bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tolvaptan-induced hypernatremia related to low serum potassium level accompanying high blood pressure in patients with acute decompensated heart failure
Authors: Fukuoka Hidetada , Yachibana Koichi , Shinoda Yukinori , Minamisaka Tomoko , Inui Hirooki , Ueno Keisuke , Inoue Soki , Mine Kentaro , Ueda Kumpei , Hoshida Shiro 
Published: October 2020

Abstract
Backgrounds: Tolvaptan significantly increases urine volume in acute decompensated heart failure (ADHF); serum sodium level increases due to aquaresis in almost all cases. We aimed to elucidate clinical factors associated with hypernatremia in ADHF patients treated with tolvaptan.Methods: We enrolled 117 ADHF patients treated with tolvaptan in addition to standard therapy. We examined differences in clinical factors at baseline between patients with and without hypernatremia in the initial three days of hospitalization. Results: Systolic (p=0.045) and diastolic (p=0.004) blood pressure, serum sodium level (p=0.002), and negative water balance (p=0.036) were significantly higher and serum potassium level (p=0.026) was significantly lower on admission day in patients with hypernatremia (n=22). In multivariate regression analysis, hypernatremia was associated with low serum potassium level (p=0.034). Among patients with serum potassium level ≤3.8 mEq/L, the cutoff value obtained using receiver operating characteristic curve analysis, those with hypernatremia related to tolvaptan treatment showed significantly higher diastolic blood pressure on admission day (p=0.004).Conclusion: In tolvaptan treatment combined with standard therapy in ADHF patients, serum potassium level ≤ 3.8mEq/L may be a determinant factor for hypernatremia development. Among hypokalemic patients, those with higher diastolic blood pressure on admission may be carefully managed to prevent hypernatremia.
Exploring the usability of the COM-B model and Theoretical Domains Framework (TDF) to define the helpers of and hindrances to evidence-based practice in midwifery.
Authors: De Leo Annemarie , BAYES Sara , BLOXSOME Dianne , BUTT Janice 
Published: October 2020

Abstract
Background Despite the advancement of scientific research in the field of maternity care, midwives face challenges translating latest evidence into evidence-based practice (EBP) and express reticence towards leading practice change in clinical areas. This study aimed to explore midwifery leaders’ views on what factors help or hinder midwives’ efforts to translate latest evidence into everyday practice and consider them in relation to both the Capability, Opportunity, Motivation and Behaviour (COM-B) model and Theoretical Domains Framework (TDF).Methods This qualitative study formed part of a larger Action Research (AR) project that was designed to improve midwives’ EBP implementation capability. Data were obtained from eight Western Australian midwifery leaders who were employed in either managerial or executive positions within their organisation. Five midwives attended a focus group workshop and three opted for face-to-face interviews. Thematic analysis was used to code the transcribed data and group alike findings into sub-categories, which were collapsed to four major categories and one overarching core finding. These were mapped to a matrix combining the COM-B and TDF to establish the usability of these tools in midwifery contexts. Results Four major categories were developed from the data collected in this study. Three reported the hindrances midwives’ experienced when trying to initiate new EBPs: “For midwives, medical opposition and workplace culture are the biggest challenges”, “Fear can stop change: it’s personal for midwives” and “Midwives are tired of fighting the battle for EBP; they need knowledge and the confidence to bring about practice change.” The other major category highlighted factors midwives’ considered helpers of EBP: “Having stakeholder buy-in and strong midwifery leadership is a huge advantage.” When mapped to the TDF and COM-B, these findings provided valuable insight into the helpers of and hindrances to evidence-based practice in midwifery. Conclusion Midwives are motivated to initiate evidence-based change yet have limited knowledge of implementation processes or the confidence to lead practice change. Factors such as inter-disciplinary buy-in, clear instruction for midwives and support from midwifery leaders were considered beneficial to implementing practice change in clinical areas. The TDF when used in combination with the COM-B was deemed useful to midwives wanting to lead practice change projects in clinical areas.
Efficient Protection of Microorganisms for Delivery to the Intestinal tract by Cellulose Sulphate Encapsulation
Authors: Gunzburg Walter Henry , Aung Myo Myint , Toa Pauline , Ng Shirelle , Read Eliot , Tan Wee Jin , Brandtner Eva Maria , Dangerfield John , Salmons Brian 
Published: October 2020

