bluuebunny/crossref_metadata_2025_split huggingface dataset:
Innovative education for people with chronic kidney disease: an evaluation study
Authors: Rainey Helen , Hussain Shaila , Thomas Nicola 
Published: March 2020

SUMMARYBackgroundAn innovative Community Kidney Service has been running since 2016 in four health regions in East London, United Kingdom. This paper focuses on the patient education (self‐management) programme within the service.ObjectiveTo understand the experiences of people with stage 1–3b chronic kidney disease invited to individual or group education sessions. To assess the usefulness of the programme's educational resources to primary care nurses.DesignA mixed‐method project. A steering group involving patients shaped both survey and interview questions.ParticipantsPaper surveys (n = 266) were sent to patients 7–19 months after they had attended. Semi‐structured interviews were undertaken with patients who returned the survey and indicated they were willing to be interviewed (n = 9). Survey links were sent electronically to primary care nurses.ResultsFifty‐four surveys were returned from patients. The education session increased self‐reported knowledge about kidney disease and two‐thirds of patients reported making lifestyle changes. Analysis of interview data identified recognition of kidney disease, motivation to change and reliance on “experts” as key themes. Surveys were returned from 21 nurses. Most were aware of the community kidney service but only one‐third had used the education resources with their patients.ConclusionSecondary care nursing involvement in primary care‐based education for people with kidney disease is rare in the United Kingdom and internationally. This educational intervention, developed with patients, supports people to make changes that have the potential to reduce progression of kidney disease and our findings have significance for other teams working in chronic kidney disease management.
An ancient solution to a modern problem
Authors: Davies Julian E. , Behroozian Shekooh 
Published: March 2020

AbstractThe dearth of new antibiotics and escalating emergence of multidrug resistant bacteria have created a global healthcare crisis and highlight the drastic need for novel antimicrobial agents. Complementary and alternative strategies including the investigation of ancient medicinals could address this problem. Natural clay minerals with a long history of medicinal and biomedical applications have become an interest due to their broad‐spectrum antimicrobial activity. Such untapped natural sources may provide new therapeutic agents in the battle against infectious diseases in the post‐antibiotic era.
Superficial fungal infections in the department of dermatology, University Hospital Jena: A 7‐year retrospective study on 4556 samples from 2007 to 2013
Authors: Gamage Hasanga , Sivanesan Pirabakaran , Hipler Uta‐Christina , Elsner Peter , Wiegand Cornelia 
Published: March 2020

AbstractBackgroundSuperficial fungal infections are often seen in day‐to‐day clinical practice, and their prevalence continues to rise worldwide. Over the years, a change in the pattern of dermatophytoses has been noted.ObjectivesThis study aimed to determine the epidemiologic profile of dermatophytes at the Department of Dermatology, University Hospital Jena, from 2007 to 2013.MethodsThe retrospective study was carried out with a total of 4556 samples collected from 3607 patients suspected of superficial fungal infections during the 7‐year study period.ResultsAmong the 3607 suspected patients, 1951 (54.09%) were men and 1656 (45.91%) were women. Of 4556 samples, 703 (15.43%) samples were positive for fungal culture, which included 585 (83.21%) dermatophytes and 118 (16.79%) non‐dermatophytes. Trichophyton (T.) rubrum was the most common isolated pathogen in 73.33% of the dermatophyte cases. Among dermatophyte‐infected patients, men were most likely to be affected (63.48%) as well as those of higher age (61 to 80). The most commonly affected areas were nails (33.16%) and feet (33%). T rubrum was recurrently isolated in several regions with exception of the scalp where M canis (58.33%) was the most frequently isolated pathogen. About 16.04% of cases had a history of treatment taken prior to sampling. The majority of the affected individuals did not have any prior animal contact (77.26%). T benhamiae was exclusively associated with contact to guinea pigs.ConclusionTrichophyton rubrum was the most frequently isolated pathogen in several regions except the scalp. New dermatophyte species emerged with time especially T benhamiae.
Fluorescence Intensity Enhancement of Green Carbon Dots: Synthesis, Characterization and Cell Imaging
Authors: Hashemi Fatemeh , Heidari Fatemeh , Mohajeri Nasrin , Mahmoodzadeh Farideh , Zarghami Nosratollah 
Published: March 2020

