bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes of gut microbiota during silybin‐mediated treatment of high‐fat diet‐induced non‐alcoholic fatty liver disease in mice
Authors: Li Xiuxia , Wang Yanping , Xing Yilan , Xing Renxin , Liu Yongsheng , Xu Yinsheng 
Published: October 2019

AimGut microbiota are involved in the pathogenesis of non‐alcoholic fatty liver disease (NAFLD). Silybin (Sil), a naturally occurring hepatoprotective agent, is widely used for treating NAFLD. Whether Sil affects gut microbiota during its actions in treating NAFLD is unknown. We aimed to examine the effect of Sil on intestinal flora dysbiosis induced by a high‐fat diet (HFD).MethodsAfter 10 weeks of feeding normal chow diet or HFD, mice were given a daily gavage for 8 weeks. Cecal contents were harvested for study of short‐chain fatty acids, bile acids, and gut microbiota alteration.ResultsSil showed protective effects against dietary‐induced obesity and liver steatosis; accordingly, gut microbiota composition changed. At the phylum level, compared with the HFD group, mice in the Sil‐treated group had significantly lower levels of Firmicutes, and the ratio of Firmicutes‐to‐Bacteroidetes was lower (P < 0.05). At the genus level, the Sil‐treated group have significantly lower levels of Lachnoclostridium, Lachnospiraceae_UCG‐006, and Mollicutes_RF9, which were reported to be potentially related to diet‐induced obesity, and increased levels of Blautia (P < 0.05), Akkermansia (P < 0.05), and Bacteroides (P < 0.05), which are known to have a beneficial effect on improving NAFLD. Sil also showed an inhibitory effect on well‐known beneficial bacteria, such as Alloprevotella and Lactobacillus. Furthermore, the production of acetate, propionate, and butyrate increased, whereas the generation of formate and conversion of cytotoxic secondary metabolites (lithocholic acid and deoxy‐cholic acid) decreased in mice treated with Sil.ConclusionsSil might have beneficial effects on ameliorating NAFLD and mediating HFD‐induced change of gut microbiota composition, followed by major changes in secondary metabolites, such as short‐chain fatty acids and bile acids.
Preferences for interventions designed to increase cervical screening uptake in non‐attending young women: How findings from a discrete choice experiment compare with observed behaviours in a trial
Authors: Campbell Helen E. , Gray Alastair M. , Watson Judith , Jackson Cath , Moseley Carly , Cruickshank Margaret E. , Kitchener Henry C. , Rivero‐Arias Oliver 
Published: October 2019

AbstractBackgroundYoung women’s attendance at cervical screening in the UK is continuing to fall, and the incidence of invasive cervical cancer is rising.ObjectivesWe assessed the preferences of non‐attending young women for alternative ways of delivering cervical screening.DesignPostal discrete choice experiment (DCE) conducted during the STRATEGIC study of interventions for increasing cervical screening uptake. Attributes included action required to arrange a test, location of the test, availability of a nurse navigator and cost to the National Health Service.Setting and participantsNon‐attending young women in two UK regions.Main outcome measuresResponses were analysed using a mixed multinomial logit model. A predictive analysis identified the most preferable strategy compared to current screening. Preferences from the DCE were compared with observed behaviours during the STRATEGIC trial.ResultsThe DCE response rate was 5.5% (222/4000), and 94% of respondents agreed screening is important. Preference heterogeneity existed around attributes with strong evidence for test location. Relative to current screening, unsolicited self‐sampling kits for home use appeared most preferable. The STRATEGIC trial showed this same intervention to be most effective although many women who received it and were screened, attended for conventional cytology instead.ConclusionsThe DCE and trial identified the unsolicited self‐sampling kit as the most preferred/effective intervention. The DCE suggested that the decision of some women receiving the kit in the trial to attend for conventional cytology may be due to anxieties around home testing coupled with a knowledge that ignoring the kit could potentially have life‐changing consequences.
Does asymptomatic bacteriuria affect the response to intravesical bacillus Calmette–Guérin?
Authors: Herr Harry 
Published: October 2019

