bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary Care and Mental Health Prescribers, Key Clinical Leaders, and Clinical Pharmacist Specialists’ Perspectives on Opioids and Benzodiazepines
Authors: Hawkins Eric J , Lott Aline M , Danner Anissa N , Malte Carol A , Hagedorn Hildi J , Berger Douglas , Donovan Lucas M , Sayre George G , Mariano Anthony J , Saxon Andrew J 
Published: November 2020

Abstract

Objective
Due to increased risks of overdose fatalities and injuries associated with coprescription of opioids and benzodiazepines, healthcare systems have prioritized deprescribing this combination. Although prior work has examined providers’ perspectives on deprescribing each medication separately, perspectives on deprescribing patients with combined use is unclear. We examined providers’ perspectives on coprescribed opioids and benzodiazepines and identified barriers and facilitators to deprescribing.

Design
Qualitative study using semistructured interviews.

Setting
One multisite Veterans Affairs (VA) healthcare system in the United States of America.

Subjects
Primary care and mental health prescribers, key clinical leaders, clinical pharmacist specialists (N = 39).

Methods
Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. Themes were identified iteratively, through a multidisciplinary team-based process.

Results
Analyses identified four themes related to barriers and facilitators to deprescribing: inertia, prescriber self-efficacy, feasibility of deprescribing/tapering, and promoting deprescribing, as well as a fifth theme, consequences of deprescribing. Results highlighted the complexity of deprescribing when multiple prescribers are involved, a need for additional support and time, and concerns about patients’ reluctance to discontinue these medications. Facilitators included agreement with the goal of deprescribing and fear of negative consequences if medications are continued. Providers spoke to how deprescribing efforts impaired patient-provider relationships and informed their decisions not to start patients on these medications.

Conclusions
Although providers agree with the goal, prescribers’ belief in a limited deprescribing role, challenges with coordination among prescribers, concerns about insufficient time and patients’ resistance to discontinuing these medications need to be addressed for efforts to be successful.
Groundwork for a Fallibilist Account of Mathematics
Authors: De Toffoli Silvia 
Published: November 2020

Abstract
According to the received view, genuine mathematical justification derives from proofs. In this article, I challenge this view. First, I sketch a notion of proof that cannot be reduced to deduction from the axioms but rather is tailored to human agents. Secondly, I identify a tension between the received view and mathematical practice. In some cases, cognitively diligent, well-functioning mathematicians go wrong. In these cases, it is plausible to think that proof sets the bar for justification too high. I then propose a fallibilist account of mathematical justification. I show that the main function of mathematical justification is to guarantee that the mathematical community can correct the errors that inevitably arise from our fallible practices.
Consequences of prefrontal tDCS on inhibitory control and reactive aggression
Authors: Weidler Carmen , Habel Ute , Wallheinke Paul , Wagels Lisa , Hofhansel Lena , Ling Shichun , Blendy Julie A , Clemens Benjamin 
Published: November 2020

Abstract
Increased aggression and impulsivity represent a key component of several psychiatric disorders, including substance use disorder, which is often associated with deficient prefrontal brain activation. Thus, innovative tools to increase cognitive control are highly warranted. The current study investigates the potential of transcranial direct current stimulation (tDCS), a tool to modulate cortical activation and to increase cognitive control in individuals with a high potential for impulsive and aggressive behavior. In a double-blind, sham-controlled study, we applied anodal tDCS over the right dorsolateral prefrontal cortex in an all-male sample of alcohol-dependent patients (AD), tobacco users (TU) and healthy controls (HC), who completed the Taylor Aggression Paradigm and Stop Signal Reaction Time Task twice. While there were no observable effects of tDCS in controls, the results revealed altered aggressive behavior in AD following active stimulation. Specifically, these individuals did not show the standard increase in aggression over time seen in the other groups. Furthermore, improved response inhibition was found in AD and TU following active but not sham stimulation. Our study demonstrates that prefrontal tDCS improves our laboratory measure of impulse control in at-risk groups, illustrating the importance of sample characteristics such as nicotine intake and personality traits for understanding the effects of brain stimulation.
Cattle and carcass performance, and life cycle assessment of production systems utilizing additive combinations of growth promotant technologies
Authors: Webb Megan J , Block Janna J , Harty Adele A , Salverson Robin R , Daly Russell F , Jaeger John R , Underwood Keith R , Funston Rick N , Pendell Dustin P , Rotz Clarence A , Olson Kenneth C , Blair Amanda D 
Published: November 2020