AbstractThe hydrothermal treatment of green carbon dots (CDs) is an appropriate fluorescent probe synthesis method. CDs are exploited as biological staining agents, especially for cellular detection and imaging. The nitrogen‐doped green carbon dots (N‐CDs) formation can improve the fluorescence intensity property in a one‐step process. Here, we report two N‐CDs from lemon and tomato extraction in the presence of hydroxylamine. Lemon and tomato N‐CDs showed the blue fluorescence under ultraviolet radiation of about 360 nm. The characterization of CDs and N‐CDs showed the presence of N‐H and C–N bonds which enhanced the fluorescence efficiency. The mean size of lemon and tomato N‐CDs were about 2 and 3 nm with an increased quantum yield (QY) of 5% and 3.38%, respectively. The CDs and N‐CDs cytotoxicity assay exhibited high cell viability approximately 85% and 73%, respectively. N‐CDs show superior fluorescent intensity in different solvents and significant stability under long‐time UV irradiation, different PH and high ionic strength. Our results indicated that the use of N‐CDs in cell imaging can lead to fluorescence intensity enhancement as well as proper biocompatibility. Therefore, the safe and high fluorescence intensity of green N‐CDs can be utilized for fluorescent probes in biolabeling and bioimaging applications.
Pre‐race screening and stratification predicts adverse events—A 4‐year study in 29585 ultra‐marathon entrants, SAFER X
Authors: Sewry Nicola , Schwellnus Martin , Borjesson Mats , Swanevelder Sonja , Jordaan Esme 
Published: March 2020

BackgroundPre‐race screening and risk stratification in recreational endurance runners may predict adverse events (AEs) during a race.AimTo determine if pre‐race screening and risk stratification predict AEs during a race.MethodsA total of 29 585 participants (Male 71.1%, average age = 42.1 years; Female 28.9%, average age = 40.2 years) at the Two Oceans ultra‐marathon races (56 km) completed a pre‐race medical screening questionnaire and were risk stratified into four pre‐specified groups [very high risk (VHR; existing cardiovascular disease–CVD:3.2%), high risk (HR; risk factors for CVD:10.5%), intermediate risk (IR; existing other chronic disease, medication use or injury:53.3%), and low risk (LR:33.0%)]. Race starters, finishers, and medical encounters (ME) were recorded. Did‐not‐start (DNS) rate (per 1000 entrants that did‐not‐start), did‐not‐finish (DNF) rate (per 1000 starters that did‐not‐finish), AE rate [per 1000 starters that either DNF or had an ME], and ME rate (per 1000 starters with an ME) were compared across risk categories.ResultsAdverse events were significantly higher (per 1000 starters; 95%CI) in the VHR (68.9; 52.4‐89.9:P = .0407) compared with the LR (51.3; 46.5‐56.7). The DNS rate was significantly different between the IR (190.3; 184.0‐196.9) and LR (207.4; 199.2‐216.0: P = .0011). DNF rates were not different in the VHR (56.4; 41.9‐75.9) compared to LR (44.2; 39.7‐49.1: P = .1295), and ME rate was also not different between risk categories, however, VHR (12.9; 7.0‐23.9) was approaching significance compared to LR (6.9; 5.2‐9.1: P = .0662).ConclusionPre‐race medical screening and risk stratification may identify athletes at higher risk of AEs. Further studies should be performed in larger cohorts to clarify the role of pre‐race medical screening in reducing AEs in endurance runners.
Impact of repeated cycles of EGF bispecific angiotoxin (eBAT) administered at a reduced interval from doxorubicin chemotherapy in dogs with splenic haemangiosarcoma
Authors: Borgatti Antonella , Fieberg Ann , Winter Amber L. , Stuebner Kathleen , Taras Elizabeth , Todhunter Deborah , Masyr Alison , Rendhal Aaron , Vallera Daniel A. , Koopmeiners Joseph S. , Modiano Jaime F. 
Published: March 2020