Abstract
Background Gut microbiota in humans and animals play an important role in health, aiding in digestion, regulation of the immune system and protection against pathogens. Changes or imbalances in the gut microbiota (dysbiosis) have been linked to a variety of local and systemic diseases, and there is growing evidence that restoring the balance of the microbiota by delivery of probiotic microorganisms can improve health. However, orally delivered probiotic microorganisms must survive transit through lethal highly acid conditions of the stomach and bile salts in the small intestine. Current methods to protect probiotic microorganisms are still not effective enough.Results We have developed a cell encapsulation technology based on the natural polymer, cellulose sulphate (CS) that protects members of the microbiota from stomach acid and bile. Here we show that six commonly used probiotic strains (5 bacteria and 1 yeast) can be encapsulated within CS microspheres. These encapsulated strains survive low pH in vitro for up to 4 hours without appreciable loss in viability as compared to their respective non-encapsulated counterparts. They also survive subsequent exposure to bile. The CS microspheres can be digested by cellulase in levels found in the human intestine, indicating one mechanism of release. Studies in mice that were fed CS encapsulated autofluorescing, commensal E. coli demonstrated release and colonization of the intestinal tract.Conclusion Taken together, the data suggests that CS microencapsulation can protect bacteria and yeasts from viability losses due to stomach acid, allowing the use of lower oral doses of probiotics and microbiota, whilst ensuring good intestinal delivery and release.
Occult Foreign Body Aspirations in Pediatric Patients: 20-years of Experience
Authors: Liu Bo , Ding Fengxia , An Yong , Li Yonggang , Pan Zhengxia , Wang Gang , Dai Jiangtao , Li Hongbo , Wu Chun 
Published: October 2020

Abstract
Background: The purpose of our study was to assess the frequency of occult foreign body aspiration (FBA) and to evaluate the diagnostic difficulties and therapeutic methods for these patients.Methods: Between May 2000 and May 2020, 3557 patients with the diagnosis of FBA were treated in our department. Thirty-five patients with occult FBA were included in this study. A retrospective analysis of medical records was performed.Results: Twenty-three male patients (65.7%) and 12 female patients (34.3%) were hospitalized due to occult FBA. The average age was 3.60 years (range 9 months-12 years). Most of the patients were younger than 3 years old (n=25, 71.4%). Coughing (n=35, 100%) and wheezing (n=18, 51.4%) were the main symptoms and signs. All the patients were found to have a FBA under the fiberoptic bronchoscope. The most common organic foreign bodies were peanuts (n=10) and the most common inorganic foreign bodies were pen caps (n=5). The extraction of foreign bodies under rigid bronchoscopy was applied successfully in 34 patients. Only one patient needed a surgical intervention.Conclusions: Occult FBA should always be considered in the differential diagnosis of chronic or recurrent respiratory diseases that are poorly explained, even in the absence of a previous history of aspiration.
Perceived Social support and compliance with stay-at-home orders during the COVID-19 outbreak: Evidence from Iran
Authors: Paykani Toktam , Zimet Geregory D. , Esmaeili Reza , khajedaluee Amir Reza , Khajedaluee Mohammad 
Published: October 2020

