bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gastrointestinal investigation of parasites and Enterobacteriaceae in loggerhead sea turtles from Italian coasts
Authors: Pace Antonino , Rinaldi Laura , Ianniello Davide , Borrelli Luca , Cringoli Giuseppe , Fioretti Alessandro , Hochscheid Sandra , Dipineto Ludovico 
Published: October 2019

Abstract

Background
Caretta caretta is the most abundant sea turtle species in the Mediterranean, and studies on this species have vastly expanded during recent years, including those investigating gut bacterial and parasitic communities. Members of these communities have been reported with variable prevalence and pathogenicity, mainly depending on their host and environment (e.g. lifespan, distribution, habitat, diet, health status and stressors). Indeed, many species commonly inhabiting the sea turtle gastrointestinal tract exhibit an opportunistic behaviour.
This study aimed to provide baseline data on enterobacterial and parasitic composition, through bacteriological culture-based methods and the FLOTAC parasitological technique, in cloacal and faecal samples of 30 live Caretta caretta, examined upon their arrival at the Marine Turtle Research Centre (Portici, Italy).

Results
Enterobacteriaceae were isolated in 18/23 cloacal samples (78.3%), with Citrobacter and Morganella as the most common genera, followed by Proteus, Enterobacter, Providencia, and Hafnia. Parasitic elements were detected in 11/30 faecal samples (36.7%), with Enodiotrema, Rhytidodes, and Eimeria as most common genera, followed by Pachypsolus and Cymatocarpus. Additionally, Angiodyctium is reported for the first time in this host. The majority (47.8%) of sea turtles hosted exclusively Enterobacteriaceae, whereas 30.4% hosted both parasites and Enterobacteriaceae; the remaining 21.8% hosted neither of the agents.

Conclusions
Bacteria and parasites evaluated in the present study are common in Mediterranean loggerhead sea turtles, with slight differences between the western and eastern basin. Although naturally present in the gastrointestinal system of free-living sea turtles, their relationship with these hosts might range from mutualism to parasitism. Indeed, members of the gut community might express their pathogenic potential in immune-compromised animals, such as those in rehabilitation facilities. Therefore, it is advisable to include in the standard work-up of rescued sea turtles a screening procedure for such opportunistic agents, in order to better evaluate the animal’s health status and achieve timely intervention with appropriate treatment, thus improving rehabilitation. Furthermore, data collected from free-living sea turtles represent a starting point for investigating wild populations. However, further studies are needed to clarify the differences between sea turtle’s normal gut microbiome and pathobiome.
The prevalence of Coxiella burnetii in ticks and animals in Slovenia
Authors: Knap Nataša , Žele Diana , Glinšek Biškup Urška , Avšič-Županc Tatjana , Vengušt Gorazd 
Published: October 2019

Abstract

Background
The obligate intracellular bacterium Coxiella burnetii causes globally distributed zoonotic Q fever. Ruminant livestock are common reservoirs of C. burnetii. Coxiella burnetii are shed in large numbers in the waste of infected animals and are transmitted by inhalation of contaminated aerosols. This study was conducted to evaluate the prevalence of C. burnetii infection in domestic animals and ticks in areas of Slovenia associated with a history of Q fever outbreaks.

Results
A total of 701 ticks were collected and identified from vegetation, domestic animals and wild animals. C. burnetii DNA was detected in 17 out of 701 (2.4%) ticks. No C. burnetii DNA was found in male ticks. Ticks that tested positive in the PCR-based assay were most commonly sampled from wild deer (5.09%), followed by ticks collected from domestic animals (1.16%) and ticks collected by flagging vegetation (0.79%). Additionally, 150 animal blood samples were investigated for the presence of C. burnetii-specific antibodies and pathogen DNA. The presence of pathogen DNA was confirmed in 14 out of 150 (9.3%) blood samples, while specific antibodies were detected in sera from 60 out of 150 (40.4%) animals.