AbstractWe previously reported that eBAT, an EGF‐targeted angiotoxin, was safe and it improved the overall survival for dogs with splenic haemangiosarcoma when added to the standard of care in a single cycle of three administrations in the minimal residual disease setting. Our objective for the SRCBST‐2 trial was to assess whether increased dosing through multiple cycles of eBAT would be well tolerated and would further enhance the benefits of eBAT. Eligibility was expanded to dogs with stage 3 haemangiosarcoma, provided that gross lesions could be surgically excised. The interval between eBAT and the start of chemotherapy was reduced, and the experimental therapy was expanded to three cycles, each administered at the biologically active dose (50 μg/kg) on a Monday/Wednesday/Friday schedule following splenectomy, and scheduled 1 week prior to the first, second and fifth doxorubicin chemotherapy. Twenty‐five dogs were enrolled; six experienced acute hypotension with two requiring hospitalization. Self‐limiting elevation of ALT was observed in one dog. A statistically significant survival benefit was not seen in this study in eBAT‐treated dogs compared with a Contemporary comparison group of dogs with stages 1‐3 haemangiosarcoma treated with standard of care alone. Our results indicate that repeated dosing cycles of eBAT starting 1 week prior to doxorubicin chemotherapy led to greater toxicity and reduced efficacy compared with a single cycle given between surgery and a delayed start of chemotherapy. Further work is needed to understand the precise mechanisms of action of eBAT in order to optimize its clinical benefits in the treatment of canine haemangiosarcoma and other tumours. IACUC Protocols 1110A06186 and 1507‐32804A.
Payment Delays and Financial Performance of Construction Firms in Vihiga County, Kenya
Authors: Kalegera Brenda Ajema , Omoro Nixon Oluoch 
Published: March 2020

The purpose of this study was to establish whether payment delays affect financial performance of construction firms. The study employed cross sectional research design, stratified simple random sampling and census survey of 32 construction firms. The study relied on secondary data from audited financial reports. Data was analyzed using both descriptive and inferential statistics - multivariate analysis. There was no statistical significant effect between delayed payments and financial performance as measured by Net profit margin and current ratio, probably other factors or measures such as management style and strategies could have affected the two variables. Our conclusion however, is that late payments in commercial transactions by the public or generations and private entities have detrimental effects on the business environment, especially by exacerbating the burden of already financially constrained firms which can ultimately push them out of business. The study was only limited to one financial year and construction firm.
Influence of Maturation Status on Eccentric Hamstring Strength Improvements in Youth Male Soccer Players After the Nordic Hamstring Exercise
Authors: Drury Benjamin , Green Thomas , Ramirez-Campillo Rodrigo , Moran Jason 
Published: March 2020

Purpose: This study examined the effects of a 6-week Nordic hamstring exercise (NHE) program in youth male soccer players of less mature (pre–peak height velocity [PHV]) or more mature (mid/post-PHV) status. Methods: Forty-eight participants were separated into pre-PHV (11.0 [0.9] y) or mid/post-PHV (13.9 [1.1]) groups and further divided into experimental (EXP) and control groups with eccentric hamstring strength assessed (NordBord) both before and after the training program. Participants in the EXP groups completed a periodized NHE program performed once or twice weekly over a 6-week period. Results: The NHE program resulted in moderate and small increases in relative eccentric hamstring strength (in newtons per kilogram) in the pre-PHV EXP (d = 0.83 [0.03–1.68]) and mid-PHV EXP (d = 0.53 [−0.06 to 1.12]) groups, respectively. Moderate increases in the same measure were also seen in the between-groups analyses in the pre-PHV (d = 1.03 [0.23–1.84]) and mid-PHV (d = 0.87 [0.22–1.51]) groups, with a greater effect observed in the former. Conclusion: The results from this study demonstrate that a 6-week NHE program can improve eccentric hamstring strength in male youth soccer players, with less-mature players achieving mostly greater benefits. The findings from this study can aid in the training prescription of NHE in youth male soccer players.
Hybrid turbidite-drift channel complexes: An integrated multiscale model
Authors: Fuhrmann A. , Kane I.A. , Clare M.A. , Ferguson R.A. , Schomacker E. , Bonamini E. , Contreras F.A. 
Published: March 2020