ObjectiveTo determine the initial response to intravesical bacillus Calmette–Guérin and the 3‐year recurrence rate of high‐risk non‐muscle‐invasive bladder cancer in patients who have asymptomatic bacteriuria.MethodsResponse and recurrence rates were investigated in 505 patients with high‐risk non‐muscle‐invasive bladder cancer after treatment with induction bacillus Calmette–Guérin (TICE strain) therapy. Initial response was determined after 3 months and patients were followed every 3–6 months for 3 years. Before bacillus Calmette–Guérin and each follow‐up cystoscopy, urine cultures were obtained, stratified as no growth, <104, >104 or >105 colony‐forming unit/mL. Any degree of bacteriuria on culture was classified as asymptomatic bacteriuria.ResultsOf the 505 cases, 270 (53%) had asymptomatic bacteriuria. A total of 89% of patients with asymptomatic bacteriuria showed a complete response to bacillus Calmette–Guérin versus 76% of uninfected patients (P = 0.001), and 75% of bacteriuric patients survived tumor‐free for 3 years versus 65% of uninfected patients.ConclusionsChronic bacteriuria might enhance the response of high‐risk non‐muscle‐invasive bladder cancer to intravesical bacillus Calmette–Guérin and result in longer tumor‐free survival than uninfected patients.
Goals of care conversations and documentation in patients triggering medical emergency team calls
Authors: Kerkham Telena , Brain Matthew 
Published: October 2019

AbstractBackgroundIt is widely accepted that early discussions about goals of care (GOC) should occur during a hospital admission. Whilst rapid response systems such as Medical Emergency Team (MET) calls were designed to identify patients at risk of deterioration early enough in their illness to intervene, it is becoming apparent that these teams frequently diagnose the dying patient.AimsTo determine how frequently Launceston General Hospital MET doctors are involved in discussions surrounding GOC.MethodsA retrospective audit of all MET calls and Code Blues at the Launceston General Hospital over an 18 month period was performed.Results50% of MET calls occurred in patients with no valid GOC form completed prior. At 3% of events, the GOC form was completed for the first time, and at 3% it was modified. At a further 3% the notes implied there had been a modification to the GOC but the form had not been completed.ConclusionsThis audit confirms that documentation surrounding GOC is inadequate, and that at 9% of MET calls, MET doctors are involved in discussions surrounding treatment limitations. This suggests that further education and training is required for doctors working in inpatient care, including those who staff the MET.
Tocilizumab therapy in rheumatoid arthritis with interstitial lung disease: a multicentre retrospective study
Authors: Manfredi Andreina , Cassone Giulia , Furini Federica , Gremese Elisa , Venerito Vincenzo , Atzeni Fabiola , Arrigoni Eugenio , Della Casa Giovanni , Cerri Stefania , Govoni Marcello , Petricca Luca , Iannone Florenzo , Salvarani Carlo , Sebastiani Marco 
Published: October 2019

AbstractBackgroundInterstitial lung disease (ILD) is the most severe extra‐articular manifestation of rheumatoid arthritis (RA). Although it is responsible of 10–20% of all RA mortality, no controlled studies are available for the treatment of RA‐ILD and its therapeutic approach is still debated.AimsTo analyse the evolution of ILD in a population of RA patients treated with tocilizumab (TCZ).MethodsIn this national multicentre study, we retrospectively collected patients with RA‐ILD treated with at least one dose of TCZ. For each patient, disease activity and serological data were evaluated. Moreover, we analysed the evolution of high‐resolution computed tomography (HRCT) and pulmonary function tests, including forced vital capacity (FVC) and diffusing capacity of the lung for carbon monoxide (DLCO).ResultsTwenty‐eight RA‐ILD patients were identified (females/males 18/10, mean age 61.6 years), with a mean follow up for TCZ therapy of 30 months. At the end of follow up, FVC remained stable in 14 (56%) patients, improved in 5 (20%) and worsened in 6 (24%). DLCO remained stable in 14 (56%) patients, improved in 5 (20%) and worsened in 6 (24%), even though in 3 patients DLCO and FVC showed an opposite trend. HRCT remained stable in the majority (25) of cases, worsened in two patients with a usual interstitial pneumonia pattern and improved in only one case with a non‐specific interstitial pneumonia pattern.ConclusionsThe management of RA‐ILD patients remains a critical unmet need. TCZ demonstrated a good safety profile in patients with RA‐ILD and a potential effect on the stabilisation of lung involvement.
Clinical relevance of bilateral pleural effusion in patients with acute pulmonary embolism
Authors: Levy Ofer , Fux Daniel , Bartsikhovsky Tetiana , Vosko Sergei , Tishler Moshe , Copel Laurian 
Published: October 2019

