New Zealand rabbit tibial fracture models were established and randomly divided into two groups. Rabbits in experiment group (n=36) were subjected to external axial stress stimulation for 30 minutes every two days from the eighth day postoperative, but rabbits in control group received no stress stimulation. All rabbits were treated with external plaster for limb immobilization after operation. Lane-Sandhu X-ray evaluation system was used to evaluate the bone healing process at 2, 4, 6 and 8 weeks postoperative. Specimens were harvested for immunohistochemical test and semi quantitative analysis. They were applied to evaluate the expression of vascular endothelial growth factor (VEGF), CD34, bone morphogenetic protein-2 (BMP-2) and transforming growth factor-β1 (TGF-β1) at postoperative2,4,6and8weeks,respectively.ResultsThe mean Lane-Sandhu X-ray score of experiment group was significantly higher than control group at 4, 6 and 8 weeks (P<0.05, P<0.01 and P<0.01，respectively). More callus and better calcification were observed in the experiment group. The expression of VEGF (P<0.01, P<0.05, P<0.01, P<0.01, respectively) and BMP-2 (P<0.05, P<0.05, P<0.01, P<0.01, respectively) at each phase in the experiment group was significantly higher than the control group. The expression of CD34 (P<0.01 and P<0.01, respectively) and TGF-β1(P<0.01, P<0.01, respectively) in experimental group was higher than control group at2and4weeks.ConclusionsPostoperative external axial stress stimulation can facilitate the expression of VEGF, CD34, BMP-2 and TGF-β1, and stimulate the vascularization and ossification of the fracture site, therefore,acceleratethefractureunion.
Association Between Cystatin C, Cystatin C Rangeability and Mortality of COVID-19 Patients With or Without Type 2 Diabetes Mellitus: An Opportunistic Retrospective Analysis
Authors: Yang Lei , Xu Dou , Tan Yiqing , Li Bolin , Zhu Dan , Wang Jingbo , Sun Hui , Liu Xinglong , Zheng Xiao-Pu , Zhu Ling , Li Zhongyu 
Published: November 2020

Abstract
Background: Since December of 2019, novel coronavirus (SARS-CoV-2)-induced pneumonia (COVID-19) exploded in Wuhan, and rapidly spread throughout China. Patients with COVID-19 demonstrated quite different appearances and outcomes in clinical manifestations. We aimed to figure out whether risk factors of the cystatin C (CysC) and the CysC rangeability are influencing the prognosis of COVID-19 patients with or without type 2 diabetes mellitus (T2DM).Methods: 675 T2DM patients and 602 non-T2DM patients were divided into low CysC group, high CysC group and low CysC rangeability group, high CysC rangeability group according to the serum CysC level and the change range of CysC. Demographic characteristics, clinical data and laboratory results of the four groups were collected and analyzed.Results: Our data showed that COVID-19 patients with high CysC level and CysC rangeability had more organic damage and higher mortality rate compared to those with low level or low rangeability of CysC. Furthermore, patients with higher CysC level and CysC rangeability also demonstrated higher blood lymphocytes (lymph), C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST) which may greatly influence disease progression and poor prognosis of COVID-19. After adjusting for possible confounders, multivariate analysis revealed that CysC≤0.93mg/dl as a reference, CysC＞0.93mg/dl were significantly associated with the risk of heart failure (OR=2.401, 95% CI: 1.118–5.156) and all-cause death (OR=2.734, 95% CI: 1.098-6.811); referring to CysC rangeability≤0, CysC rangeability＞0 significantly associated with all-cause death (OR=4.029, 95% CI: 1.864-8.706). Further grouped by T2DM, these associations were stronger in T2DM than in non-T2DM.Conclusions: It suggests that CysC level and CysC rangeability contribute to clinical manifestations and may influence the prognosis of COVID-19. The CysC is considered as a potential risk factor of the prognosis of COVID-19. Special medical care and appropriate intervention should be performed in COVID-19 patients with elevated CysC during hospitalization and later clinical follow-up, especially for those with T2DM.
Synthesis and release behavior of layered double hydroxides – carbamazepine composites
Authors: Peralta Maria , Mendieta Silvia , Scolari Ivana , Granero Gladys , Crivello Monica 
Published: November 2020