Abstract
The interaction of deep-marine bottom currents with episodic, unsteady sediment gravity flows affects global sediment transport, forms climate archives, and controls the evolution of continental slopes. Despite their importance, contradictory hypotheses for reconstructing past flow regimes have arisen from a paucity of studies and the lack of direct monitoring of such hybrid systems. Here, we address this controversy by analyzing deposits, high-resolution seafloor data, and near-bed current measurements from two sites where eastward-flowing gravity flows interact(ed) with northward-flowing bottom currents. Extensive seismic and core data from offshore Tanzania reveal a 1650-m-thick asymmetric hybrid channel levee-drift system, deposited over a period of ∼20 m.y. (Upper Cretaceous to Paleocene). High-resolution modern seafloor data from offshore Mozambique reveal similar asymmetric channel geometries, which are related to northward-flowing near-bed currents with measured velocities of up to 1.4 m/s. Higher sediment accumulation occurs on the downstream flank of channel margins (with respect to bottom currents), with inhibited deposition or scouring on the upstream flank (where velocities are highest). Toes of the drift deposits, consisting of thick laminated muddy siltstone, which progressively step back into the channel axis over time, result in an interfingering relationship with the sandstone-dominated channel fill. Bottom-current flow directions contrast with those of previous models, which lacked direct current measurements or paleoflow indicators. We finally show how large-scale depositional architecture is built through the temporally variable coupling of these two globally important sediment transport processes. Our findings enable more-robust reconstructions of past oceanic circulation and diagnosis of ancient hybrid turbidite-drift systems.
Hepatic de novo lipogenesis is suppressed and fat oxidation is increased by omega-3 fatty acids at the expense of glucose metabolism
Authors: Green Charlotte J , Pramfalk Camilla , Charlton Catriona A , Gunn Pippa J , Cornfield Thomas , Pavlides Michael , Karpe Fredrik , Hodson Leanne 
Published: March 2020

ObjectiveIncreased hepatic de novo lipogenesis (DNL) is suggested to be an underlying cause in the development of nonalcoholic fatty liver disease and/or insulin resistance. It is suggested that omega-3 fatty acids (FA) lower hepatic DNL. We investigated the effects of omega-3 FA supplementation on hepatic DNL and FA oxidation using a combination of human in vivo and in vitro studies.Research design and methodsThirty-eight healthy men were randomized to take either an omega-3 supplement (4 g/day eicosapentaenoic acid (EPA)+docosahexaenoic acid (DHA) as ethyl esters) or placebo (4 g/day olive oil) and fasting measurements were made at baseline and 8 weeks. The metabolic effects of omega-3 FAs on intrahepatocellular triacylglycerol (IHTAG) content, hepatic DNL and FA oxidation were investigated using metabolic substrates labeled with stable-isotope tracers. In vitro studies, using a human liver cell-line was undertaken to gain insight into the intrahepatocellular effects of omega-3 FAs.ResultsFasting plasma TAG concentrations significantly decreased in the omega-3 group and remained unchanged in the placebo group. Eight weeks of omega-3 supplementation significantly decreased IHTAG, fasting and postprandial hepatic DNL while significantly increasing dietary FA oxidation and fasting and postprandial plasma glucose concentrations. In vitro studies supported the in vivo findings of omega-3 FAs (EPA+DHA) decreasing intracellular TAG through a shift in cellular metabolism away from FA esterification toward oxidation.ConclusionsOmega-3 supplementation had a potent effect on decreasing hepatic DNL and increasing FA oxidation and plasma glucose concentrations. Attenuation of hepatic DNL may be considered advantageous; however, consideration is required as to what the potential excess of nonlipid substrates (eg, glucose) will have on intrahepatic and extrahepatic metabolic pathways.Trial registration numberNCT01936779.
Sustaining improved nutritional support for very low birthweight infants
Authors: Kresch Mitchell , Mehra Kashish , Jack Richard , Greecher Coleen 
Published: March 2020

BackgroundPostnatal growth failure (PGF) in very low birthweight (VLBW) infants is a result of factors such as prematurity, acute illness and suboptimal nutritional support. Before this project began, 84% of appropriately grown VLBW infants in our neonatal intensive care unit experienced PGF. The aims of this quality improvement project were to reduce the percentage of infants discharged with PGF to less than 50% within 2 years and to maintain a rate of PGF under 50%.MethodsAll inborn VLBW infants were eligible for this study. Infants with congenital anomalies were excluded. We determined key drivers for optimal nutrition and identified potentially better practices (process measures) based on a review of the literature, which included more rapid initiation of starter total parenteral nutrition (TPN), aggressive use and advancement of regular TPN, and fortification of human milk when the volume of intake reached 80 mL/kg/day. Three Plan-Do-Study-Act (PDSA) cycles were tested.ResultsTime to initiation of starter TPN was significantly reduced from 5.5 hours to under 3 hours. Regular TPN provided the goals for amino acids and lipids at increased frequency after the first two PDSA cycles. The proportion of infants whose milk was fortified at 80 mL/kg/day increased after the third PDSA cycle.ConclusionsWe found a sustained decrease in the percentage of infants discharged with PGF from 84% at baseline to fewer than 50% beginning in 2010–2011 through 2016, with 23.1% of infants experiencing PGF in 2016. We have achieved improved nutritional support for VLBW infants using the model for improvement.
Age-stratified burden of pneumococcal community acquired pneumonia in hospitalised Canadian adults from 2010 to 2015
Authors: LeBlanc Jason , ElSherif May , Ye Lingyun , MacKinnon-Cameron Donna , Ambrose Ardith , Hatchette Todd F , Lang Amanda LS , Gillis Hayley D , Martin Irene , Demczuk Walter H , LaFerriere Craig , Andrew Melissa K , Boivin Guy , Bowie William , Green Karen , Johnstone Jennie , Loeb Mark , McCarthy Anne , McGeer Allison , Semret Makeda , Trottier Sylvie , Valiquette Louis , Webster Duncan , McNeil Shelly A 
Published: March 2020

