bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acceptability and tolerability of alcohol-based hand hygiene products for elderly residents in long-term care: a crossover study
Authors: O’Donoghue Margaret , Ho Jacqueline M. C. , Pittet Didier , Suen Lorna K. P. 
Published: October 2019

Abstract

Background
Hand hygiene is a critical component of infection control. Much of the focus on improving hand hygiene in healthcare settings has been directed towards healthcare worker compliance but its importance for patients, including those in long-term care facilities (LTCFs), is increasingly being recognised. Alcohol-based hand rub (ABHR) can lead to improved compliance. We aimed to determine acceptability and tolerability of two ABHRs for hand hygiene of elderly LTCF residents using a modified version of the WHO protocol.

Methods
Thirty six elderly LTCF residents participated in this crossover study. A modified and translated (Chinese) version of the WHO protocol for evaluation of two or more ABHRs was used to determine product acceptability and tolerability for one gel (bottle with reclosable cap) and one foam (pump). During the 3-day testing period, participants were provided with their own portable bottle of ABHR. A research nurse objectively assessed the skin integrity of the hands at baseline and throughout the study. Skin moisture content was determined using a Scalar Moisture Checker Probe (Science Technology Resources, Ca, USA). Participants rated ABHR tolerability and acceptability using the WHO checklist at the end of each test period.

Results
Both products passed the WHO criteria for acceptability and tolerability. The foam (86%) scored higher than the gel (51%) for ease of use possibly because some participants found the cap of the gel bottle difficult to open due to finger stiffness. No evidence of damage to skin integrity was observed. Overall, skin moisture content had improved by the end of the study. Residents preferred either of the test products to the liquid formulation currently in use by the LTCF.

Conclusions
Overall, the elderly were willing to use ABHR for hand hygiene. Both products were well tolerated and preferred over the usual product provided by the LTCF. However, forgetfulness and difficulty rubbing the product over the hands due to finger stiffness posed a challenge for some residents. This could be overcome by using healthcare worker-assisted hand hygiene at specified times each day and prompts to serve as reminders to perform hand hygiene.
Microbiota analysis optimization for human bronchoalveolar lavage fluid
Authors: Schneeberger Pierre H. H. , Prescod Janice , Levy Liran , Hwang David , Martinu Tereza , Coburn Bryan 
Published: October 2019

AbstractBackgroundIt is now possible to comprehensively characterize the microbiota of the lungs using culture-independent, sequencing-based assays. Several sample types have been used to investigate the lung microbiota, each presenting specific challenges for preparation and analysis of microbial communities. Bronchoalveolar lavage fluid (BALF) enables the identification of microbiota specific to the lower lung but commonly has low bacterial density, increasing the risk of false-positive signal from contaminating DNA. The objectives of this study were to investigate the extent of contamination across a range of sample densities representative of BALF and identify features of contaminants that facilitate their removal from sequence data and aid in the interpretation of BALF sample 16S sequencing data.ResultsUsing three mock communities across a range of densities ranging from 8E+ 02 to 8E+ 09 16S copies/ml, we assessed taxonomic accuracy and precision by 16S rRNA gene sequencing and the proportion of reads arising from contaminants. Sequencing accuracy, precision, and the relative abundance of mock community members decreased with sample input density, with a significant drop-off below 8E+ 05 16S copies/ml. Contaminant OTUs were commonly inversely correlated with sample input density or not reproduced between technical replicates. Removal of taxa with these features or physical concentration of samples prior to sequencing improved both sequencing accuracy and precision for samples between 8E+ 04 and 8E+ 06 16S copies/ml. For the lowest densities, below 8E+ 03 16S copies/ml BALF, accuracy and precision could not be significantly improved using these approaches. Using clinical BALF samples across a large density range, we observed that OTUs with features of contaminants identified in mock communities were also evident in low-density BALF samples.ConclusionRelative abundance data and community composition generated by 16S sequencing of BALF samples across the range of density commonly observed in this sample type should be interpreted in the context of input sample density and may be improved by simple pre- and post-sequencing steps for densities above 8E+ 04 16S copies/ml.
Aromatase inhibitors and risk of cardiovascular events in breast cancer patients: a systematic review and meta-analysis
Authors: He Yang , Zhang Jianhua , Shen Guofang , Liu Lin , Zhao Qingwei , Lu Xiaoyang , Yang Hongyu , Hong Dongsheng 
Published: October 2019