Conclusions
Our results indicate that ticks, although not the primary source of the bacteria, are infected with C. burnetii and may represent a potential source of infection for humans and animals. Ticks collected from animals were most likely found to harbor C. burnetii DNA, and the infection was not lost during molting. The persistence and distribution of pathogens in cattle and sheep indicates that C. burnetii is constantly present in Slovenia.
Socioeconomic inequalities in the use of caesarean section delivery in Ghana: a cross-sectional study using nationally representative data
Authors: Dankwah Emmanuel , Kirychuk Shelley , Zeng Wu , Feng Cindy , Farag Marwa 
Published: October 2019

Abstract

Background
Inappropriate use of Caesarean Section (CS) delivery is partly to blame for Ghana’s high maternal mortality rate. However, previous research offered mixed findings about factors associated with CS use. The goal of this study is to examine use of CS in Ghana and the socioeconomic factors associated with it.

Methods
Data from the nationally representative 2014 Ghana Demographic and Health Survey (GDHS) was used after permission from the Monitoring and Evaluation to Assess and Use Results (MEASURE) Demographic and Health Survey (DHS) program. Univariable and multivariable logistic regression models were fitted to examine the socioeconomic inequalities in CS use. The independent variables included maternal age, marital status, religion, ethnicity, education, place of residence, wealth quintile, and working status. Concentration index (CI) and rate-ratios were computed to ascertain the level of CS inequalities.

Results
Out of the 4294 women, 11.4% had CS delivery. However, the percentage of CS delivery ranged from 5% of women in the poorest quintile to 27.5% of women in the richest qunitle. Significant associations were detected between CS delivery and maternal age, parity, education, and wealth quintile .

Conclusions
This study revealed that first, even though Ghana has achieved an aggregate CS rate consistent with WHO recommendations, it still suffers from inequities in the use of CS. Second, both underuse of CS among poorer women in Ghana and overuse among rich and educated women are public health concerns that need to be addressed. Third, the results show in spite of Ghana’s free maternal care services policies, wealth status of women continues to be strongly and signtificantly associated with CS delivery, indicating that there are indirect health care costs and other reasons preventing poorer women from having access to CS which should be understood better and addressed with appropriate policies.
Comparing legislation for involuntary admission and treatment of mental illness in four South Asian countries
Authors: Dey Sangeeta , Mellsop Graham , Diesfeld Kate , Dharmawardene Vajira , Mendis Susitha , Chaudhuri Sreemanti , Deb Aniruddha , Huq Nafisa , Ahmed Helal Uddin , Shuaib Mohammad , Khan Faisal Rashid 
Published: October 2019

Abstract

Background
Involuntary admission or treatment for the management of mental illness is a relatively common practice worldwide. Enabling legislation exists in most developed and high-income countries. A few of these countries have attempted to align their legislation with the United Nations Convention on the Rights of Persons with Disabilities. This review examined legislation and associated issues from four diverse South Asian countries (Bangladesh, India, Pakistan and Sri Lanka) that all have a British colonial past and initially adopted the Lunacy Act of 1845.

Method
A questionnaire based on two previous studies and the World Health Organization checklist for mental health legislation was developed requesting information on the criteria and process for involuntary detention of patients with mental illness for assessment and treatment. The questionnaire was completed by psychiatrists (key informants) from each of the four countries. The questionnaire also sought participants’ comments or concerns regarding the legislation or related issues.

Results
The results showed that relevant legislation has evolved differently in each of the four countries. Each country has faced challenges when reforming or implementing their mental health laws. Barriers included legal safeguards, human rights protections, funding, resources, absence of a robust wider health system, political support and sub-optimal mental health literacy.

Conclusion
Clinicians in these countries face dilemmas that are less frequently encountered by their counterparts in relatively more advantaged countries. These dilemmas require attention when implementing and reforming mental health legislation in South Asia.
Protocol for a multi-centered, stepped wedge, cluster randomized controlled trial of the de-adoption of oral chlorhexidine prophylaxis and implementation of an oral care bundle for mechanically ventilated critically ill patients: the CHORAL study
Authors: Dale Craig M. , Rose Louise , Carbone Sarah , Smith Orla M. , Burry Lisa , Fan Eddy , Amaral Andre Carlos Kajdacsy-Balla , McCredie Victoria A. , Pinto Ruxandra , Quiñonez Carlos R. , Sutherland Susan , Scales Damon C. , Cuthbertson Brian H. 
Published: October 2019

Abstract

Background
Routine application of chlorhexidine oral rinse is recommended to reduce risk of ventilator-associated pneumonia (VAP) in mechanically ventilated patients. Recent reappraisal of the evidence from two meta-analyses suggests chlorhexidine may cause excess mortality in non-cardiac surgery patients and does not reduce VAP. Mechanisms for possible excess mortality are unclear. The CHORAL study will evaluate the impact of de-adopting chlorhexidine and implementing an oral care bundle (excluding chlorhexidine) on mortality, infection-related ventilator-associated complications (IVACs), and oral health status.