Abstract
Background: Strong evidence demonstrates that social support plays a key role in facilitating preventive health behaviors. The aim of the current study was to assess the effects of perceived social support on compliance with stay-at-home orders in response to a COVID-19 outbreak during the Persian New Year (Nowruz) holydays, since Nowruz holidays of 2020 coincided with the peak of the coronavirus epidemic in Iran. Methods: This cross-sectional survey was carried out based on phone interviews of 1073 adults aged over 18 years from 4 to 12 April 2020 in Mashhad, Khorasan-Razavi Province, as the second largest city of Iran. A systematic random sampling was carried out using fixed phone number lists provided by Telecommunication Company of Khorasan-Razavi Province. Phone interviews were carried out by trained interviewers from the Iranian Students Polling Agency (ISPA) at various times of the day. The survey included sociodemographic questions, perceived social support scale (MSPSS) and questions about self-isolation during the Nowruz holiday. Statistical analysis included Chi-square test, Mann-Whitney test and multivariate logistic regression.Results: 20.5% of participants reported poor compliance with stay at home orders during the first two weeks of Nowruz. Clear social gradients were not found in stay-at-home compliance. When controlling socio-demographic factors, perceived social support, interestingly, both fostered and hindered people’s compliance with stay at home orders, depending on the source of support from family members (OR=.874, 95% CI=.803, .950, p<.005), friends (OR=1.147, 95% CI=1.076, 1.222, p<.001) and a significant other person (OR=.926, 95% CI=.849, 1.010, p=.084).Conclusions: Public health messaging may need to emphasize the role that friends and families can play in helping to protect those in their friendship/family groups by promoting compliance with social distancing. Further in-depth studies are recommended to evaluate how this kind of messaging can most effectively encourage people to engage in social distancing practices.
New World screwworm (Cochliomyia hominivorax) myiasis in feral swine of Uruguay: One Health and transboundary disease implications
Authors: Altuna Martín , Hickner Paul V. , Castro Gustavo , Mirazo Santiago , de León Adalberto A. Pérez , Arp Alex P 
Published: October 2020

Abstract
Background: Feral swine (Sus scrofa) are highly invasive and threaten animal and public health in the Americas. Screwworm (Cochliomyia hominivorax) is listed by the World Organization for Animal Health as a notifiable infestation because myasis cases affect livestock, wildlife, and humans in endemic areas, and outbreaks can be of high socioeconomic consequence in regions where screwworm was eradicated. However, a knowledge gap exists on screwworm infestation of feral swine in South America, where screwworm is endemic. Here, we report infestation with screwworm in feral swine harvested in the Department of Artigas, where the Republic of Uruguay shares borders with Brazil and Argentina. Methods: Myiasis caused by the larvae of screwworm were identified in feral swine with the support and collaboration of a local feral swine hunting club over a three-year period in the Artigas Department of Uruguay. Harvested feral swine were examined for the presence of lesions where maggots causing the myiasis could be sampled and processed for taxonomic identification. The sites of myiasis on the body of infested feral swine and geospatial data for each case were recorded. Feral swine sex and relative size were recorded. Temperature and precipitation for the region were obtained from public sources.Results: Myiases caused by screwworms were recorded in 27 of 618 feral swine harvested. Cases detected in males over 40 kg were associated with wounds that, because of their location, were likely caused by aggressive dominance behavior between adult males. The overall prevalence of screwworm infestation in feral swine was associated with ambient temperature, but not precipitation. Case numbers peaked in the warmer spring and summer months. Conclusions: This is the first report for South America of myasis caused by screwworm in feral swine. In contrast to myasis in cattle that can reach deep into host tissues, screwworms in feral swine tended to cause superficial infestation. The presence of feral swine is a challenge to control screwworms in endemic areas. Screwworm populations maintained by feral swine may contribute to human cases in rural areas of Uruguay, which highlights the One Health importance of this invasive host species-ectoparasite interaction.
Effects of three plantation coniferous species on plant-soil feedbacks and soil physical and chemical properties in semi-arid mountain ecosystems
Authors: Han Chun , Liu Yongjing , Zhang Cankun , Li Yage , Zhou Tairan , Khan Salman , Chen Ning , Zhao Changming 
Published: October 2020