Abstract
The objective of this study was to determine the impact of beef production systems utilizing additive combinations of growth promotant technologies on animal and carcass performance and environmental outcomes. Crossbred steer calves (n =120) were stratified by birth date, birth weight, and dam age and assigned randomly to one of four treatments: 1) no technology (NT; control), 2) antibiotic treated (ANT; NT plus therapeutic antibiotics and monensin and tylosin), 3) implant treated (IMP; ANT plus a series of 3 implants, and 4) beta-agonist treated (BA; IMP plus ractopamine-HCl for the last 30 d prior to harvest). Weaned steers were fed in confinement (dry lot) and finished in an individual feeding system to collect performance data. At harvest, standard carcass measures were collected and the United States Department of Agriculture (USDA) Yield Grade and Quality Grade were determined. Information from the cow-calf, growing, and finishing phases were used to simulate production systems using the USDA Integrated Farm System Model, which included a partial life cycle assessment of cattle production for greenhouse gas (GHG) emissions, fossil energy use, water use, and reactive N loss. Body weight in suckling, growing, and finishing phases as well as hot carcass weight was greater (P &lt; 0.05) for steers that received implants (IMP and BA) than non-implanted steers (NT and ANT). The average daily gain was greater (P &lt; 0.05) for steers that received implants (IMP and BA) than non-implanted steers during the suckling and finishing phases, but no difference (P = 0.232) was detected during the growing phase. Dry matter intake and gain:feed were greater (P &lt; 0.05) for steers that received implants than non-implanted steers during the finishing phase. Steers that received implants responded (P &lt; 0.05) with a larger loin muscle area, less kidney pelvic and heart fat, advanced carcass maturity, reduced marbling scores, and a greater percentage of carcasses in the lower third of the USDA Choice grade. This was offset by a lower percentage of USDA Prime grading carcasses compared with steers receiving no implants. Treatments did not influence (P &gt; 0.05) USDA Yield grade. The life cycle assessment revealed that IMP and BA treatments reduced GHG emissions, energy use, water use, and reactive nitrogen loss compared to NT and ANT. These data indicate that growth promoting technologies increase carcass yield while concomitantly reducing carcass quality and environmental impacts.
Back in the saddle: student response to remote online equine science classes
Authors: Merson Courtney , Navas Gonzalez Francisco Javier , Orth Emma , Adams Anneli , McLean Amy 
Published: November 2020

Abstract
The COVID-19 pandemic has challenged professors and students of all disciplines to adjust quickly to remote online teaching and education platforms. In this new era of remote teaching, a greater challenge has been presented in the field of equine science; how to effectively share knowledge that is most often demonstrated by providing students access to live, in-person animal examples. Historically, students and teachers believed skill sets, which are vital for future careers in the industry (e.g., veterinarian) must be learned through hands-on experience. However, in-person methods were not available, so students were taught through the Zoom platform. Students enrolled in various levels of equine science classes were invited to complete a short voluntary questionnaire measuring their response and perception to equine courses taught in an entirely online remote setting by the same professor. One group was comprised of undergraduates majoring in the field (n = 44) in upper level equine science courses, Advanced Equine Reproduction Physiology and/or Equine Enterprise. These students, 41 females and 3 males, ranged in age from 20 to 25 yr, were provided a voluntary questionnaire seeking responses related to the perceived effectiveness and individual preferences of in-class lectures and in-person labs vs. remote online teaching practices. A similar questionnaire was offered on a volunteer basis to precollege students (n = 17). These students, female, high-school students from freshman to senior status (14–18 yr of age), were interested in equine science as a major at UC Davis in the future. This questionnaire evaluated their response to a 2-week remote synchronous online equine science course, which included multiple teaching methods, including lectures, mini labs, and full labs. Responses from both populations suggested that equine courses were perceived as effective when offered as online, remote courses. Live (synchronous) classes and labs offered on Zoom increased engagement and interaction, but students also appreciated the opportunity to access recorded materials. Students responded positively to online remote teaching and found courses to be effective for increasing their knowledge about equine science in an engaging manner, despite their continued preference for in-person instruction.
The first laboratory-confirmed imported infections of SARS-CoV-2 in Sudan
Authors: Aljak Elham R , Eldigail Mawahib , Mahmoud Iman , Elhassan Rehab M , Elduma Adel , Ibrahim Abubakr A , Ali Yousif , Weaver Scott C , Ahmed Ayman 
Published: November 2020