Methods
The CHORAL study is a stepped wedge, cluster randomized controlled trial in six academic intensive care units (ICUs) in Toronto, Canada. Clusters (ICU) will be randomly allocated to six sequential steps over a 14-month period to de-adopt oral chlorhexidine and implement a standardized oral care bundle (oral assessment, tooth brushing, moisturization, and secretion removal). On study commencement, all clusters begin with a control period in which the standard of care is oral chlorhexidine. Clusters then begin crossover from control to intervention every 2 months according to the randomization schedule. Participants include all mechanically ventilated adults eligible to receive the standardized oral care bundle. The primary outcome is ICU mortality; secondary outcomes are IVACs and oral health status. We will determine demographics, antibiotic usage, mortality, and IVAC rates from a validated local ICU clinical registry. With six clusters and 50 ventilated patients on average each month per cluster, we estimate that 4200 patients provide 80% power after accounting for intracluster correlation to detect an absolute reduction in mortality of 5.5%. We will analyze our primary outcome of mortality using a generalized linear mixed model adjusting for time to account for secular trends. We will conduct a process evaluation to determine intervention fidelity and to inform interpretation of the trial results.

Discussion
The CHORAL study will inform understanding of the effectiveness of de-adoption of oral chlorhexidine and implementation of a standardized oral care bundle for decreasing ICU mortality and IVAC rates while improving oral health status. Our process evaluation will inform clinicians and decision makers about intervention delivery to support future de-adoption if justified by trial results.

Trial registration
ClinicalTrials.gov, NCT03382730. Registered on December 26, 2017.
Effect of etelcalcetide on cardiac hypertrophy in hemodialysis patients: a randomized controlled trial (ETECAR-HD)
Authors: Dörr Katharina , Kammer Michael , Reindl-Schwaighofer Roman , Lorenz Matthias , Loewe Christian , Marculescu Rodrig , Erben Reinhold , Oberbauer Rainer 
Published: October 2019

AbstractBackgroundFibroblast growth factor 23 (FGF23) is associated with left ventricular hypertrophy (LVH) in patients with chronic kidney disease, and calcimimetic therapy reduces plasma concentrations of FGF23. It remains unknown whether treatment with the calcimimetic etelcalcetide (ETL) reduces LVH in patients on hemodialysis.Methods/designThis single-blinded randomized trial of 12 months duration will test the effects of ETL compared with alfacalcidol on LVH and cardiac fibrosis in maintenance hemodialysis patients with secondary hyperparathyroidism. Both treatment regimens will be titrated to equally suppress secondary hyperparathyroidism while alfacalcidol treatment causes an increase and ETL a decrease in FGF23, respectively.Patients treated thrice weekly with hemodialysis for ≥ 3 months and ≤ 3 years with parathyroid hormone levels ≥ 300 pg/ml and LVH will be enrolled in the study.The primary study endpoint is change from baseline to 12 months in left ventricular mass index (LVMI; g/m2) measured by cardiac magnetic resonance imaging. Sample size calculations showed that 62 randomized patients will be necessary to detect a difference in LVMI of at least 20 g/m2between the two groups at 12 months. Due to the strong association of volume overload and LVH, randomization will be stratified by residual kidney function, and regular body composition monitoring will be performed to control the volume status of patients.Study medication will be administered intravenously by the dialysis nurses after every hemodialysis session, thus omitting adherence issues.Secondary study endpoints are cardiac parameters measured by echocardiography, biomarker concentrations of bone metabolism (FGF23, vitamin D, parathyroid hormone, calcium, phosphate, s-Klotho), cardiac markers (pro-brain natriuretic peptide, pre- and postdialysis troponin T) and metabolites of the renin–angiotensin–aldosterone cascade (angiotensin I (Ang I), Ang II, Ang-(1–7), Ang-(1–5), Ang-(1–9), and aldosterone).DiscussionThe causal inference and pathophysiology of LVH regression by FGF23 reduction using calcimimetic treatment has not yet been shown. This intervention study has the potential to discover a new strategy for the treatment of cardiac hypertrophy and fibrosis in patients on maintenance hemodialysis. It might be speculated that successful treatment of cardiac morphology will also reduce the risk of cardiac death in this population.Trial registrationEuropean Clinical Trials Database, EudraCT number 2017-000222-35; ClinicalTrials.gov,NCT03182699. Registered on
NT3P75-2 gene-modified bone mesenchymal stem cells improve neurological function recovery in mouse TBI model
Authors: Wu Ke , Huang Dongdong , Zhu Can , Kasanga Ella A. , Zhang Ying , Yu Enxing , Zhang Hengli , Ni Zhihui , Ye Sheng , Zhang Chunli , Hu Jiangnan , Zhuge Qichuan , Yang Jianjing 
Published: October 2019

