bluuebunny/crossref_metadata_2025_split huggingface dataset:
Care after pancreatic resection according to an algorithm for early detection and minimally invasive management of pancreatic fistula versus current practice (PORSCH-trial): design and rationale of a nationwide stepped-wedge cluster randomized trial
Authors: Smits Francina J , Henry AC , Eijck CH van , Besselink MG , Busch OR , Arntz M , Bollen TL , Delden OM van , Heuvel D van den , Leij C van der , Lienden KP van , Moelker A , Bonsing BA , Rinkes IHM Borel , Bosscha K , Dam RM van , Festen S , Koerkamp B Groot , Harst E van der , de Hingh I , Kazemier G , Liem M , Kolk BM van der , de Meijer VE , Patijn GA , Roos D , Schreinemakers JM , Wit F , Werkhoven CH van , Molenaar IQ , Santvoort HC van 
Published: February 2020

Abstract
Background Pancreatic resection is a major abdominal operation with 50% risk of postoperative complications. A common complication is pancreatic fistula, which may have severe clinical consequences such as postoperative bleeding, organ-failure and death. The objective of this study is to investigate whether implementation of an algorithm for early detection and minimally invasive management of pancreatic fistula may improve outcomes after pancreatic resection.

Methods This is a nationwide stepped-wedge, cluster randomized, superiority trial, designed in adherence to the CONSORT guidelines. During a period of 22 months, all Dutch centers performing pancreatic surgery will cross over in a randomized order from current practice to best practice according to the algorithm. This evidence- and consensus based algorithm will provide daily multilevel advice on the management of patients after pancreatic resection (i.e. indication for abdominal imaging, antibiotic treatment, percutaneous drainage and removal of abdominal drains). The algorithm is designed to aid early detection and minimally invasive step-up management of postoperative pancreatic fistula. Outcomes of current practice will be compared with outcomes after implementation of the algorithm. The primary outcome is a composite of major complications (i.e. postpancreatectomy bleeding, new-onset organ failure and death) and will be measured in a sample size of at least 1600 patients undergoing pancreatic resection. Secondary endpoints include the individual components of the primary endpoint and other clinical outcomes, healthcare resource utilization and costs analysis. Follow-up will be up to 90 days after pancreatic resection.

Discussion It is hypothesized that a structured nationwide implementation of a dedicated algorithm for early detection and minimally invasive step-up management of postoperative pancreatic fistula will reduce the risk of major complications and death after pancreatic resection, as compared to current practice.
Culture of 16HBE14o- Cells
Authors: McNabb Nicole A. , McCullough Shaun D. 
Published: February 2020

Abstract
This protocol describes the thawing, culturing, and cryopreservation of the human bronchial epithelial cell line 16HBE14o- (referred to as “16HBE”). The attached methods document is a formal version of the information included here. The attached worksheet is a fillable PDF that can be used to maintain cell passage records using this protocol.Please note: Deviation from the three-day passage cycle and cell plating density described here typically results in greater culture and experimental variability.Disclaimer: The contents of this article have been reviewed by the US Environmental Protection Agency and approved for publication and do not necessarily represent Agency policy. Mention of trade names or commercial products does not constitute endorsement or recommendations for use.
Measurement of Trans-Epithelial Electrical Resistance with EVOM2 and Chopstick Electrode
Authors: McCullough Shaun D. 
Published: February 2020

Abstract
Trans-epithelial Electrical Resistance (TEER) can be used as a measure of cell monolayer confluence, health, and integrity. An Epithelial Voltohmmeter (EVOM) is used to take TEER measurements. This method details how to take TEER readings using an EVOM with chopstick electrode.Please note that chopstick electrodes are only designed for use with 12 mm inserts.Disclaimer: The contents of this article have been reviewed by the US Environmental Protection Agency and approved for publication and do not necessarily represent Agency policy. Mention of trade names or commercial products does not constitute endorsement or recommendations for use.
Comparisons of Social and Demographic Determinants of Tobacco Use in the Democratic Republic of the Congo
Authors: Colwell Brian , Mosema Kizito , Bramble Matthew S. , Maddock Jay 
Published: February 2020