Abstract
Carbamazepine (CBZ) was incorporated into Layered Double Hydroxides (LDH) to be used as controlled drug delivery in solid tumors. CBZ has a formal charge of 0, which implies a challenge to be incorporated in the anionic clay. Aiming to overcome this problem, CBZ was first incorporated in micelles of sodium cholate (SC), a surfactant with negative charge. CBZ in SC micelles and, for comparison, free CBZ were incorporated in LDH by reconstruction method. It was found that resultant nano-composites had similar CBZ encapsulation efficiency, around 75 %, but drug release in simulated body fluid (pH 7.4) and acetate buffer (pH 4.8) was efficient only with the LDH-CBZ sample. CBZ dimensions were measured with Chem3D and, according to the basal spacing obtained from X rays patterns, it can arrange as monolayer with the long axis parallel to the LDH layers. Fourier Transform Infrared Spectroscopy confirmed the incorporation of the drug. Thermogravimetric analyses showed and enhanced thermal stability for CBZ. These results have interesting implications since they increase the spectrum of LDH application as controlled drug delivery to a large number of non-ionic drugs, without the addition of other components.
Knee Extensor and Flexor Strength are Related to One-Leg Hop Distances in Three Directions in Patients Six Months After Anterior Cruciate Ligament Reconstruction
Authors: Aizawa Junya , Hirohata Kenji , Ohji Shunsuke , Ohmi Takehiro , Mitomo Sho , Koga Hideyuki , Yagishita Kazuyoshi 
Published: November 2020

Abstract
Background: When planning rehabilitation and conditioning for performance enhancement and a return to sports after anterior cruciate ligament reconstruction, identifying the elements of physical function associated with one-leg hop is important. The purpose of this study was to clarify the relationship between one-leg hop distances in 3 directions and knee extensor and flexor strengths at 6 months after reconstruction.Methods: Participants were 47 patients taking part in training sessions for sports involving cutting, pivoting, and jump-landing 6 months after reconstruction using a hamstring tendon. Demographics, activity scale score, days before and after reconstruction, and meniscus surgery procedure were analyzed. One-leg hop distances in 3 directions (anterior, lateral, and medial) and isokinetic strengths of knee extension and flexion were measured. Simple regression analyses using Spearman's rank correlation coefficient were performed to assess relationships between one-leg hop distances and knee strengths.Results: In the involved limb, correlations between one-leg hop distance in 3 directions and knee strengths were significant and effect sizes ranged from medium to large. Correlation coefficients between all one-leg hop parameters and knee extension/flexion strengths at an angular velocity of 180°/s were greater than those of 60°/s.Conclusions: Knee strength showed moderate to high associations with lateral and medial one-leg hop distances in addition to anterior one-leg hop distance. The results of this study will be useful in planning and teaching conditioning to improve multi-directional one-legged hop skills and improve knee strength for a full-scale return to sports after reconstruction.
Expression Profiling and Functional Analysis of Circular RNAs in Inner Mongolian Cashmere Goats Hair Follicles
Authors: Shang Fangzheng , Wang Yu , Ma Rong , Di Zhengyang , Wu Zhihong , Hai Erhan , Rong Youjun , Pan Jianfeng , Liang Lili , Wang Zhiying , Wang Ruijun , Su Rui , Liu Zhihong , Zhao Yanhong , Wang Zhixin , Li Jinquan , Zhang Yanjun 
Published: November 2020

