bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined application of Ascophyllum nodosum extract and chitosan synergistically activates host-defense of peas against powdery mildew
Authors: Patel Jai Singh , Selvaraj Vinodkumar , Gunupuru Lokanadha Rao , Rathor Pramod Kumar , Prithiviraj Balakrishnan 
Published: March 2020

AbstractBackgroundPowdery mildew (PM) is an important disease of pea that reduce yield.Ascophyllum nodosumextract (ANE) and chitosan (CHT) are biostimulants used to improve plant health. Efficacy of ANE and CHT was assessed individually and in combination against pea powdery mildew.ResultsCombined applications of ANE and CHT had a significant inhibitory effect on pathogen development and it reduced disease severity to 35%, as compared to control (90.5%). The combination of ANE and CHT enhanced the activity of plant defense enzymes; phenylalanine ammonia lyases (PAL), peroxidase (PO) and production of reactive oxygen species (ROS) and hydrogen peroxide (H2O2). Further, the treatment increased the expression of a number of plant defense genes in jasmonic acid (JA) signaling pathway such asLOX1andCOIand salicylic acid (SA)-mediated signaling pathway such asNPR1andPR1. Other genes involved in defense mechanisms likeNADPH oxidaseandC4Hwere also upregulated by the combination treatment.ConclusionThe combination of ANE and CHT suppresses pea powdery mildew largely by modulating JA and SA-mediated signaling pathways.
Infection control in ERCP using a duodenoscope with a disposable cap (ICECAP): rationale for and design of a randomized controlled trial
Authors: Forbes Nauzer , Elmunzer B. Joseph , Allain Thibault , Chau Millie , Koury Hannah F. , Bass Sydney , Belletrutti Paul J. , Cole Martin J. , Gonzalez-Moreno Emmanuel , Kayal Ahmed , Kumar Puja , Mohamed Rachid , Turbide Christian , Buret Andre G. , Heitman Steven J. 
Published: March 2020

Abstract
Background
Endoscopic retrograde cholangio-pancreatography (ERCP) is commonly performed in the management of pancreatic and biliary disease. Duodenoscopes are specialized endoscopes used to perform ERCP, and inherent to their design, a high rate of persistent bacterial contamination exists even after automated reprocessing and disinfection. Consequently, in recent years, ERCP has been associated with infection transmission, leading to several fatal patient outbreaks. Due to increasing fears over widespread future duodenoscope-related outbreaks, regulatory bodies have called for alterations in the design of duodenoscopes. A duodenoscope has recently been developed that employs a disposable cap. This novel design theoretically eliminates the mechanism behind persistent bacterial contamination and infection transmission. However, there are no data demonstrating persistent bacterial contamination rates, technical success rates, or clinical outcomes associated with these duodenoscopes.

Methods
A parallel arm randomized controlled trial will be performed for which 520 patients will be recruited. The study population will consist of consecutive patients undergoing ERCP procedures for any indication at a high-volume tertiary care centre in Calgary, Alberta, Canada. Patients will be randomized to an intervention group, that will undergo ERCP with a novel duodenoscope with disposable cap, or to a control group who will undergo ERCP with a traditional duodenoscope. Co-primary outcomes will include persistent bacterial contamination rates (post automated reprocessing) and ERCP technical success rates. Secondary outcomes include clinical success rates, overall and specific early and late adverse event rates, 30-day mortality and healthcare utilization rates, procedure and reprocessing times, and ease of device use.

Discussion
The ICECAP trial will answer important questions regarding the use of a novel duodenoscope with disposable cap. Specifically, persistent bacterial contamination, technical performance, and relevant clinical outcomes will be assessed. Given the mortality and morbidity burden associated with ERCP-related infectious outbreaks, the results of this study have the capacity to be impactful at an international level.

Trial registration
This trial was registered on clinicaltrials.gov (NCT04040504) on July 31, 2019.
Use of microbiological and patient data for choice of empirical antibiotic therapy in acute cholangitis
Authors: Kruis Tassilo , Güse-Jaschuck Sarah , Siegmund Britta , Adam Thomas , Epple Hans-Jörg 
Published: March 2020

Abstract
Background
Ineffective antibiotic therapy increases mortality of acute cholangitis. The choice of antibiotics should reflect local resistance patterns and avoid the overuse of broad-spectrum agents. In this study, we analysed how results of bile and blood cultures and patient data can be used for selection of empirical antibiotic therapy in acute cholangits.