Abstract
Background: Large-scale afforestation can significantly change the ground cover and soil physicochemical properties, especially the soil fertility maintenance and water conservation functions of artificial forests are very important in semi-arid mountain ecosystems. However, how different tree growth affect soil nutrient and soil physicochemical properties following afforestation and which is the best plantation tree species for improving soil fertility and water conservation functions remain largely unknown. Methods: This study investigated the soil nutrient contents of three plantations with different tree species (Larix principis-rupprechtii, Picea crassifolia, Pinus tabuliformis), soils and plant-soil feedbacks, as well as the interaction between soil physicochemical properties. Results: The results revealed that the leaf and litter layer strongly influence soil nutrient availability through biogeochemical processes: P. tabuliformis has higher organic carbon, ratio of organic carbon to total nitrogen (C:N) and organic carbon to total phosphorus (C:P) in the leaves and litter layer than L. principis-rupprechtii or P. crassifolia, suggesting that higher C:N and C:P hinder litter decomposition. As a result, the L. principis-rupprechtii and P. crassifolia plantation forests significantly improve soil nutrients and clay components than the P. tabuliformis plantation forest. Furthermore, the L. principis-rupprechtii and P. crassifolia plantation forests significantly improved the soil capacity, soil total porosity, and capillary porosity, decreased soil bulk density, and enhanced water storage capacity than the P. tabuliformis plantation forest. In conclusion, the results of this study showed that the strong link between plants and soil is tightly coupled to C:N and C:P, and there had a close correlation between soil particle size distribution and soil physicochemical properties. Conclusions: Therefore, our results recommend planting the L. principis-rupprechtii and P. crassifolia as the preferred tree species to enhance the soil fertility and water conservation functions, especially in semi-arid regions mountain forest ecosystems.
The impact of parturition induction with cloprostenol on immunological parameters in the sow colostrum
Authors: Hlavová Karolina , Kudláčková Hana , Faldyna Martin 
Published: October 2020

Abstract
Background: Farrowing induction with prostaglandin F2 analogue cloprostenol is commonly used on commercial farms to manage the timing of farrowing. When labour induction is applied, the questions arise about possible side effects of such a hormonal intervention on physiological processes connected with labour and lactation, including colostral immunity. Results: In this study, immune cells composition, lysozyme concentration, complement bacteriolytic activity and proinflamatory (GM-CSF2, IL-1β, IL-6, a TNFα) and anti-inflammatory (IL-4, IL-10, TGFβ1 a TGFβ2) cytokines were measured in colostrum samples from sows farrowing naturally (NP) and from sows with farrowing induced using cloprostenol administration on day 113 of gestation (IP). A significantly higher proportion of lymphocytes was found in colostrum of induced sows compared to colostrum of non-induced sows. No significant differences between NP and IP were found in complement activity, in the proportions of granulocytes, macrophages and lymphocyte subpopulations. Lower lysozyme concentration and higher IL-1β, IL-6, TGFβ1 and TNFα concentrations were found in IP sow colostrum compared to colostrum from NP sows. Conclusions: An increased proportion of colostral lymphocytes can positively influence the cellular immunity transmission from sow to her offspring. On the other hand, a lower lysozyme concentration can adversely affect newborn’s intestinal immunity, as well as changes in cytokine concentrations can have an adverse effect on newborn piglet intestinal epithelium development and its defence function.
Patterns of primary care among persons with schizophrenia: the role of patients, general practitioners and centre factors
Authors: Anguiano Mª Carmen Castillejos , Pérez Carlos Martín , Aragon Antonio Bordallo , Muñoz Jesus Sepúlveda , Küstner Berta Moreno 
Published: October 2020