Abstract
Background:Inner Mongolian cashmere goats have hair of excellent quality and high economic value, and the skin hair follicle traits of cashmere goats have a direct and important effect on cashmere yield and quality.Circular RNA has been studied in a variety of tissues and cells. Result:In this study, high-throughput sequencing was used to obtain the expression profiles of circRNA in the hair follicles of Inner Mongolia cashmere goats at different embryonic stages (45, 55 , 65 and 75 days). A total of 21784 circRNAs were identified. At the same time, the differentially expression circRNA in the six control groups formed in the four stages were: d75vsd45, circRNA up-regulated by 59 and down-regulated by 33; d75vsd55, circRNA up-regulated by 61 and down-regulated by 102; d75vsd65, circRNA up-regulated by 32 and down-regulated by 33; d65vsd55, circRNA up-regulated by 67 and down-regulated by 169; d65vsd45, circRNA up-regulated by 96 and down-regulated by 63; and d55vsd45, circRNA up-regulated by 76 and down-regulated by 42. Six DE circRNA were randomly selected to verify the reliability of the sequencing results by qRT-PCR. Subsequently,the circRNA corresponding host genes were analyzed by GO and the KEGG pathaway. The results showed that the biological processes related to hair follicle growth and development enriched by GO mainly included hair follicle morphogenesis, hair follicle maturation and cell development, and the signal pathways related to hair follicle development included the Notch signaling pathway and NF-kappa B signaling pathway.We combined the DE circRNA of d75vsd45 with miRNA and mRNA databases(unpublished) to construct the co-expression network of circRNA-miRNA-mRNA, and formed a total of 102 pairs of circRNA-miRNA and 126 pairs of miRNA-mRNA interactions. The binding relationship of circRNA3236-chi-miR-27b-3p and circRNA3236-chi-miR-16b-3p was further verified by dual-luciferase reporter assays,and the results showed that circRNA3236 and chi-miR-27b-3p,circRNA3236 and chi-miR-16b-3p have a targeted binding relationship.Conclusion:To summarize, we established the expression profile of circRNA in the fetal skin hair follicles of cashmere goats, and found that the host gene of circRNA may be involved in the development of hair follicles of cashmere goats. The co-expression network of circRNA-miRNA-mRNA that DE circRNA was constructed and preliminary verification was carried out.
The antifungal mechanism of the biogenic antimicrobial Ningnanmycin on Didymella segeticola involves binding to tryptophanyl-tRNA synthetase, inhibiting translation
Authors: Dongxue Li , Yin Qiaoxiu , Wang Xue , Jiang Shilong , Dharmasena Dissanayake Saman Pradeep , Wu Xian , Wang Delu , Chen Zhuo 
Published: November 2020

Abstract
BackgroundTea [Camellia sinensis (L.) Kuntze] has been recently cultivated in Guizhou Province, China, where the cultivated area has reached 350,000 hectares, making it the major tea-growing region in world. Tea leaf spot caused by Didymella segeticola can induce the decreases in quality and quantity of tea leaves, which is an important disease in tea plantations at higher altitude, where cold spells occur in late spring. As a promising biogenic antimicrobial agent against crop diseases, Ningnanmycin (NNM) was produced from Streptomyces noursei var. xichangensisn, represented higher field efficiency against fungal, bacterial and viral phytopathogens, lower toxicity and lower residue. However, the action mechanism of NNM against phytopathogens just stays on the stage of anti-viral mechanism, which limits the application of NNM in the management of plant fungal diseases. Here, we studied the action mechanism of NNM against D. segeticola using many methods of transcriptome, ultrastructure, molecular biology and molecular docking.ResultsNNM strongly inhibited the mycelial growth of D. segeticola with the half-maximal effective concentration of 1287.54 U/mL. Optical, fluorescence, scanning and transmission electron microscopy were applied to observe morphological changes of cellular, organelle for D. segeticola treated by NNM. A great number of morphological changes of D. segeticola indicated that NNM could affect the biosynthesis of the phytopathogen. For further, RNA-Seq results showed that NNM treated D. segeticola induced 1,363 significantly differentially expressed genes (DEGs) comparing with the control (P < 0.05). The DEGs were highly enriched in structural component of ribosome, ribosome and translation by Gene Ontology, as well as in ribosome pathway at Kyoto Encyclopedia of Genes and Genomes. NNM regulated the mRNA levels of RPS7, RPS9, RPS10b, RPL9, RPL11 and TrpRS, and represent the different regulation mode by the comparative analysis with a classical translation extension inhibitor, cycloheximide. The molecular docking indicated that NNM possessed a marked affinity with TrpRS, with the binding free energy is -101.55 kcal/mol.ConclusionsNNM could potentially affect translation by binding to tryptophanyl-tRNA synthetase, thus inhibiting mycelial growth. This study will provide insights for anti-fungal mechanism of NNM and contribute to the control and prevention of tea leaf spot disease.
Building Capacity for Implementation – The KT Challenge
Authors: Black Agnes , Steinberg Marla , Chisholm Amanda , Coldwell Kristi , Hoens Alison , Koh Jiak Chin , LeBlanc Allana , Mackay Martha , Salmon Amy , Snow M Elizabeth 
Published: November 2020