Methods
Pathogen frequencies and susceptibility rates were determined in 423 positive bile duct cultures and 197 corresponding blood cultures obtained from 348 consecutive patients with acute cholangitis. Patient data were retrieved from the medical records. Associations of patient and microbiological data were assessed using the Chi-2 test and multivariate binary logistic regression.

Results
In bile cultures, enterobacterales and enterococci were isolated with equal frequencies of approximately 30% whereas in blood cultures, enterobacterales predominated (56% compared to 21% enterococci). Antibiotic resistance rates of enterobacterales were > 20% for fluorochinolones, cephalosporines and acylureidopenicillins but not for carbapenems (< 2%). The efficacy of empirical therapy was poor with a coverage of bacterial bile and blood culture isolates in 51 and 69%, respectively. By multivariate analysis, predictors for pathogen species, antibiotic susceptibility and expected antibiotic coverage were identified.

Conclusions
In unselected patients treated for acute cholangitis in a large tertiary refferential center, use of carbapenems seems necessary to achieve a high antibiotic coverage. However, by analysis of patient and microbiological data, subgroups for highly effective carbapenem-sparing therapy can be defined. For patients with community-acquired cholangitis without biliary prosthesis who do not need intensive care, piperacillin/tazobactam represents a regimen with an expected excellent antibiotic coverage.
Direct endoscopic full-thickness resection for submucosal tumors with an intraluminal growth pattern originating from the muscularis propria layer in the gastric fundus
Authors: Hu Jinlong , Ge Nan , Wang Sheng , Guo Jintao , Liu Xiang , Wang Guoxin , Sun Siyu 
Published: March 2020

Abstract
Background and aims
Endoscopic full-thickness resection (EFTR) is difficult to perform in a retroflexed fashion in the gastric fundus. The present study aims at exploring whether direct EFTR can be a simple, effective and safe procedure to treat intraluminal-growth submucosal tumors originating from the muscularis propria.

Methods
The patients with intraluminal-growth submucosal tumors originating from the muscularis propria in gastric fundus treated by direct EFTR between 01 January 2017 and 01 September 2018 were retrospectively reviewed. In addition, we analyzed the patients with intraluminal-growth submucosal tumors originating from the muscularis propria in gastric fundus treated by traditional EFTR. The differences in tumor resection time, cost-effectiveness, and complication rate were evaluated.

Results
Forty patients were enrolled in the present study, 20 patients of which were in the direct EFTR group and 20 patients of which were in the traditional EFTR group. En-bloc resections of gastric tumors were successfully performed in all 40 cases. There was no significant difference in the average tumor size of the two groups (24.3 ± 2.9 mm in direct EFTR group verus 24.0 ± 2.6 mm in the traditional group, p = 0.731), but significant difference existed in the operative time between two groups (35.0 ± 8.2 min in direct EFTR group verus 130.6 ± 51.9 min in the traditional group, p<0.05). No complications, such as postoperative bleeding and perforation, occurred in any groups.

Conclusions
Direct EFTR is a safe, simple and cost-effective procedure for SMTs with an intraluminal growth pattern originating from the muscularis propria layer in the gastric fundus.
Prevalence and associated factors for frailty among elder patients in China: a multicentre cross-sectional study
Authors: Jiao Jing , Wang Yu , Zhu Chen , Li Fangfang , Zhu Minglei , Wen Xianxiu , Jin Jingfen , Wang Hui , Lv Dongmei , Zhao Shengxiu , Wu Xinjuan , Xu Tao 
Published: March 2020

Abstract
Background
To date, most previous studies of frailty among hospitalized elderly Chinese patients have been conducted based on small samples, which cannot represent the elderly patient population. The aim of this study was to identify the prevalence of and risk factors for frailty among elderly patients in China.