Abstract
Background. Patients with schizophrenia and related disorders have more physical problems than the general population. Primary care professionals play an important role in the care of these patients as they are the main entry point into the healthcare system. We aimed to identify patient, general practitioner, and primary care centre factors associated with the number of visits of patients with schizophrenia and related disorders to general practitioners.Methods. A descriptive, cross-sectional study was conducted in 13 primary care centres belonging to the Clinical Management Unit of Mental Health of the Regional Hospital of Málaga, Spain. The eligible population was composed of patients with schizophrenia and related disorders attending the primary care centres in the study area, and the general practitioners who attend these patients. Our dependent variable was the total number of general practitioner visits made by patients with schizophrenia and related disorders during the 3.5-year observation period. The independent variables were grouped into three: a) patient variables (sociodemographic and clinical), b) general practitioner variables, and c) primary care centre characteristics. Descriptive, bivariate, and multivariate analyses using the random forest method were performed.Results. A total of 259 patients with schizophrenia and related disorders, 96 general practitioners, and 13 primary care centres were included. The annual mean was 3.9 visits per patient. The results showed that younger general practitioners, patients who were women, patients who were married, some primary care centres to which the patient belonged, taking antipsychotic medication, presenting any cardiovascular risk factor, and more frequency of mental health training sessions at the primary care centre were associated with an increased number of visits to general practitioners.Conclusions. The only general practitioner variable that was associated with the number of visits was age, the older the less contact. There were also patient variables involved in the number of visits. Finally, mental health training for general practitioners was important for these professionals to manage patients with schizophrenia and related disorders.
Clinical decision support improves the appropriateness of laboratory test ordering in primary care without increasing diagnostic error: the ELMO cluster randomized trial
Authors: Delvaux Nicolas , Piessens Veerle , De Burghgraeve Tine , Mamouris Pavlos , Vaes Bert , Stichele Robert Vander , Cloetens Hanne , Thomas Josse , Ramaekers Dirk , De Sutter An , Aertgeerts Bert 
Published: October 2020

Abstract
Background Inappropriate laboratory test ordering poses an important burden for healthcare. Clinical decision support systems (CDSS) have been cited as promising tools to improve laboratory test ordering behavior. The objectives of this study were to evaluate the effects of an intervention that integrated a clinical decision support service into a computerized physician order entry (CPOE) on the appropriateness and volume of laboratory test ordering, and on diagnostic error in primary care.Methods This study was a pragmatic, cluster randomized, open label, controlled clinical trial. Setting 280 general practitioners (GPs) from 72 primary care practices in Belgium. Patients Patients aged ≥18 years with a laboratory test order for at least one of 17 indications; cardiovascular disease management, hypertension, check-up, chronic kidney disease (CKD), thyroid disease, type 2 diabetes mellitus, fatigue, anemia, liver disease, gout, suspicion of acute coronary syndrome (ACS), suspicion of lung embolism, rheumatoid arthritis, sexually transmitted infections (STI), acute diarrhea, chronic diarrhea, and follow-up of medication. Interventions The CDSS was integrated into a computerized physician order entry (CPOE) in the form of evidence-based order sets that suggested appropriate tests based on the indication provided by the general physician. Measurements The primary outcome of the ELMO study was the proportion of appropriate tests over the total number of ordered tests and inappropriately not-requested tests. Secondary outcomes of the ELMO study included diagnostic error, test volume and cascade activities.Results CDSS increased the proportion of appropriate tests by 0.21 (95% CI 0.16 - 0.26, p<.0001) for all tests included in the study. GPs in the CDSS arm ordered 7 (7.15 (95% CI 3.37 - 10.93, p=.0002)) tests fewer per panel. CDSS did not increase diagnostic error. The absolute difference in proportions was a decrease of 0.66% (95% CI 1.4% decrease - 0.05% increase) in possible diagnostic error.Conclusions A CDSS in the form of order sets, integrated within the CPOE improved appropriateness and decreased volume of laboratory test ordering without increasing diagnostic error. Trial Registration Clinicaltrials.gov Identifier: NCT02950142, registered on October 25, 2016Funding source This study was funded through the Belgian Health Care Knowledge Centre (KCE) Trials Programme agreement KCE16011.