AbstractBackgroundThe attainment of extensive neurological function recovery remains the key challenge for the treatment of traumatic brain injury (TBI). Transplantation of bone marrow-derived mesenchymal stem cells (BMSCs) has been shown to improve neurological function recovery after TBI. However, the survival of BMSCs after transplantation in early-stage TBI is limited, and much is unknown about the mechanisms mediating this neurological function recovery. Secretion of neurotrophic factors, including neurotrophin 3 (NT3), is one of the critical factors mediating BMSC neurological function recovery. Gene mutation of NT3 (NT3P75-2) has been shown to enhance the biological function of NT3 via the reduction of the activation of the P75 signal pathway. Thus, we investigated whether NT3P75-2gene-modified BMSCs could enhance the survival of BMSCs and further improve neurological function recovery after TBI.MethodsThe ability of NT3P75-2induction to improve cell growth rate of NSC-34 and PC12 cells in vitro was first determined. BMSCs were then infected with three different lentiviruses (green fluorescent protein (GFP), GFP-NT3, or GFP-NT3P75-2), which stably express GFP, GFP-NT3, or GFP-NT3P75-2. At 24 h post-TBI induction in mice, GFP-labeled BMSCs were locally transplanted into the lesion site. Immunofluorescence and histopathology were performed at 1, 3, and/or 7 days after transplantation to evaluate the survival of BMSCs as well as the lesion volume. A modified neurological severity scoring system and the rotarod test were chosen to evaluate the functional recovery of the mice. Cell growth rate, glial activation, and signaling pathway analyses were performed to determine the potential mechanisms of NT3P75-2in functional recovery after TBI.ResultsOverall, NT3P75-2improved cell growth rate of NSC-34 and PC12 cells in vitro. In addition, NT3P75-2significantly improved the survival of transplanted BMSCs and neurological function recovery after TBI. Overexpression of NT3P75-2led to a significant reduction in the activation of glial cells, brain water content, and brain lesion volume after TBI. This was associated with a reduced activation of the p75 neurotrophin receptor (P75NTR) and the c-Jun N-terminal kinase (JNK) signal pathway due to the low affinity of NT3P75-2for the receptor.ConclusionsTaken together, our results demonstrate that administration of NT3P75-2gene-modified BMSCs dramatically improves neurological function recovery after TBI by increasing the survival of BMSCs and ameliorating the inflammatory environment, providing a new promising treatment strategy for TBI.
A time-efficient data offloading method with privacy preservation for intelligent sensors in edge computing
Authors: Xu Zhanyang , Liu Xihua , Jiang Gaoxing , Tang Bowei 
Published: October 2019

Abstract
Over the past years, with the development of hardware and software, the intelligent sensors, which are deployed in the wearable devices, smart phones, and etc., are leveraged to collect the data around us. The data collected by the sensors is analyzed, and the corresponding measures will be implemented. However, due to the limited computing resources of the sensors, the overload resource usage may occur. In order to satisfy the requirements for strong computing power, edge computing, which emerges as a novel paradigm, provides computing resources at the edge of networks. In edge computing, the computing tasks could be offloaded from the sensors to the other sensors for processing. Despite the advantages of edge computing, during the offloading process of computing tasks between sensors, private data, including identity information and address, may be leaked, which threatens personal security. Hence, it is important to avoid privacy leakage in edge computing. In addition, the time consumption of offloading computing tasks affects the using experience of customers, and low time consumption makes contributions to the development of applications which are strict with time. To satisfy the above requirements, a time-efficient offloading method (TEO) with privacy preservation for intelligent sensors in edge computing is proposed. Technically, the time consumption and the offloading of privacy data are analyzed in a formalized way. Then, an improved of Strength Pareto Evolutionary Algorithm (SPEA2) is leveraged to optimize the average time consumption and average privacy entropy jointly. At last, abundant experimental evaluations are conducted to verify efficiency and reliability of our method.
A meta-epidemiological study of subgroup analyses in cochrane systematic reviews of atrial fibrillation
Authors: Paquette Miney , Alotaibi Ahlam Mohammed , Nieuwlaat Robby , Santesso Nancy , Mbuagbaw Lawrence 
Published: October 2019