Abstract
Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity and practice change. MethodsThe evaluation used a mixed-methods, time-series design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, six months into implementation, and at the end of the two-year funded projects) to measure KT capacity ( knowledge, skills and confidence), and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analysed using non-parametric statistics. ResultsParticipants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. ConclusionsThe KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the KT Challenge program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.
A Case of Lipomyelomeningocele causing Equinovarus is Reported
Authors: Zhang Guanghui , han hui , Hou Chengcai 
Published: November 2020

Abstract
Background Lipomyelomeningocele ( LMM) is a congenital factor that causes clubfoot. This disease often develops into adulthood and often has rigid deformities. This is the most difficult orthopedic and functional reconstruction surgery.Case presentation We reporta case of stiff clubfoot caused by Lipomyelomeningocele（LMM）. Through osteotomy correction and Soft tissue loosening, clubfoot deformity was corrected and good results were achieved.Conclusion The use of osteotomy correction technology combined with Soft tissue loosening to treat adult stiff clubfoot can correct the deformity and restore the shape of the foot and ankle. The effect is definite and it is worthy of popularization and application.
Carotid Intima-Media Thickness Correlation with Metabolic Syndrome Parameters in Military Pilots
Authors: Rad Masud Pezeshki , Shahali Hamzeh , Momenzadeh Mahmud , Yarmohammadi Bita 
Published: November 2020

Abstract
Introduction: Metabolic syndrome is one of the important risk factors in increasing the risk of cardiovascular disease. Recent studies have shown that increasing the thickness of the intima-medial layer of the carotid artery can be a risk factor associated with metabolic syndrome. Methods: This was a cross-sectional analytical study. All individuals underwent ultrasound of the carotid arteries. In the presence of stenosis, the stenosis caused by the plaque by North American symptomatic carotid endarterectomy trial (NASCET) was considered as a decrease in the diameter of the lumen compared to the diameter of the normal lumbar distal lobe and was expressed as a percentage. Statistical analysis of chi-square tests, independent t-test, ANOVA, and regression analysis were performed. Results: This study was performed on 112 male pilots (average age of 41.3 years, average flight time 2435 hours). There was no statistically significant relationship between the mean thickness of intima media carotid and metabolic syndrome (no versus with metabolic syndrome: 0.62 versus 0.64 mm p = 0.355). The average thickness of the intima media carotid was significantly statistically different between the three groups of flight types (transport aircraft: 01.61 against fighter: 0.70 and helicopter: 0.59 mm p = 0.004). There is also a significant correlation between flight time and carotid thickness (p = 0.001, r = 0.380). In addition, there was a significant correlation between the age of the pilots and the thickness of the carotid artery (p = 0.001, r = 0.033) as well as the age of the pilots and the flight time (p = 0.001, r = 0.713). Conclusion: Based on the results, there was no significant relationship between carotid thickness and metabolic syndrome and metabolic syndrome components in the studied pilots.