AbstractBackgroundThe clinical relevance of bilateral pleural effusion (BPE) in patients with acute pulmonary embolism (PE) is unclear.AimsTo describe characteristics of patients with acute PE that present with BPE.MethodsPatients with acute PE were retrospectively analysed and divided into three groups: without pleural effusion, unilateral pleural effusion and bilateral effusion. Clinical, laboratory and radiological characteristics were compared between the three groups.ResultsThe study population (n = 343) consisted of unilateral effusion group (n = 83), BPE group (n = 94) and without effusion group (n = 166). Several variables were noted in higher proportion (%), in the BPE group in comparison to both the unilateral effusion and without effusion groups: heart failure (17.0 vs 7.2 vs 6.7, P = 0.017), hypoalbuminaemia (59.3 vs 39.5 vs 25.6, P ˂ 0.001), PE occurrence in‐hospital setting (51 vs 25.6 vs 15.1, P ˂ 0.001), major operation (31 vs 19.2 vs 15.2, P = 0.01) and mechanical ventilation (13.0 vs 4.9 vs 4.2, P = 0.019). Norton scale scores were found to be lower among patients with BPE in comparison to both patients with unilateral and without pleural effusion (15.55 vs 16.92 vs 17.36, P = 0.006). After adjusting confounding variables, patients with BPE have lower probability for in‐hospital survival in comparison to both patients with unilateral pleural effusion (odds ratio = 0.30, 95% confidence interval 0.12–0.79), and patients without pleural effusion (odds ratio = 0.26, 95% confidence interval 0.11–0.61).ConclusionsBPE in patients with acute PE may have significant clinical implications. It may signify serious underlying comorbidities which contribute to higher in‐hospital mortality in comparison to both patients with unilateral pleural effusion and patients without pleural effusion.
Long‐term care nurses’ attitudes and the incidence of voluntary stopping of eating and drinking: A cross‐sectional study
Authors: Stängle Sabrina , Schnepp Wilfried , Büche Daniel , Fringer André 
Published: October 2019

AbstractAimsTo assess the incidence of voluntary stopping of eating and drinking (VSED) in long‐term care and to gain insights into the attitudes of long‐term care nurses about the VSED.DesignA cross‐sectional study.MethodsHeads of Swiss nursing homes (535; 34%) answered the Online‐Survey between June – October 2017, which was evaluated using descriptive data analysis.ResultsThe incidence of patients who died in Swiss nursing homes by voluntarily stopping eating and drinking is 1.7% and 67.5% of participants consider this phenomenon highly relevant in their daily work. Most participants (64.2%) rate VSED as a natural death accompanied by health professionals and patients are also granted the right to care (91.9%). This phenomenon is expected by the participants less at a young age and more in old age.ConclusionParticipants’ overall views on the VSED are very positive, whereas it is assumed that VSED is a phenomenon of old age. Professionals still lack sufficient knowledge about this phenomenon, which could be clarified through training.ImpactVoluntary stopping of eating and drinking is much discussed interprofessional, but there is a lack of knowledge on how this is perceived in the context of long‐term care and about the incidence of the phenomenon. Voluntary stopping of eating and drinking is rare but noticeable end‐of‐life practises that is considered by professionals to be mainly dignified and peaceful, although moral concerns make it difficult to accompany. These findings call on long‐term care institutions to discuss VSED as an end‐of‐life practice. Positioning on the issue provides clarity for staff and patients and promotes to develop standardized care.International Registered Report Identifier (IRRID): DERR1‐10.2196/10358.
Haemin pre‐treatment augments the cardiac protection of mesenchymal stem cells by inhibiting mitochondrial fission and improving survival
Authors: Deng Rui , Liu Yaming , He Haiwei , Zhang Hao , Zhao Chenling , Cui Zhen , Hong Yimei , Li Xin , Lin Fang , Yuan Dongsheng , Liang Xiaoting , Zhang Yuelin 
Published: October 2019