Abstract
Background Worldwide, tobacco use has caused over 100 million deaths in the twentieth century and is projected to cause death in up to one billion people in the twenty-first century. It is a leading cause of early death and disability in over 100 countries and accounts for over 11% of global deaths, disproportionately affecting low- and middle-income countries. The purpose of the study was to examine a variety of social determinants of tobacco use in the Democratic Republic of the Congo, including region, sex, ethnicity, education, literacy, wealth index and place of residence, to gain insights with regard to tobacco use among sub-national groups. Methods This project was a secondary data analysis of the 2013-2014 Demographics and Health Survey (DHS) for the Democratic Republic of the Congo. Logistic regressions predicting smoking, use of snuff and smoking cigars or natural tobacco as dichotomous variables were conducted. Independent variables included age, educational level, religion, rurality, literacy, wealth index, occupation and ethnicity. Results Tobacco use is highest among those with less education and low literacy. It was also highest among the working poor. Older age predicted smoking, as did living in small towns or the countryside, although the relationship between age and smoking was not linear. There was a strong linear effect for wealth. Being in a professional, technical or managerial position was highly protective against smoking while being engaged in services, skilled and unskilled manual labor, and the army had significantly greater odds of smoking. Conclusions Data indicate that tobacco use in the DRC, as is common in the developing world, is heavily concentrated in the working poor with lower educational status. Higher educational status is consistently predictive of avoiding tobacco use. Additionally, examining only national-level data to ascertain tobacco use levels and patterns may lead to mistaken conclusions that can lead to inefficient and ineffective allocation of resources aimed at controlling tobacco use.
Spirulina platensis enhances immune status, inflammatory and oxidative markers of HIV patients on antiretroviral therapy in Cameroon
Authors: Moor Vicky Jocelyne Ama , Anatole Pieme Constant , Nkeck Jan René , Nya Prosper Cabral Biapa , Mondinde Georges Ikomey , Kouanfack Charles , Assoumou Marie Claire Okomo , Ngogang Jeanne 
Published: February 2020

Abstract
Background Spirulina platensis is traditionally used as a food supplement with a potential strengthening of the immune system, inhibition of the replication of some viruses, and lipid-lowering effect. The aim of this study was to determine its effect on the inflammatory, immunological, and oxidative status of HIV patients on antiretroviral therapy (ART). Methods We performed a study on 62 HIV patients on ART (Tenofovir-Lamivudine-Efavirenz) divided into 2 groups. Group I, supplemented with 10 grams of Spirulina platensis daily, and group II only ART. Participants were paired on ART duration and followed-up for 6 months from December 2015 to June 2016 at the HIV care unit of the Yaounde Central Hospital and the Cité-Verte Hospital, Yaounde. Each group was sampled for CD4-count, viral load, serum levels of interleukins 6 and 8, TNFα and oxidative markers (malondialdehyde, FRAP, catalase, total peroxides, superoxide dismutase, glutathione peroxidase, reduced glutathione) at the beginning (T0) and the end of the trial (T1). Ethical clearance was obtained from the Cameroon National Ethics Committee for Human Health and Research (Ref 2016/01/699/CE/CNERSH/SP). Statistical analysis was performed using the software SPSS 21.0. The threshold of significance was set at 0.05. Results Mean ages of participants were 35 ± 8 and 37 ± 7 respectively for group I and II. We observed a significant decrease in viral load in patients receiving spirulina comparing at T0 and T1 (p = 0.001), not observed for participants in group II (p>0.05). CD4-counts were unchanged. There was a significant reduction of TNFα levels in group 1. The levels of pro-oxidative markers were significantly reduced in group 1 while increased in the other group. Antioxidant levels significantly increased in both groups. Conclusion Daily supplementation of Spirulina platensis could improve the immune status of HIV patients on ART, and decrease inflammatory and pro-oxidant levels.
Antimicrobial practices among small animal veterinarians in Greece: a survey
Authors: Valiakos George , Pavlidou Eleni , Zafeiridis Christos , Athanasakopoulou Zoi , Tsokana Constantina N , Vilas Victor J Del Rio 
Published: February 2020