Abstract

Background
Cardiovascular events (CVEs) was considered as one of the primary cause to reduce the quality of life in breast cancer patients with aromatase inhibitors (AIs) treatment, which has not been sufficiently addressed. The aim of this study was to assess the correlation between risk of CVEs and AIs in patients with breast cancer.

Methods
Included studies were obtained from the databases of Embase, Pubmed, Cochrane Library, Clinical Trials.gov, and reference lists. The main outcome measures were overall incidence, odds ratios (ORs), and 95% confidence intervals (CIs). Furthermore, the association and the risk differences among different tumor types, AIs,ages,or treatment regimens were conducted. Fixed-effect or random-effect models were applied in the statistical analyses according to the heterogeneity. Our analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

Results
Seventeen studies, which included 44,411 subjects, were included in our analyses. The overall incidence of CVEs in AIs group was 13.02% (95% CI: 8.15–20.17%) and almost all of the high-grade CVEs occurred in patients treated with AIs. The pooled ORs of CVEs was 0.9940 (95% CI: 0.8545–1.1562). Under sub-group analysis, the incidence of CVEs related to exemestane was higher than that of controls (OR = 1.1564, 95% CI: 1.0656–1.2549), but no statistical differences in risk of CVEs were found in other sub-group analysis. No evidence of publication bias was found for incidence of CVEs in our meta-analysis by a funnel plot.

Conclusions
These results suggest that patients with breast cancer treated with AIs do not have a significant risk of developing CVEs in comparison with the controls, and exemestane might not be considered as the alternative AI to the breast cancer patients from the perspective of CVEs. Further studies are recommended to investigate this association and the risk differences among different tumor types, AIs or treatment regimens.
Evidence of niche differentiation for two sympatric vulture species in the Southeastern United States
Authors: Holland Amanda E. , Byrne Michael E. , Hepinstall-Cymerman Jeffrey , Bryan A. Lawrence , DeVault Travis L. , Rhodes Olin E. , Beasley James C. 
Published: October 2019

Abstract

Background
As obligate scavengers utilizing similar habitats, interspecific competition undoubtedly occurs between resident black (Coragyps atratus) and turkey (Cathartes aura) vultures. In the interest of exploring how sympatric species coexist through habitat segregation, we examined resource selection of resident black and turkey vultures in the southeastern United States (US) for evidence of niche differentiation.

Methods
Using fine-scale movement data, we assessed interspecific seasonal differences in monthly roost reuse frequency and roost site fidelity, as well as monthly flight, roost, and diurnal rest site resource selection based on > 2.8 million locations of 9 black vultures and 9 turkey vultures tracked from September 2013 to August 2015 using Groupe Spécial Mobile/Global Positioning System (GSM/GPS) transmitters.

Results
Black vultures generally exhibited greater roost fidelity as well as a greater maximum number of nights spent at a single roost than turkey vultures. Patterns of flight, roost, and resting habitat selection within the home range varied monthly as well as between species, providing evidence for habitat segregation and niche differentiation by sympatric vultures. In particular, our results indicate the importance of wooded wetlands for resting and roosting locations for both species, and revealed clear differences in the use of forested habitats between species during flight, resting, and roosting behavioral states.