Abstract

Background
The rapidly growing pandemic of coronavirus disease 2019 (COVID-19) has challenged health systems globally. Here we report the first identified infections of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; aetiology of COVID-19) among recent international arrivals to Sudan and their contacts.

Methods
Suspected cases were identified clinically and/or epidemiologically. Samples from suspected cases and their contacts were tested in the National Influenza Centre following World Health Organization protocols. Two real-time reverse transcription quantitative polymerase chain reaction assays were used to detect and confirm SARS-CoV-2 infection.

Results
Seven cases of COVID-19, including two deaths, were confirmed in Sudan between 27 February and 30 March 2020. Suspected cases were identified and tested. As of 30 March, no local transmission was yet reported in the country. Fifty-nine percent of the suspected cases were international travellers coming from areas with current COVID-19 epidemics. Cough and fever were the major symptoms, presented by 65% and 60% of the suspected cases, respectively. By early April, an additional seven cases were confirmed through limited contact tracing that identified the first locally acquired infections in recent contact with imported cases.

Conclusions
The high mortality rate of COVID-19 cases in Sudan might be due to limitations in test and trace and case management services. Unfortunately, infections have spread further into other states and the country has no capacity for mass community screening to better estimate disease prevalence. Therefore external support is urgently needed to improve the healthcare and surveillance systems.
RibBX of Bradyrhizobium ORS285 Plays an Important Role in Intracellular Persistence in Various Aeschynomene Host Plants
Authors: Nouwen Nico , Arrighi Jean-Francois , Gully Djamel , Giraud Eric 
Published: November 2020

Bradyrhizobium ORS285 forms a nitrogen-fixating symbiosis with both Nod factor (NF)-dependent and NF-independent Aeschynomene spp. The Bradyrhizobium ORS285 ribBA gene encodes for a putative bifunctional enzyme with 3,4-dihydroxybutanone phosphate (3,4-DHBP) synthase and guanosine triphosphate (GTP) cyclohydrolase II activities, catalyzing the initial steps in the riboflavin biosynthesis pathway. In this study, we show that inactivating the ribBA gene does not cause riboflavin auxotrophy under free-living conditions and that, as shown for RibBAs from other bacteria, the GTP cyclohydrolase II domain has no enzymatic activity. For this reason, we have renamed the annotated ribBA as ribBX. Because we were unable to identify other ribBA or ribA and ribB homologs in the genome of Bradyrhizobium ORS285, we hypothesize that the ORS285 strain can use unconventional enzymes or an alternative pathway for the initial steps of riboflavin biosynthesis. Inactivating ribBX has a drastic impact on the interaction of Bradyrhizobium ORS285 with many of the tested Aeschynomene spp. In these Aeschynomene spp., the ORS285 ribBX mutant is able to infect the plant host cells but the intracellular infection is not maintained and the nodules senesce early. This phenotype can be complemented by reintroduction of the 3,4-DHBP synthase domain alone. Our results indicate that, in Bradyrhizobium ORS285, the RibBX protein is not essential for riboflavin biosynthesis under free-living conditions and we hypothesize that its activity is needed to sustain riboflavin biosynthesis under certain symbiotic conditions. [Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Symptomatic hyponatremia induced by low-dose cyclophosphamide in patient with systemic lupus erythematosus
Authors: Chen Jiali , Jin Yuebo , Li Chun , Li Zhanguo 
Published: November 2020

Abstract

Rationale:
Cyclophosphamide (CY) is an alkylating agent used widely to treat cancer and autoimmune diseases. Hyponatremia is a common adverse effect of high-dose and moderate-dose of intravenous CY, but is rare in patients treated with low-dose (<15 mg/kg).