Abstract
Background The inappropriate use of antibiotics is a major issue in clinical practice in Greece with serious implications for public health and animal health. The purpose of the present study was to provide a first insight into the use of antibiotics by small animal practitioners in Greece and assess their compliance with general rules for the rational use of antibiotics. This is the first survey of its kind in Greece. Methods A questionnaire was designed to collect basic information on the use of antibiotics by pet veterinarians. The questionnaire was sent to a total of 70 veterinarians mainly operating in the region of Attica, a region that comprises almost 50% of the Greek population and where veterinarians are engaged solely in small animal practice. The questionnaire consisted of 37 closed questions dealing with various aspects on the use of antibiotics. Results The majority of respondents’ report cases where the pet owner initiated antibiotic treatment without veterinary prescription. Almost every clinician reported owner-compliance challenges. Regarding microbiological analysis, 73% of respondents prefer to adopt the empirical treatment while waiting the laboratory results or use antibiogram only when the treatment is unsuccessful. Eighty-eight per cent declared to use antimicrobials postoperatively in clean surgical procedures. Different types of antimicrobials and treatment durations than the ones proposed by guidelines on rational use of antibiotics are preferred for various organ systems e.g. in urinary and gastrointestinal infections. Conclusions Our findings suggest the need for guidelines on antibiotic use in small animal practice in Greece, and the deployment of systematic surveillance on antimicrobials use and resistance to inform the initial choice of antibiotics upon local antimicrobial resistance profiles. Targeting the other end of the problem, pet owners, our findings indicate the need to educate them on the rational use of antibiotics and, critically, stop antibiotic availability without prescription.
Photodegradation kinetics of alkyd paints: the influence of varying amounts of inorganic pigments on the stability of the synthetic binder
Authors: Pagnin Laura , Wiesinger Rita , Schreiner Manfred 
Published: February 2020

Abstract
Nowadays, understanding the degradation processes of artworks exposed to outdoor conditions is essential in order to conserve these objects. In fact, the continuous climate changes risk to increasingly affecting their chemical-physical stability, especially for modern and contemporary ones. For this purpose, in this study, the kinetics of photo-oxidation processes occurring in synthetic binders and their stability in mixtures with different inorganic pigments were investigated. The aim was not only to characterize the different degradation reactions over time but to study the photodegradation kinetics according to the different pigments and pigment/binder ratio (P/BM) chosen. A total of 9 paint samples were prepared by mixing the inorganic pigments (artificial ultramarine blue, hydrated chromium oxide green, and cadmium yellow) with alkyd resin, in three different pigment/binder (P/BM) ratios: 1:2, 1:3, and 1:6. The paint samples were exposed to artificial sunlight for up to 1008 h, documented by optical 3D microscopy and analysed by Infrared Spectroscopy (ATR-FTIR) and colourimetry every 168 hours. The results obtained demonstrate that the degradation processes of alkyd resin are influenced by the different inorganic pigment used and its amount/concentration in the mixtures. Evaluation of these different deterioration mechanisms took into account the morphological/colour changes, the chemical reactions, and the physical properties of the materials. This study should contribute to the field of conservation-restoration, such as finding protection strategies for surfaces from degradation agents.
District-level differentiated HIV testing strategies are needed to achieve the 1st 90 in Zimbabwe
Authors: Makurumidze Richard , Decroo Tom , Lynen Lutgarde , Chinwadzimba Zororo Kudzaishe , Damme Wim Van , Hakim James , Rusakaniko Simbarashe 
Published: February 2020

Abstract
Objective Despite the improvement towards the 90-90-90 targets, more than 25% of people living with HIV in Zimbabwe still do not know their HIV status. We used data from a recently published survey to recommend district-level HIV testing strategies based on HIV prevalence and antiretroviral therapy coverage to implementers and policy makers. Results Of the 62 districts in Zimbabwe 38% were in the low HIV prevalence /low antiretroviral therapy coverage, 34% in low HIV prevalence /high antiretroviral therapy coverage, 15% in high HIV prevalence/high antiretroviral therapy coverage and 13% in high HIV prevalence/low antiretroviral therapy coverage categories. Districts with low HIV prevalence and low antiretroviral therapy coverage should employ targeted HIV testing approaches (index case testing, targeting sexual partners and HIV exposed infants; intensified provider initiated testing; key populations and hot spots). Those with high HIV prevalence and low antiretroviral therapy coverage should focus on expanding access to HIV testing to the community. Districts with already high antiretroviral therapy coverage should move to targeted HIV testing so that the few yet to be tested are reached. Further exploration to assess other contextual factors in the cascade of care beyond HIV testing is warranted to achieve the 90-90-90 strategies.
Association between socioeconomic status and fertility among adolescents aged 15 to 19: An analysis of the 2013/2014 Zambia Demographic Health Survey (ZDHS)
Authors: Munakampe Margarate Nzala , Fwemba Isaac , Zulu Joseph Mumba , Michelo Charles 
Published: February 2020