Conclusions
By examining differences in resource selection and spatial ecology of black and turkey vultures across a range of behaviors, this study demonstrates mechanisms of niche differentiation in these ecologically similar species, and enhances potential for conservation and informed management of this important group of birds.
Neuropathology of RAN translation proteins in fragile X-associated tremor/ataxia syndrome
Authors: Krans Amy , Skariah Geena , Zhang Yuan , Bayly Bryana , Todd Peter K. 
Published: October 2019

Abstract
CGG repeat expansions in FMR1 cause the neurodegenerative disorder Fragile X-associated Tremor/Ataxia Syndrome (FXTAS). Ubiquitinated neuronal intranuclear inclusions (NIIs) are the neuropathological hallmark of FXTAS. Both sense strand derived CGG repeats and antisense strand derived CCG repeats support non-AUG initiated (RAN) translation of homopolymeric proteins in potentially 6 different reading frames. However, the relative abundance of these proteins in FXTAS brains and their co-localization with each other and NIIs is lacking. Here we describe rater-blinded assessment of immunohistochemical and immunofluorescence staining with newly generated antibodies to different CGG RAN translation products in FXTAS and control brains as well as co-staining with ubiquitin, p62/SQSTM1, and ubiquilin 2. We find that both FMRpolyG and a second CGG repeat derived RAN translation product, FMRpolyA, accumulate in aggregates in FXTAS brains. FMRpolyG is a near-obligate component of both ubiquitin-positive and p62-positive NIIs in FXTAS, with occurrence of aggregates in 20% of all hippocampal neurons and > 90% of all inclusions. A subset of these inclusions also stain positive for the ALS/FTD associated protein ubiquilin 2. Ubiquitinated inclusions and FMRpolyG+ aggregates are rarer in cortex and cerebellum. Intriguingly, FMRpolyG staining is also visible in control neuronal nuclei. In contrast to FMRpolyG, staining for FMRpolyA and CCG antisense derived RAN translation products were less abundant and less frequent components of ubiquitinated inclusions. In conclusion, RAN translated FMRpolyG is a common component of ubiquitin and p62 positive inclusions in FXTAS patient brains.
The national entrepreneurship framework conditions in sub-Saharan Africa: a comparative study of GEM data/National Expert Surveys for South Africa, Angola, Mozambique and Madagascar
Authors: Herrington Mike , Coduras Alicia 
Published: October 2019

Abstract
Entrepreneurship is widely argued to be critical for economic development and alleviating extreme poverty. However, entrepreneurship research in sub-Saharan Africa has not received much attention over the last few decades possibly due to a lack of sufficient resources. It is becoming increasingly important as Africa, especially sub-Saharan Africa, is developing rapidly and moving from a resource-based economy to one of innovation and progress. Using data from the Global Entrepreneurship Monitor (GEM), this paper discusses the opinions of national expert informants in Angola, Madagascar, Mozambique and South Africa and looks at the factors which are possibly hindering and inhibiting entrepreneurial development. The results indicate that there are four main inhibitors ranging from lack of access to finance, government policies, regulations and practices for entrepreneurs and the poor levels of entrepreneurship education. Some recommendations are made as to what can be done to assist in promoting economic development.
Biomechanical correlation at the knee joint between static lunge and single-leg drop landing - a comparative study among three different toe directions
Authors: Harato Kengo , Sakurai Aiko , Morishige Yutaro , Kobayashi Shu , Niki Yasuo , Nagura Takeo 
Published: October 2019