Study design and setting
This cross-sectional study surveyed 9996 elderly patients from 6 tertiary-level hospitals in China. The prevalence of frailty among patients from selected wards was surveyed by trained investigators. A mixed-effects Poisson regression model was used to analyse the factors associated with frailty among elderly patients.

Results
The mean age of all subjects was 72.47 ± 5.77 years. The prevalence rate of frailty in this study was 18.02%. After adjustments were made for the confounding effect of the clustering of hospital wards, a mixed-effects Poisson regression model showed that the associated factors of frailty included the following: age (OR: 1.016, 95% CI: 1.012–1.020), BMI < 18.5 (OR: 1.248, 95% CI: 1.171–1.330), female gender (OR: 1.058, 95% CI: 1.004–1.115), ethnic minority (OR: 1.152, 95% CI: 1.073–1.236), admission to hospital by the emergency department (OR: 1.104, 95% CI: 1.030–1.184), transit from another hospital (OR: 1.159, 95% CI: 1.049–1.279), former alcohol use (OR: 1.094, 95% CI: 1.022–1.171), fall history in the past 12 months (OR: 1.257, 95% CI: 1.194–1.323), vision dysfunction (OR: 1.144, 95% CI: 1.080–1.211), cognition impairment (OR: 1.182, 95% CI: 1.130–1.237), sleeping dysfunction (OR: 1.215, 95% CI: 1.215–1.318), urinary dysfunction (OR: 1.175, 95% CI: 1.104–1.251), and defecation dysfunction (OR: 1.286, 95% CI: 1.217–1.358). The results also showed some of the following protective effects: BMI > 28 (OR: 0.897, 95% CI: 0.856–0.940); higher education level, including middle school (OR: 0.915, 95% CI: 0.857, 0.977) and diploma and above (OR: 0.891, 95% CI: 0.821, 0.966); and current alcohol use (OR: 0.869, 95% CI: 0.815, 0.927).

Conclusion
We identified a relatively high prevalence of frailty among elderly patients, and there are several associated factors among the population derived from this investigation of a large-scale, multicentre, nationally representative Chinese elderly inpatient population.

Trial registration
Chinese Clinical Trial Registry, ChiCTR1800017682, registered 09 August 2018.
The time series seasonal patterns of dengue fever and associated weather variables in Bangkok (2003-2017)
Authors: Polwiang Sittisede 
Published: March 2020

Abstract
Background
In Thailand, dengue fever is one of the most well-known public health problems. The objective of this study was to examine the epidemiology of dengue and determine the seasonal pattern of dengue and its associate to climate factors in Bangkok, Thailand, from 2003 to 2017.

Methods
The dengue cases in Bangkok were collected monthly during the study period. The time-series data were extracted into the trend, seasonal, and random components using the seasonal decomposition procedure based on loess. The Spearman correlation analysis and artificial neuron network (ANN) were used to determine the association between climate variables (humidity, temperature, and rainfall) and dengue cases in Bangkok.

Results
The seasonal-decomposition procedure showed that the seasonal component was weaker than the trend component for dengue cases during the study period. The Spearman correlation analysis showed that rainfall and humidity played a role in dengue transmission with correlation efficiency equal to 0.396 and 0.388, respectively. ANN showed that precipitation was the most crucial factor. The time series multivariate Poisson regression model revealed that increasing 1% of rainfall corresponded to an increase of 3.3% in the dengue cases in Bangkok. There were three models employed to forecast the dengue case, multivariate Poisson regression, ANN, and ARIMA. Each model displayed different accuracy, and multivariate Poisson regression was the most accurate approach in this study.

Conclusion
This work demonstrates the significance of weather in dengue transmission in Bangkok and compares the accuracy of the different mathematical approaches to predict the dengue case. A single model may insufficient to forecast precisely a dengue outbreak, and climate factor may not only indicator of dengue transmissibility.
Cobalamin c deficiency associated with antifactor h antibody-associated hemolytic uremic syndrome in a young adult
Authors: Philipponnet C. , Desenclos J. , Brailova M. , Aniort J. , Kemeny J. L. , Deville C. , Fremeaux-Bacchi V. , Souweine B. , Heng A. E. 
Published: March 2020

Abstract
Background
Thrombotic microangiopathy (TMA) syndromes are characterized by the association of hemolytic anemia, thrombocytopenia and organ injury due to arteriolar and capillary thrombosis.