AbstractThe cardiac protection of mesenchymal stem cell (MSC) transplantation for myocardial infarction (MI) is largely hampered by low cell survival. Haem oxygenase 1 (HO‐1) plays a critical role in regulation of cell survival under many stress conditions. This study aimed to investigate whether pre‐treatment with haemin, a potent HO‐1 inducer, would promote the survival of MSCs under serum deprivation and hypoxia (SD/H) and enhance the cardioprotective effects of MSCs in MI. Bone marrow (BM)‐MSCs were pretreated with or without haemin and then exposed to SD/H. The mitochondrial morphology of MSCs was determined by MitoTracker staining. BM‐MSCs and haemin‐pretreated BM‐MSCs were transplanted into the peri‐infarct region in MI mice. SD/H induced mitochondrial fragmentation, as shown by increased mitochondrial fission and apoptosis of BM‐MSCs. Pre‐treatment with haemin greatly inhibited SD/H‐induced mitochondrial fragmentation and apoptosis of BM‐MSCs. These effects were partially abrogated by knocking down HO‐1. At 4 weeks after transplantation, compared with BM‐MSCs, haemin‐pretreated BM‐MSCs had greatly improved the heart function of mice with MI. These cardioprotective effects were associated with increased cell survival, decreased cardiomyocytes apoptosis and enhanced angiogenesis. Collectively, our study identifies haemin as a regulator of MSC survival and suggests a novel strategy for improving MSC‐based therapy for MI.
Association between cancer antigen 19‐9 and diabetes risk: A prospective and Mendelian randomization study
Authors: Li Zhaoyang , Wang Jing , Han Xu , Wang Fei , Hu Hua , Yuan Jing , Yao Ping , Wei Sheng , Guo Huan , Zheng Dan , Tang Yuhan , Yang Handong , He Meian 
Published: October 2019

AbstractAims/IntroductionElevated serum cancer antigen 19‐9 (CA19‐9) levels have been found in diabetes patients in most observational studies; however, whether there is a causal association between CA19‐9 and diabetes mellitus is unclear.Materials and MethodsOur study was carried out based on the Dongfeng‐Tongji cohort comprising 27,009 individuals. We first investigated the associations between serum CA19‐9 levels and incident diabetes mellitus risk in a prospective cohort study (12,700 individuals). Then, we explored the potential causal relationship between CA19‐9 and diabetes mellitus risk in a cross‐sectional study (3,349 diabetes mellitus patients and 8,341 controls) using Mendelian randomization analysis. A weighted genetic risk score was calculated by adding the CA19‐9 increasing alleles in five single‐nucleotide polymorphisms (rs17271883, rs3760776 and rs3760775 in FUT6, rs11880333 in CA11, rs265548 in B3GNT3, and rs1047781 in FUT2), which were identified in a previous genome‐wide association study on serum CA19‐9 levels.ResultsIn the prospective study, a total of 1,004 incident diabetes mellitus patients were diagnosed during a mean 4.54‐year follow‐up period. Elevated serum CA19‐9 level was associated with a higher incident diabetes risk after adjustment for confounders, with a hazard ratio of 1.20 (95% confidence interval 1.11–1.30) per standard deviation (12.17 U/mL) CA19‐9 increase. Using the genetic score to estimate the unconfounded effect, we did not find a causal association of CA19‐9 with diabetes risk (odds ratio per weighted CA19‐9‐increasing allele: 0.99, 95% confidence interval 0.94–1.04; P = 0.61).ConclusionsThe present study did not support a causal association of serum CA19‐9 with diabetes risk. CA19‐9 might be a potential biomarker of incident diabetes mellitus risk.
Thermal habitat of adult Atlantic salmon Salmo salar in a warming ocean
Authors: Strøm John Fredrik , Thorstad Eva Bonsak , Rikardsen Audun Håvard 
Published: October 2019

AbstractThe year‐round thermal habitat at sea for adult Atlantic salmon Salmo salar (n = 49) from northern Norway was investigated using archival tags over a 10 year study period. During their ocean feeding migration, the fish spent 90% of the time in waters with temperatures from 1.6–8.4°C. Daily mean temperatures ranged from −0.5 to 12.9°C, with daily temperature variation up to 9.6°C. Fish experienced the coldest water during winter (November–March) and the greatest thermal range during the first summer at sea (July–August). Trends in sea‐surface temperatures influenced the thermal habitat of salmon during late summer and autumn (August–October), with fish experiencing warmer temperatures in warmer years. This pattern was absent during winter (November–March), when daily mean temperatures ranged from 3.4–5.0°C, in both colder and warmer years. The observations of a constant thermal habitat during winter in both warmer and colder years, may suggest that the ocean distribution of salmon is flexible and that individual migration routes could shift as a response to spatiotemporal alterations of favourable prey fields and ocean temperatures.
Potential for children with intellectual disability to engage in cognitive behaviour therapy: the parent perspective
Authors: Hronis A. , Roberts R. , Roberts L. , Kneebone I. 
Published: October 2019