Patient concerns:
A 52-year-old woman with new-onset systemic lupus erythematosus (SLE) was treated with low-dose cyclophosphamide (8 mg/kg, CY), but showed sudden headaches, disorientation and weakness. Laboratory examinations revealed severe isovolumic hyponatremia along with low-serum osmolality and high urine osmolality.

Diagnosis:
The acute hyponatremia was consistent with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and was an adverse event of low-dose CY, with no evidence of endocrine, cancer, pulmonary, or cerebral abnormalities relevant to the SIADH.

Intervention:
The hyponatremia was resolved after the supplementation of NaCl solution.

Outcomes:
The hyponatremia was resolved without any complications.

Lessons:
Hyponatremia induced by low-dose CY should be recognized as an underlying life-threatening complication in clinical practice.
Defining prognosis in sarcoidosis
Authors: Lopes Mariana Carneiro , Amadeu Thaís Porto , Ribeiro-Alves Marcelo , Costa Claudia Henrique da , Silva Bruno Rangel Antunes , Rodrigues Luciana Silva , Bessa Elisabeth Jauhar Cardoso , Bruno Leonardo Palermo , Lopes Agnaldo José , Rufino Rogerio 
Published: November 2020

Abstract
Sarcoidosis is a multi-systemic granulomatous disease. Affected individuals can show spontaneous healing, develop remission with drug treatment within 2 years, or become chronically ill. Our main goal was to identify features that are related to prognosis.
The study consisted of 101 patients, recruited at a single center, who were already diagnosed with sarcoidosis at the start of the study or were diagnosed within 48 months. Ninety individuals were followed-up for at least 24 months and were classified according to clinical outcome status (COS 1 to 9). Those with COS 1–4 and COS 5–9 were classified as having favorable and unfavorable outcomes, respectively. Unconditional logistic regression analyses were conducted to define which variables were associated with sarcoidosis outcomes. Subsequently, we established a scoring system to help predict the likelihood of a favorable or unfavorable outcome.
Of our patients, 48% developed a chronic form of the disease (COS 5–9). Three clinical features were predictive of prognosis in sarcoidosis. We built a score-based model where the absence of rheumatological markers (1 point), normal pulmonary functions (2 points), and the presence of early respiratory symptoms manifestations (2 points) were associated with a favorable prognosis. We predicted that a patient with a score of 5 had an 86% (95% confidence interval [CI] 74%–98%) probability of having a favorable prognosis, while those with scores of 4, 3, 2, 1, and 0 had probabilities of 72% (95% CI 59–85%), 52% (95% CI 40–63%), 31% (95% CI 17–44%), 15% (95% CI 2–28%), and 7% (95% CI 0–16%) of having a favorable prognosis, respectively. Thus, our easy-to-compute algorithm can help to predict prognosis of sarcoidosis patients, facilitating their management.
Psychological nursing intervention on anxiety and depression in patients with urinary incontinence after radical prostatectomy
Authors: Yang Liying , Ling Danjuan , Ye Lanfen , Zeng Manping 
Published: November 2020

Abstract

Background:
Prostate cancer (PC) is one of the most familiar disease of the male reproductive system globally. In treating the clinically localized PC, the radical prostatectomy is regarded as a gold standard, but it is associated with syndromes as urinary incontinence (UI), which can have a significant impact on patients’ quality of life. Nurse takes responsibility in the management of the UI for their convenience compared with doctors to contact with patients and build better trust relationships with survivals. However, most of the studies focus on the physiological level, the psychological nursing intervention research is less. The purpose of the trial is to introduce a psychological intervention program and to study its effects on anxiety and depression after prostatectomy in IU patients.

Methods:
This is a single-center randomized controlled trial that was authorized by Ethics Committee of the First People's Hospital of Chenzhou City (2020054). One hundred participants who undergo radical prostatectomy are analyzed. Inclusion criteria are the following: PC is diagnosed based on histological results; Participants in the study voluntarily sign the informed consent table; Severe UI after extubation; Patients with postoperative UI do not receive any drug treatment. Exclusion criteria are the followings: patients with the history of prostate operation; patients with the history of severe renal and liver malignancy; UI caused by reasons other than prostatectomy. The main outcomes are the degree of anxiety and depression 2 months after urinary catheter is removed. The secondary outcomes are the quality of life 2 months after urinary catheter is removed. All data are collected and analyzed by the Social Science software version 21.0 (SPSS, Inc., Chicago, IL) program.