Case presentation
We report the first case of adult onset cobalamin C (Cbl C) disease associated with anti-factor H antibody-associated hemolytic uremic syndrome (HUS).
A 19-year-old woman was admitted to the nephrology department owing to acute kidney failure, proteinuria, and hemolytic anemia with schizocytes.
TMA was diagnosed and plasma exchanges were started in emergency.
Exhaustive analyses showed 1) circulating anti factor H antibody and 2) hyperhomocysteinemia, hypomethioninemia and high levels of methylmalonic aciduria pointing towards Clb C disease. Cbl C disease has been confirmed by methylmalonic aciduria and homocystinuria type C protein gene sequencing revealing two heterozygous pathogenic variants.
The kidney biopsy showed 1) intraglomerular and intravascular thrombi 2) noticeable thickening of the capillary wall with a duplication aspect of the glomerular basement membrane and a glomerular capillary wall IgM associated with Cbl C disease related TMA.
We initiated treatment including hydroxycobalamin, folinic acid, betaine and levocarnitine and Eculizumab. Rituximab infusions were performed allowing a high decrease in anti-factor H antibody rate.
Six month after the disease onset, Eculizumab was weaning and vitaminotherapy continued. Outcome was favorable with a dramatic improvement in kidney function.

Conclusion
TMA with renal involvement can have a complex combination of risk factors including anti-FH autoantibody in the presence of cblC deficiency.
Symptomatic hemiparkinsonism due to extensive middle and posterior fossa arachnoid cyst: case report
Authors: Wimmer Bernadette , Mangesius Stephanie , Seppi Klaus , Iglseder Sarah , Di Pauli Franziska , Ortler Martin , Gizewski Elke , Poewe Werner , Wenning Gregor Karl 
Published: March 2020

Abstract
Introduction
Intracranial neoplasms are an uncommon cause of symptomatic parkinsonism. We here report a patient with an extensive middle and posterior fossa arachnoid cyst presenting with parkinsonism that was treated by neurosurgical intervention.

Methods
Retrospective chart review and clinical examination of the patient.

Case report
This 55-year-old male patient with hemiparkinsonism and recurrent bouts of headaches was first diagnosed in 1988. CT scans revealed multiple cystic lesions compressing brainstem and basal ganglia, which were partially resected. Subsequently, the patient was free of complaints for 20 years. In 2009 the patient presented once more with severe unilateral tremor and thalamic pain affecting the right arm. Despite symptomatic treatment with L-Dopa and pramipexole symptoms worsened over time. In 2014 there was further progression with increasing hemiparkinsonism, hemidystonia, unilateral thalamic pain and pyramidal signs. Repeat CT scanning revealed a progression of the cysts as well as secondary hydrocephalus. Following repeat decompression of the brainstem and fenestration of all cystic membranes parkinsonism improved with a MDS- UPDRS III score reduction from 39 to 21. Histology revealed arachnoid cystic material.

Conclusion
We report on a rare case of recurrent symptomatic hemiparkinsonism resulting from arachnoid cysts.
Intergenerational transmission of health disparities among Turkish-origin immigrants in Germany: study protocol of a multi-centric cohort study (BaBi-stress and BaBeK study)
Authors: Spallek Jacob , Scholaske Laura , Kurt Medlin , Lindner-Matthes Denise , Entringer Sonja 
Published: March 2020

Abstract
Background
Immigrants in Germany exhibit higher levels of social disadvantage when compared to the non-immigrated population. Turkish-origin immigrants constitute an important immigrant group in Germany and show disparities in some health domains that are evident from birth onwards. Several studies have shown the mechanisms by which social disadvantage is biologically embedded to affect health over the lifespan. Relatively little, however, is still known about if and how the maternal social situation is transmitted to the next generation. This study therefore aims to analyse the effects of maternal socioeconomic status and migration status on stress-related maternal-placental-fetal (MPF) biological processes during pregnancy on infant birth and health outcomes.