AbstractBackgroundThis study aimed to obtain the opinions of parents and carers of children with intellectual disability (ID) as to whether cognitive behaviour therapy (CBT) could be useful for their children.MethodsA mixed qualitative and quantitative method was employed. Twenty‐one carers of children aged 10 to 17 having borderline to moderate intellectual functioning responded to an online questionnaire. Participants were provided with information about CBT and asked to respond to open‐ended questions. Quantitative data pertained to questions about their child's ability to identify and describe thoughts, feelings and behaviours. Thematic analysis of responses was conducted using an inductive method of identifying themes from the qualitative data collected.ResultsFive themes emerged from the qualitative analysis: Emotional Attunement (i.e. parent's understanding and recognition of their child's emotions), Role of the Therapist (i.e. ways therapists could facilitate the intervention), Role of the Parent (i.e. ways parents could engage in the therapy process), Anticipated Obstacles (i.e. what may get in the way of the therapy) and Suggested Adaptations for Therapy (i.e. how CBT can be adapted to suit the needs of children with ID). Seventy‐six per cent agreed that their child would be able to engage in CBT with assistance.ConclusionsThe majority of parents believed that CBT is an intervention that children with ID could engage in, provided the therapy is adapted, and the therapist accommodates their needs.
Efficacy of a skin care cream with TRPV1 inhibitor 4‐t‐butylcyclohexanol in the topical therapy of perioral dermatitis
Authors: Srour Jerome , Bengel Julia , Linden Teresa , Jovanovic Zorica , Roggenkamp Dennis , Reinholz Markus , Rothenberger Christoph , Neufang Gitta , Wollenberg Andreas 
Published: October 2019

AbstractBackgroundPerioral dermatitis is a clinically distinctive reaction pattern of facial dermatitis, including redness, dryness, burning, pruritus and skin tightness. A gold standard treatment remains unclear.ObjectivesOur study evaluates the clinical value of a skin care cream with the transient receptor potential vanilloid type 1 inhibitor 4‐t‐butylcyclohexanol in POD patients over 8 weeks.MethodsThis open, unblinded 8‐week clinical trial included 48 patients. A skin care cream containing 4‐t‐butylcyclohexanol was applied over a period of 8 weeks. Standardized questionnaires were used at baseline, 4 and 8 weeks, for history documentation, objective and subjective severity scores, and quality of life assessments. Six different skin physiology parameters were assessed at all timepoints.ResultsThe perioral dermatitis severity score decreased significantly during the treatment period. This was mirrored by significantly lower patients’ subjective numerical rating score and an improved quality of life score. Transepidermal water loss, stratum corneum hydration and skin erythema improved significantly during the treatment period.ConclusionThis transient receptor potential vanilloid type 1 inhibitor‐based skin care cream improved subjective and objective parameters of perioral dermatitis. Decreased transepidermal water loss values and increased stratum corneum hydration demonstrate a restored skin barrier function. Consequently, the topical inhibition of these receptors is a promising management option for POD.
A secondary discoid lupus erythematosus induced by scald of edible oil: An illustration of Koebner phenomenon
Authors: Ji Yong‐Zhi , Mei Xiang‐Lin , Wei Fang‐Li , Liu Shi‐Rui , Ji You‐Bo 
Published: October 2019

AbstractBackgroundDiscoid lupus erythematosus (DLE) is a most well‐known clinical variation of chronic cutaneous lupus erythematosus inside the spectrum of lupus erythematosus (LE). Cutaneous trauma remains a significant and peculiar causative factor for DLE.AimsWe present a case wherein the patient demonstrated unilateral distribution of DLE on a clinically normal appearing occult facial scald of edible oil, representing Koebner phenomenon (KP) i.e. occurrence of a new skin disease at the site of an unrelated and already healed one.Patient/MethodsThe 53 years old female patient was unique because she experienced DLE on the nasal back.ResultsThe injury was totally settled following a month treatment of oral hydroxychloroquine and topical 0.03% tacrolimus ointment. After three months, she encountered an accidental edible oil scald on the right upper cheek. Several small vesicles appeared on a soybean‐sized erythema base with a burning sensation.ConclusionWe review the literature and conclude by discussing important histologic highlights to think about while endeavoring to perceive the fundamental character and pathogenicity of such sores.