bluuebunny/crossref_metadata_2025_split huggingface dataset:
Habitat disturbance influences the skin microbiome of a rediscovered neotropical-montane frog
Authors: Jiménez Randall R. , Alvarado Gilbert , Sandoval José , Sommer Simone 
Published: September 2020

Abstract
Background
The skin microbiome serves as a first line defense against pathogens in vertebrates. In amphibians, it has the potential to protect against the chytrid fungus Batrachochytrium dendrobatis (Bd), a likely agent of amphibian declines. Alteration of the microbiome associated with unfavorable environmental changes produced by anthropogenic activities may make the host more susceptible to pathogens. Some amphibian species that were thought to be “extinct” have been rediscovered years after population declines in the late 1980s probably due to evolved Bd-resistance and are now threatened by anthropogenic land-use changes. Understanding the effects of habitat disturbance on the host skin microbiome is relevant for understanding the health of these species, along with its susceptibility to pathogens such as Bd. Here, we investigate the influence of habitat alteration on the skin bacterial communities as well as specifically the putative Bd-inhibitory bacterial communities of the montane frog Lithobates vibicarius. This species, after years of not being observed, was rediscovered in small populations inhabiting undisturbed and disturbed landscapes, and with continuous presence of Bd.

Results
We found that cutaneous bacterial communities of tadpoles and adults differed between undisturbed and disturbed habitats. The adults from disturbed habitats exhibited greater community dispersion than those from undisturbed habitats. We observed a higher richness of putative Bd-inhibitory bacterial strains in adults from disturbed habitats than in those from undisturbed habitats, as well as a greater number of these potential protective bacteria with a high relative abundance.

Conclusions
Our findings support the microbial “Anna Karenina principle”, in which disturbance is hypothesized to cause greater microbial dispersion in communities, a so-called dysbiosis, which is a response of animal microbiomes to stress factors that decrease the ability of the host or its microbiome to regulate community composition. On the positive side, the high richness and relative abundance of putative Bd-inhibitory bacteria may indicate the development of a defense mechanism that enhances Bd-protection, attributed to a co-occurrence of more than 30-years of host and pathogen in these disturbed habitats. Our results provide important insight into the influence of human-modified landscapes on the skin microbiome and health implications of Bd-survivor species.
Associated factors of pregnancy spacing among women of reproductive age Group in South of Iran: cross-sectional study
Authors: Dehesh Tania , Salarpour Elaheh , Malekmohammadi Neda , Kermani Sepideh Arjomand 
Published: September 2020

Abstract
Background
Optimal pregnancy spacing is an important incidence in reproductive women’s health. Short or long pregnancy spacing leads to the greatest health, social and economic problems such as increase in maternal and infant mortality and morbidity, and adverse pregnancy outcomes. The aim of this study is to assess the mean of pregnancy spacing and associated factors of pregnancy spacing among women of reproductive age group with recurrent event analysis.

Methods
The fertility history of 1350 women aged 15–49 years was collected in this cross-sectional study. The women were selected through multistage random sampling method from a list of clinics in 2018. Some predictors were collected from their records and others were collected by face-to-face interview. The recurrent event survival analysis was used to explore the effect of predictors on pregnancy spacing. The R software program was used for analysis.

Results
There were nine predictors that had significant effect on pregnancy spacing. These predictors included the age of mother at marriage, mother’s BMI, contraception use, breast feeding duration of the previous child, the education level of husband, the sex preference of the mother, presence of abortion or stillbirth in the preceding pregnancies, income sufficiency, and mother’s awareness of optimum pregnancy interval. The most influential predictors; contraception use (HR = 2.34, 95%CI = 1.23 to 2.76, P < 0.001) and income sufficiency (HR = 2.046, 95%CI = 1.61 to 3.02, P = 0.018) lead to longer and son preference of mother (HR = 2.231, 95%CI = 1.24 to 2.81, P = 0.023) lead to shorter pregnancy spacing.

Conclusion
The up to date contraception tool should be at hand for couples to manage their pregnancy intervals. The unfavorable economic situation of a family leads to long pregnancy spacing. Despite the relative equality of the status of girls and boys in today’s societies, the desire to have a son child is still an important factor in shorter pregnancy spacing. The benefit of optimal pregnancy spacing should be more announced.
World Health Organization grading classification for pancreatic neuroendocrine neoplasms: a comprehensive analysis from a large Chinese institution
Authors: Yang Min , Zeng Lin , Ke Neng-wen , Tan Chun-lu , Tian Bo-le , Liu Xu-bao , Xiang Bo , Zhang Yi 
Published: September 2020

Abstract
Background
Pancreatic neuroendocrine neoplasms (p-NENs) are a group of highly heterogeneous tumors with distinct clinicopathological features and long-term prognosis. In 2017, in order to better stratify patients into prognostic groups and predicting their outcomes, World Health Organization (WHO) officially updated its grading system for p-NENs which distinguished these neoplasms among Grading 1 (G1) pancreatic neuroendocrine tumors (p-NETs), G2 p-NETs, G3 p-NETs and G3 pancreatic neuroendocrine carcinomas (p-NECs). However, this new grading classification for p-NENs has not yet been rigorously validated.

Methods
Data of patients who were surgically treated and histopathologically diagnosed as p-NENs at West China Hospital of Sichuan University from January 2002 to December 2018 were retrospectively collected and analyzed according the novel WHO 2017 grading classification.