Abstract

Background
Information on subgroup assessments in systematic reviews (SR) of atrial fibrillation (AF) is limited. This review aims to describe subgroup analyses in AF SRs to inform the design of SRs and randomized trials as well as clinical practice.

Methods
We conducted a cross sectional meta-epidemiological study of Cochrane AF reviews by searching AF (including variants) in the title, abstract, or keyword field without date or language restrictions (Issue 9; September 2018). Two reviewers independently extracted study characteristics to summarize frequency of subgroups pre-specified and conducted and report credibility of subgroup effects claimed.

Results
Of 39 Cochrane reviews identified, 17 met inclusion criteria (including 168 reports of 127 randomized trials) and the majority (16; 94.1%) conducted meta-analysis of outcomes. Most (13; 76.5%) planned pre-specified subgroup analyses; 7 of which (41.2%) conducted subgroups. In these 7 reviews, 56 subgroups were planned, 17 (30.4%) conducted and 6 (10.7%) yielded subgroup effects. Variables such as co-morbid disease, stroke risk factors, prior stroke/transient ischemic attack, age, race, and sex represented 44% (24 subgroups) of all planned subgroups (8 conducted; 14.3%); however, information on covariate selection was lacking. Overall, more subgroups were planned than conducted (mean difference (95% CI) 2.3 (1.2–3.5, p < 0.001)). Of all subgroups conducted, anticoagulant characteristics comprised a third of all subgroup effects (n = 5, 35.7%).
The credibility of subgroups identified (n = 14) was assessed and less than half (43%) represented one of a small number of pre-specified hypothesis and rarely were effects seen within studies (7%). Of 5 reviews that reported subgroup effects, only 3 discussed subgroup effects as part of the overall conclusions; none discussed credibility of subgroup effects.

Conclusions
This meta-epidemiological review of a subset of Cochrane AF reviews suggests that planning and reporting of subgroup analyses in AF reviews can be improved to better inform clinical management. Most pre-specified subgroup analyses were not performed, important variables (such as stroke, bleeding risk, and other comorbidities) were rarely examined and credibility of subgroup effects claimed was low. Future reviews should aim to identify important subgroups in their protocols and use recommended approaches to test subgroup effects in order to better support clinical decision-making.
Analysis of two Legendre spectral approximations for the variable-coefficient fractional diffusion-wave equation
Authors: Chen Wenping , Lü Shujuan , Chen Hu , Jiang Lihua 
Published: October 2019

Abstract
In this paper, we solve the variable-coefficient fractional diffusion-wave equation in a bounded domain by the Legendre spectral method. The time fractional derivative is in the Caputo sense of order $\gamma \in (1,2)$
γ
∈
(
1
,
2
)
. We propose two fully discrete schemes based on finite difference in temporal and Legendre spectral approximations in spatial discretization. For the first scheme, we discretize the time fractional derivative directly by the $L_{1}$

L
1

approximation coupled with the Crank–Nicolson technique. For the second scheme, we transform the equation into an equivalent form with respect to the Riemann–Liouville fractional integral operator. We give a rigorous analysis of the stability and convergence of the two fully discrete schemes. Numerical examples are carried out to verify the theoretical results.
Nontrivial solutions of inverse discrete problems with sign-changing nonlinearities
Authors: Cabada Alberto , Dimitrov Nikolay D. 
Published: October 2019

Abstract
This paper is concerned with the existence of solutions of an inverse discrete problem with sign-changing nonlinearity. This kind of problems includes, as a particular case, nth order difference equations coupled with suitable conditions on the boundary of the interval of definition. It would be valid for the case in which the related Green’s function is positive on a subset of its rectangle of definition.
The existence results follow from spectral theory, as an application of the Krein–Rutman theorem and by means of degree theory.