AbstractBackgroundToe direction is a critical factor affecting knee biomechanics during various movements including closed kinetic chain (CKC) exercise and landing tasks. Physiotherapists always concentrate on the control of toe direction during CKC exercise as a first step for athletes, as it is believed that correction of toe direction during CKC exercise is important to maintain the appropriate toe position even in high demanding activities such as landing tasks. The purpose of the present study was to investigate knee biomechanics during CKC exercise as well as landing tasks with three different toe directions, and clarify whether biomechanical parameters during CKC exercise would be related to those during landing tasks.MethodsA total of 23 male recreational level athletes (mean age = 20.0 ± 1.1 yrs) participated. Tegner activity score were 7 for all male subjects. First, the subjects performed weight-bearing static lunge tests (SL) under three different toe directions, including 0 degrees (Toe-neutral: TN), 20 degrees (Toe-In: TI), and - 20 degrees (Toe-out: TO). Thereafter, SLDL was done under three different toe directions. Three-dimensional knee kinematics and kinetics at 60 degrees of knee flexion were calculated. As a statistical analysis, Pearson's correlation coefficient was used to evaluate the relationship between SL and SLDL. The statistical significance level wasset atP=0.05.Results and ConclusionsKnee abduction angle showed significant correlation between SL and SLDL in all three different directions (TI: r=0.631,p<0.001, TN: r=0.678,p<0.001, TO: r=0.572,p<0.001). In terms of knee internal rotation, strong correlation was also found (TI: r=0.846,p<0.001, TN: r=0.791,p<0.001, TO: r=0.749,p<0.001). In addition, external knee abduction moment presented significant correlation in all three different directions (TI: r=0.574,p<0.001, TN: r=0.499,p<0.01, TO: r=0.469,p<0.01). From the present study, significant correlation between SL and SLDL was found in knee abduction angle, knee internal rotation, and external knee abduction moment under all three different directions including TI, TN, and TO. Physiotherapist should take care of toe direction and reform the movements especially for athletes who present malalignment of the knee joint during SL with TI or TO to prevent ACL injury in landing tasks.
Endemic plants of Crete in electronic trade and wildlife tourism: current patterns and implications for conservation
Authors: Menteli Viktoria , Krigas Nikos , Avramakis Manolis , Turland Nicholas , Vokou Despoina 
Published: October 2019

AbstractBackgroundThe island of Crete is a biodiversity hotspot having 223 endemic vascular taxa (species and subspecies) as a result of its long isolation and the wide range of habitats it includes. We explore trends and patterns in the electronic trade of these unique genetic resources and in their involvement in wildlife tourism, the ways these two activities are performed and the associated potential threats on the plants’ wild populations, and we also identify priority taxa requiring special attention. The main part of the study was conducted in 2016–2017 using English as a search language; an additional search was conducted in 2019 using German and French.ResultsWe found e-commerce for 28 (13%) endemic taxa. These are traded by 65 nurseries from 14 countries, the UK primarily. Among the traded plants, 16 face extinction risk and/or are under protection status. Prices vary largely for the same taxon and form of sale. Lamiaceae is the family with the highest number of e-traded taxa,Tulipa bakeriis the most traded species, and the living plant is the commonest form of sale. Thirty-seven endemic taxa are advertised in the websites of travel agencies involved in wildlife tourism.Tulipa doerfleriis the most frequently encountered taxon in these websites, whereas Lamiaceae, Liliaceae and Orchidaceae are similarly represented. The additional search showed a very rapid increase in the e-trade of the Cretan endemis.ConclusionThe two examined markets are similar in that geophytes play a prominent role and Lamiaceae rank first among the represented plant families, but differ in several aspects: only 22.6% of the taxa detected are common in both, obedience to rules exhibited by travel agencies is not usually the case with nurseries, and potential threats to wild populations are estimated as considerably higher for the traded plants. Sixteen endemic taxa of Crete were identified as requiring special attention.
Polyphasic taxonomy of green algae strains isolated from Mediterranean freshwaters
Authors: Lortou Urania , Gkelis Spyros 
Published: October 2019

Abstract

Background
Terrestrial, freshwater and marine green algae constitute the large and morphologically diverse phylum of Chlorophyta, which gave rise to the core chlorophytes. Chlorophyta are abundant and diverse in freshwater environments where sometimes they form nuisance blooms under eutrophication conditions. The phylogenetic relationships among core chlorophyte clades (Chlorodendrophyceae, Ulvophyceae, Trebouxiophyceae and Chlorophyceae), are of particular interest as it is a species-rich phylum with ecological importance worldwide, but are still poorly understood. In the Mediterranean ecoregion, data on molecular characterization of eukaryotic microalgae strains are limited and current knowledge is based on ecological studies of natural populations. In the present study we report the isolation and characterization of 11 green microalgae strains from Greece contributing more information for the taxonomy of Chlorophyta. The study combined morphological and molecular data.