Abstract
BackgroundAdolescents face significant barriers to access and utilization of sexual and reproductive health services in many low-income settings which in turn may be associated with adverse consequences such as early pregnancy, sexually transmitted infections and unsafe abortion and mortality. There is evidence suggesting that limited access to sexual and reproductive health information and services among adolescents contribute to these outcomes. We aimed to find out the factors that affect the fertility of adolescents aged 15 to 19 years in Zambia and to identify possible drivers of adolescents’ fertility. Methods Secondary analysis of the ZDHS 2013/14 data was carried out to find out the factors that affect the fertility rate of adolescents aged 15 to 19 years using multivariate logistic regression (n=3,666). Results Overall, 23.1% of adolescents had given birth at least once in the five years leading to the survey (n= 3,666, 99.4% response), and 49.8% were rural-based while 50.2% were urban-based. The median number of schooling was 8 years (IQR= 6-10). About 52% of the adolescents were in the poorer, poor and medium wealth quintiles while the other 48% were in the rich and richer quintiles. Factors found to affect fertility include residence, wealth status, educational attainment, marriage and abortion. An urban-based adolescent with a lower socioeconomic status was 2.4 times more likely to give birth compared to rural-based poorer adolescents (95% CI 1.5, 3.7 p<0.001). Although odds of giving birth were much higher among rural married adolescents (aOR 8.0, 95%CI 8.0, 5.4, 11.9 p<0.001) compared to urban married adolescents (aOR 5.5, 95%CI 8.3, 16.0, p<0.001), and these relationship were both statistically significant. Higher educational attainment (aOR 0.7 95% CI 0.6, 0.8 p<0.001) and abortion (aOR 0.3 95% CI 0.1, 0.8 p=0.020) reduced these odds, particularly for rural-based adolescents. Conclusion Despite response aimed at reducing adolescent fertility, low wealth status, low educational attainment and early marriage remain significant drivers of adolescent fertility in Zambia. There is a need to address access to sexual and reproductive health needs of urban adolescents with a lower socioeconomic status.
Associations between infant and young child feeding practices and diarrhoea in Indian children: a regional analysis
Authors: Dhami Mansi Vijaybhai , Ogbo Felix Akpojene , Diallo Thierno , Agho Kingsley 
Published: February 2020

Abstract

Background: There are limited data on the association between infant and young child feeding (IYCF) practices and diarrhoea across regional India, to inform policy initiatives and advocacy. The present study examined the association between IYCF practices and diarrhoea in regional India. Method: The study used a weighted sample of 90,596 maternal responses from the 2015-16 National Family Health Survey in India. Prevalence estimates of diarrhoea by IYCF indicators were estimated for each administrative region, namely: North (n=11,200), South (n=16,469), East (n=23,317), West (n=11,512), Central (n=24,870) and North-East (n=3,228). Multivariate logistic regressions that adjust for clustering and sampling weights were used to investigate the association between IYCF and diarrhoea in regional India. The IYCF indicators include early initiation of breastfeeding, exclusive breastfeeding (EBF), predominant breastfeeding, bottle feeding, continued breastfeeding at one year, continued breastfeeding at two years, children ever breastfed and the introduction of solid, semi-solid or soft foods. Results: The prevalence of diarrhoea was lower among infants and young children who were breastfed within 1-hour of birth and those who were exclusively breastfed. Children whose mothers continued breastfeeding at one and two years, and infants who were introduced to complementary foods had a higher prevalence of diarrhoea. Early initiation of breastfeeding and EBF were protective against diarrhoea in the North, East and Central regions of India. However, predominant breastfeeding, bottle-feeding and introduction of complementary foods were risk factors for diarrhoea in Central India. Continued breastfeeding at two years was a risk factor for diarrhoea in Western India. Conclusion: Our study suggests that early initiation of breastfeeding and EBF were protective against diarrhoea in Northern, Eastern and Central India, while predominant breastfeeding, bottle feeding, continued breastfeeding at two years and introduction of solid, semi–solid or soft foods were risk factors for diarrhoea in various India regions. Improvements in IYCF practices are likely to reduce the burden of diarrhoea-related morbidity and mortality across India regions.
How does the self-reported health of undergraduate nursing students change during their degree programme? Survey results from a Scottish University
Authors: Evans Josie , Andreis Federico , Cameron Dawn M , Eades Claire E 
Published: February 2020