Methods
This longitudinal cohort study of N = 144 child-mother dyads is located at two study sites in Germany and includes pregnant women of Turkish origin living in Germany as well as pregnant German women. During pregnancy, MPF stress biology markers from maternal blood and saliva samples, maternal socio-economic and migration-related information, medical risk variables and psychological well-being are assessed. After birth, infant anthropometric measures and developmental outcomes are assessed. The same measures will be assessed in and compared to Turkish pregnant women based on a collaboration with BABIP study in Istanbul.

Discussion
This is the first study on intergenerational transmission of health disparities in Germany with a focus on women of Turkish-origin. The study faces similar risks of bias as other birth cohorts do. The study has implemented various measures, e.g. culturally sensitive recruitment strategies, attempt to recruit and follow-up as many pregnant women as possible independent of their social or cultural background. Nevertheless, the response rate among lower-educated families is lower. The possibility to compare results with a cohort from Turkey is a strength of this study. However, starting at different times and with slightly different recruitment strategies and designs may result in cohort effects and may affect comparability of the sub-cohorts.

Trial registration
N.A. (Observational study, no clinical trial, no interventions on human participants).
Herbal medicine use and predictors among pregnant women attending antenatal care in Ethiopia: a systematic review and meta-analysis
Authors: Adane Fentahun , Seyoum Girma , Alamneh Yoseph Merkeb , Abie Worku , Desta Melaku , Sisay Bihonegn 
Published: March 2020

Abstract
Background
The use of herbal medicine among pregnant women is increasing in many low- and high-income countries due to their cost-effectiveness in treatment and ease of access. Research findings across Ethiopia on the prevalence and predictors of herbal medicine use among pregnant women attending antenatal care are highly variable and inconsistent. Therefore, this systematic review and meta-analysis aims to estimate the overall prevalence of the use of herbal medicine and its predictors among pregnant women attending antenatal care in Ethiopia.

Method
We searched articles in Medline (PubMed), EMBASE, HINARI, Google Scholar, Science Direct, Cochrane Library, and other sources. The study included a total of eight studies that reported the prevalence and predictors of herbal medicine use among pregnant women from different regions of Ethiopia. Cochrane Q test statistics and I2 tests were used to assess heterogeneity. A random effect meta-analysis model was used to estimate the pooled prevalence. In addition, the association between risk factors and herbal medicine use in pregnant women attending antenatal care were examined.

Results
A total of eight studies were included in this review. The pooled prevalence of herbal medicine use among pregnant women attending antenatal care in Ethiopia was 47.77% (95% CI: 28.00–67.55). Subgroup analysis by geographic regions has showed that the highest prevalence (57.49%;95% CI: 53.14, 61.85) was observed in Oromia Region and the lowest prevalence was observed in Addis Ababa (31.39%; 95% CI: 2.83, 79.96). The herbal medicines commonly consumed by women during pregnancy were ginger: 41.11% (95% CI: 25.90, 56.32), damakasse: 34.63% (95% CI: 17.68, 51.58), garlic: 32.98% (95% CI: 22.21, 43.76), tenaadam: 19.59% (95% CI: 7.54, 31.63) and eucalyptus: 4.71% (95% CI: 1.1, 8.26). Mothers’ previous history of self-medication (95% CI: 1.91, 51.35), illness during pregnancy (95% CI: 1.56, 23.91), employment status (95% CI: 3.89, 10.89), educational status (95% CI: 1.52, 2.68), and place of residence (95% CI: 1.86, 3.23) were predictors of herbal medicine use by women during pregnancy.

Conclusion
In this study, about half of women attending antenatal care use herbal medicine and it is relatively high. The most commonly consumed herbal medicine during pregnancy was ginger followed by damakasse, garlic, tenaadam and eucalyptus. During pregnancy, it is not known that these most commonly consumed plant species have harmful fetal effects. However, many of the medicinal plant species are poorly studied, and it is not possible to rule out teratogenic effects. Teamwork between healthcare professionals and traditional practitioners to educate on the use of medicinal plants will encourage healthier pregnancies and better health for mothers and infants.