Results:
The relevant indexes of severe UI patients are compared in the table.

Conclusion:
Psychological nursing intervention may have a positive effect on depression and anxiety in the UI patients after receiving the radical prostatectomy.
Low-site versus traditional peritoneal dialysis catheterization
Authors: Gong Lifeng , Xu Wei , Tang Weigang , Lu Jingkui , Li Yani , Jiang Huaqin , Li Hui 
Published: November 2020

Abstract

Background:
The objective of this study was to compare the complications of low-site peritoneal dialysis (PD) catheter placement and traditional open surgery in peritoneal dialysis catheter insertion.

Methods:
The following databases were searched from inception to September 6, 2019: PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, and Wanfang. Eligible studies comparing low-site PD catheter placement and traditional open surgery in peritoneal dialysis catheter insertion were included. The data were analyzed using Review Manager Version 5.3.

Results:
Seven studies were included in the meta-analysis. A total of 504 patients were included in the low-site PD catheter placement group, and 325 patients were included in the traditional open surgery group. Compared with traditional open surgery, low-site PD catheter placement had a lower incidence rate of catheter displacement (odds ratios [OR] 0.11, 95% CI 0.05–0.22, P < .01) and noncatheter displacement dysfunction (OR 0.11, 95% CI 0.04–0.31, P < .01). However, there was no difference between the 2 catheter insertion methods concerning bleeding (OR 0.53, 95% CI 0.23–1.22, P = .13), PD fluid leakage (OR 0.40, 95% CI 0.15–1.10, P = .07), hypogastralgia (OR 0.95, 95% CI 0.32–2.80, P = .93), peritonitis (OR 0.70, 95% CI 0.32–1.54, P = .38), or exit-site and tunnel infections (OR 0.39, 95% CI 0.14–1.03, P = .06).

Conclusion:
Low-site PD catheter placement reduced the risk of catheter displacement and noncatheter displacement dysfunction and did not increase the risk of bleeding, PD fluid leakage, hypogastralgia, peritonitis, or exit site and tunnel infections. Additional large multicenter randomized controlled trials are needed to confirm these conclusions.
Heart rate variability and inflammatory bowel disease in humans
Authors: Kim Kyu-Nam , Yao Yao , Ju Sang-Yhun 
Published: November 2020

Abstract
The autonomic nervous system (ANS) maintains homeostasis in the gastrointestinal tract, including immunity, inflammation and motility, through the brain-gut axis. To date, the associations between ANS function and inflammatory bowel disease (IBD) have been controversial and inconclusive in human studies. PubMed, Cochrane Library, and Embase were searched through February 2020 for articles reporting these association between heart rate variability (HRV), an indirect measure of ANS activity, and IBD. The standardized mean differences and 95% confidence intervals (CIs) were calculated. Ten eligible studies involving 273 ulcerative colitis patients, 167 Crohn's disease patients and 208 healthy controls were included. The values of the total power (SMD = −0.83, 95% CI = −1.44, −0.21), high frequency (SMD = −0.79, 95% CI = −1.20, −0.38), RR interval (SMD = −0.66, 95% CI = −1.04, −0.27), standard deviation of the RR intervals (SMD = −1.00, 95% CI = −1.73, −0.27), percentage of RR intervals with a greater than 50-millisecond variation (SMD = −0.82, 95% CI = −1.33, −0.30) and the square root of the mean squared differences in successive RR intervals (SMD = −0.71, 95% CI = −1.15, −0.26) of the IBD patients were lower than those of the healthy controls, and moderate to large effect sizes were observed in all HRV indices, except for low frequency (SMD = −0.41, 95% CI = 0.95, 0.13). IBD was strongly associated with an overall decrease in HRV, indicating substantially decreased ANS activity. Furthermore, the parasympathetic nerve displayed a stronger inverse association with ANS activity than the sympathetic nerve, indicating ANS dysfunction in patients with IBD.