BackgroundIn Canada, 13-valent pneumococcal conjugate vaccine (PCV13) is recommended in childhood, in individuals at high risk of invasive pneumococcal disease (IPD) and in healthy adults aged ≥65 years for protection against vaccine-type IPD and pneumococcal community-acquired pneumonia (pCAP). Since vaccine recommendations in Canada include both age-based and risk-based guidance, this study aimed to describe the burden of vaccine-preventable pCAP in hospitalised adults by age.MethodsSurveillance for community-acquired pneumonia (CAP) in hospitalised adults was performed prospectively from 2010 to 2015. CAP was radiologically confirmed, and pCAP was identified using blood and sputum culture and urine antigen testing. Patient demographics and outcomes were stratified by age (16–49, 50–64, ≥65 and ≥50 years).ResultsOf 6666/8802 CAP cases tested, 830 (12.5%) had pCAP, and 418 (6.3%) were attributed to a PCV13 serotype. Of PCV13 pCAP, 41% and 74% were in adults aged ≥65 and ≥50 years, respectively. Compared with non-pCAP controls, pCAP cases aged ≥50 years were more likely to be admitted to intensive care units (ICUs) and to require mechanical ventilation. Older adults with pCAP were less likely to be admitted to ICU or required mechanical ventilation, given their higher mortality and goals of care. Of pCAP deaths, 67% and 90% were in the ≥65 and ≥50 age cohorts, respectively.ConclusionsAdults hospitalised with pCAP in the age cohort of 50–64 years contribute significantly to the burden of illness, suggesting that an age-based recommendation for adults aged ≥50 years should be considered in order to optimise the impact of pneumococcal vaccination programmes in Canada.
Prognostic value of von Willebrand factor in adult patients with congenital heart disease
Authors: Ohuchi Hideo , Hayama Yohsuke , Miike Hikari , Suzuki Dai , Nakajima Kimiko , Iwasa Toru , Konagai Nao , Sakaguchi Heima , Miyazaki Aya , Shiraishi Isao , Kurosaki Ken-ichi , Nakai Michikazu 
Published: March 2020

Objectivesvon Willebrand factor (vWF) has prognostic value in patients with heart failure (HF) and in those with liver disease. Liver congestion, due to right-sided HF (RHF), is one of the major clinical pathophysiologic manifestations in adults with congenital heart disease (ACHD). The present study’s purpose was to clarify the prognostic value of plasma levels of vWF antigen (vWF:Ag) in ACHD.MethodsWe measured vWF:Ag (%) in 382 consecutive patients (20 unrepaired cyanotic ACHD, 172 Fontan patients and 190 ACHD after biventricular repair) and compared the results with the clinical profiles and prognosis.ResultsThe plasma vWF:Ag level was 130±53 (normal range: 55%–190%), and 48 patients (13%) showed high levels of vWF:Ag (≥190%). Older age, Fontan circulation, higher central venous pressure, lower arterial oxygen saturation and lower plasma levels of albumin were independently associated with high log (vWF:Ag) (p<0.05–0.0001). During the follow-up of 2.4±1.4 years, 15 patients died. High log (vWF:Ag) predicted the all-cause mortality (HR 1.63 per 0.1, 95% CI 1.40 to 1.96, p<0.0001). Specifically, patients with high vWF:Ag (≥165%) had a substantially higher risk of all-cause mortality (HR 56.4, 95% CI 11.4 to 1020, p<0.0001), and this prognostic value was independent of plasma levels of brain-type natriuretic peptide.ConclusionsHigh vWF:Ag may reflect RHF severity and related liver dysfunction with a strong prognostic value of all-cause mortality in ACHD. Thus, vWF:Ag might be an excellent biomarker for monitoring ACHD with RHF.