Abstract
Background The lifestyle behaviours, and the physical and mental health of nurses, are poorer than those of other allied health professionals, and of the general population. However, these were no less favourable among first year undergraduate nursing students at a Scottish Higher Education Institution (HEI) than among similar people of the same age. We compared health and health behaviours among the same cohort of undergraduate nursing students over the course of their degree. Methods An anonymous self-complete repeat cross-sectional survey was administered during a timetabled teaching session at three time-points to undergraduate nursing students at the start of Years 1, 2 and 3 of their programme. They had received written information about the study previously. Results Self-reported health did not change significantly over time, but there was a clear decline over the three years in the proportions of students rating their mental health as excellent/very good/good and a concomitant increase in those rating their mental health as fair/poor. Correspondingly, the mean WEMWBS wellbeing score declined over the three years, with the proportion of students with a score of <46 (indicating either high risk of major depression, or in high risk of psychological distress and increased risk of depression) increasing from one quarter to one half. This effect was captured and described using a Bayesian regression analysis. The most noticeable change in health behaviours was a decline in physical activity levels over the study period. The proportion of students managing 150 minutes of weekly physical activity decreased from three quarters to two thirds. This was reflected in higher self-reported sedentary time, although there were no observable trends over time in mean BMI, or proportions of students categorised as overweight or obese. Conclusions A clear picture emerges from this study of nursing students experiencing much poorer mental health over the course of their degree, and a decline in physical activity. The evidence suggests a need for the incorporation of regular, timetabled physical activity into nursing programmes, offering the opportunity for students to learn about health promotion and lifestyle change in practice, to improve their own physical health, and to address mental wellbeing.
Cortical potentiation induced by calcitonin gene-related peptide (CGRP) in the insular cortex of adult mice
Authors: Liu Yinlu , Chen Qi-Yu , Lee Jung Hyun , Li Xu-Hui , Yu Shengyuan , Zhuo Min 
Published: February 2020

Abstract
Recent studies demonstrate that calcitonin gene-related peptide (CGRP) plays critical roles in migraine. Immunohistochemistry and in situ hybridization studies have shown that CGRP and its receptors are expressed in cortical areas that are critical for pain perception including the anterior cingulate cortex (ACC) and insular cortex (IC). Recent studies reported that CGRP enhanced excitatory transmission in the ACC. However, little is known about the possible effect of CGRP on excitatory transmission in the IC. In the present study, we investigated the role of CGRP on synaptic transmission in the IC slices of adult male mice. Bath application of CGRP produced dose-dependent potentiation of evoked excitatory postsynaptic currents (eEPSCs). This potentiation was NMDA receptor (NMDAR) independent. After application of CGRP1 receptor antagonist CGRP8-37 or BIBN 4096, CGRP produced potentiation was significantly reduced. Paired-pulse facilitation was significantly decreased by CGRP, suggesting possible presynaptic mechanisms. Consistently, bath application of CGRP significantly increased the frequency of spontaneous and miniature excitatory postsynaptic currents (sEPSCs and mEPSCs). By contrast, amplitudes of sEPSCs and mEPSCs were not significantly affected. Finally, adenylyl cyclase subtype 1 (AC1) and protein kinase A (PKA) are critical for CGRP-produced potentiation, since both selective AC1 inhibitor NB001 and the PKA inhibitor KT5720 completely blocked the potentiation. Our results provide direct evidence that CGRP contributes to synaptic potentiation in the IC, and the AC1 inhibitor NB001 may be beneficial for the treatment of migraine in the future.