Results
Phylogenetic analysis based on 18S rRNA, internal transcribed spacer (ITS) region and the large subunit of the ribulose-bisphosphate carboxylase (rbcL) gene revealed eight taxa. Eleven green algae strains were classified in four orders (Sphaeropleales, Chlorellales, Chlamydomonadales and Chaetophorales) and were represented by four genera; one strain was not assigned to any genus. Most strains (six) were classified to the genus Desmodesmus, two strains to genus Chlorella, one to genus Spongiosarcinopsis and one filamentous strain to genus Uronema. One strain is placed in a separate independent branch within the Chlamydomonadales and deserves further research.

Conclusions
Our study reports, for the first time, the presence of Uronema in an aquatic environment up to 40 °C and reveals new diversity within the Chlamydomonadales. The results from the ITS region and the rbcL gene corroborated those obtained from 18S rRNA without providing further information or resolving the phylogenetic relationships within certain genera, due to the limited number of ITS and rbcL sequences available. The comparison of molecular and morphological data showed that they were congruent. Cosmopolitan genera with high worldwide distribution inhabit Greek freshwaters.
Discovering myeloid cell heterogeneity in the lung by means of next generation sequencing
Authors: Ji Jing-jing , Fan Jie 
Published: October 2019

Abstract
The lung plays a vital role in maintaining homeostasis, as it is responsible for the exchange of oxygen and carbon dioxide. Pulmonary homeostasis is maintained by a network of tissue-resident cells, including epithelial cells, endothelial cells and leukocytes. Myeloid cells of the innate immune system and epithelial cells form a critical barrier in the lung. Recently developed unbiased next generation sequencing (NGS) has revealed cell heterogeneity in the lung with respect to physiology and pathology and has reshaped our knowledge. New phenotypes and distinct gene signatures have been identified, and these new findings enhance the diagnosis and treatment of lung diseases. Here, we present a review of the new NGS findings on myeloid cells in lung development, homeostasis, and lung diseases, including acute lung injury (ALI), lung fibrosis, chronic obstructive pulmonary disease (COPD), and lung cancer.
Robot-assisted low anterior resection after aluminum potassium sulfate and tannic acid sclerosing therapy for internal hemorrhoids
Authors: Itatani Yoshiro , Okada Tomoaki , Kawada Kenji , Hida Koya , Oshima Nobu , Inamoto Susumu , Mizuno Rei , Okuchi Yoshihisa , Sakai Yoshiharu 
Published: October 2019

Abstract

Background
Internal hemorrhoids are the most common anal diseases. Aluminum potassium sulfate and tannic acid (ALTA) injection is a new sclerosing therapy for the treatment of internal hemorrhoids. Although ALTA injection has been widely used, there are no previous reports of rectal cancer patients who underwent robot-assisted low anterior resection (Rob-LAR) after ALTA injection to treat internal hemorrhoids.

Case presentation
A 70-year-old man with rectal cancer was presented to our hospital. He had an ALTA injection 2 months before presentation at a clinic due to hematochezia with internal hemorrhoids. The rectal tumor was located 7 cm above the anal verge, and Rob-LAR with the da Vinci Xi system was performed. The patient had sclerosis on the stump of the anal side, which made it difficult to transect the rectum with linear staplers. This required multiple repeats of compression through the SmartClamp feedback. After anastomosis with the double-stapling technique, we constructed a diverting ileostomy.

Conclusion
Although ALTA injection is a promising strategy for internal hemorrhoids, rectal cancer should be excluded before the sclerosing therapy.
Surgical treatment of isolated right ventricular metastasis from renal cell carcinoma
Authors: Miura Shuhei , Yamada Akira , Iba Yutaka , Maruyama Ryushi , Hatta Eiichiro , Kurimoto Yoshihiko 
Published: October 2019

Abstract

Background
Cardiac metastasis from renal cell carcinoma is an exceptional event, particularly when there is lack of inferior vena cava involvement. Only a few cases have been reported worldwide so far.

Case presentation
We presented a case of a 58-year-old man diagnosed with isolated right ventricular metastasis of renal cell carcinoma in the absence of direct inferior vena cava extension, who underwent surgical tumor resection using cardiopulmonary bypass.

Conclusions
Surgical resection of the cardiac mass with an understanding of the pathology is needed to prevent sudden death from acute heart failure or tumor embolism and improve the patient’s quality of life.