Results
We eventually enrolled 480 eligible patients with p-NENs in our present study, in which 150 patients with WHO 2017 G1 p-NETs, 158 with G2 p-NETs, 64 with G3 p-NETs and 108 with G3 p-NECs were identified. The estimated 5-year overall survival for patients with G1 p-NETs, G2 p-NETs, G3 p-NETs and G3 p-NECs was 75.8, 58.4, 35.1 and 11.1%, with a median survival time of 85.3mons, 67.4mons, 51.3mons and 26.8mons, respectively. Patients with G2 p-NETs present notably worse survival than those with G1 p-NETs (P = 0.03). Survival of G3 p-NETs were significantly worse than that of G1 p-NETs or G2 p-NETs (P < 0.001, P = 0.023, respectively), as well as that when comparing G3 p-NECs with G1 p-NETs or G2 p-NETs (P < 0.001, P < 0.001, respectively). Patients with G3 p-NECs showed statistically shorter survival than those with G3 p-NETs (P < 0.001). Both WHO 2017 and 2010 grading criteria could be independent predictor for the OS of p-NENs (P = 0.016, P = 0.022; respectively). The 95% confidence intervals of WHO 2017 grading classification (0.983–9.454) was slightly smaller than that of WHO 2010 criteria (0.201–13.374), indicating a relatively more accurate predicting ability for the prognosis of p-NENs.

Conclusion
The WHO 2017 grading classification for p-NENs could successfully allocate patients into four groups with distinct clinical features and significant survival differences, which might be superior to the WHO 2010 criteria for its better prognostic stratification and more accurate predicting ability.
Multiple endo bronchial lipoma: a rare case report
Authors: Zhao Shunjin , Shui Yuexiang , Dai Zhong 
Published: September 2020

Abstract
Background
Endobronchial lipoma is an extremely rare benign tumor, which is generally located in the first three subdivisions of the tracheobronchial tree. According to the existing literature, all endobronchial lipomas are single (one per patient). Here, we report a rare case in which the patient presented with two endobronchial lipomas in the same patient, and underwent a bronchoscopic tumor resection in the left main bronchus and the left lower bronchus. Both tumors were pathologically confirmed as endobronchial lipoma.

Case presentation
A 52-year-old Chinese man presented at the clinic reporting a mild cough with yellow color sputum and exertional dyspnea for 2 weeks. He was a heavy smoker (45 pack-years). Chest auscultation demonstrated faint wheezing in left lower lobe. Computed tomography (CT) revealed two low-density endobronchial masses located in the middle segment of the left main bronchus and the posterior basilar segmental bronchus of the left lower lobe. The neoplasms measured a CT-attenuation value of -70HU, −98HU in density with air trapping and atelectasis in the segmental bronchus of the left lower lobe. The patient underwent interventional bronchoscopic management to remove the neoplasms by using an electrosurgical snare, cryotherapy, and electrocautery. The locations of the neoplasms were confirmed at the left main bronchus and the superior segment of the left lower lobe during bronchoscopic intervention. Histopathological examination confirmed that both tissues were consistent with lipomas. After 18 months of follow-up, the patient was free of symptoms and CT revealed that bronchiectasia remained in the superior segment of the left lower lobe; however, no mass lesion was present in the left bronchus.

Conclusions
This case suggests that an endobronchial lipoma can present as multiple lesions, and both proximal and distal types can simultaneously occur in the same patient. Thus, these findings help us further understand the biology of endobronchial lipomas.
Application of a classroom-based positive psychology education course for Chinese medical students to increase their psychological well-being: a pilot study
Authors: Zhang Xiao-Qin , Zhang Bao-Shuai , Wang Meng-Die 
Published: September 2020

AbstractBackgroundAnxiety and depression have been increasing among Chinese medical students. The psychological well-being of Chinese medical students has become a critical focus of attention for the medical education community. Increasing evidence shows that positive psychology interventions can be effective in the enhancement of psychological well-being, and may help to prevent depressive symptoms in university students. In the present study, we aimed to explore the potential effect of positive psychology education on improving the mental health of Chinese medical students.MethodsAn 8-week classroom-based positive psychology intervention workshop, which was established as an elective course embedded in the regular school curriculum, was conducted at the School of Medicine, South China University of Technology (SCUT), China. Undergraduate medical students of the institute in year-2 or year-3 of academic study participated in this training course voluntarily. The participants’ self-reported data on the hope scale, life satisfaction scale, subjective happiness scale, and depression and anxiety scale were collected and analyzed at pre-course (n = 61) and post-course (n = 49) times. The investigation was also validated with an independent cohort of students who enrolled in the course in the year following the preliminary study.ResultsThe analyses showed that the psychological well-being of the participants were improved after the intervention. Their mean scores on the hope scale, life satisfaction scale and subjective happiness scale were significantly improved (P < 0.05), while their symptom levels of depression and anxiety were significantly reduced (P < 0.01). A similar trend was observed in the validation cohort.ConclusionsThese preliminary findings suggest that positive psychology education holds promise for improving psychological well-being among Chinese medical students. Further investigations with larger and well-controlled sample cohorts may yield more convincing and reliable results.
Decreased costs and retained QoL due to the ‘PACE Steps to Success’ intervention in LTCFs: cost-effectiveness analysis of a randomized controlled trial
Authors: Wichmann Anne B. , Adang Eddy M. M. , Vissers Kris C. P. , Szczerbińska Katarzyna , Kylänen Marika , Payne Sheila , Gambassi Giovanni , Onwuteaka-Philipsen Bregje D. , Smets Tinne , Van den Block Lieve , Deliens Luc , Vernooij-Dassen Myrra J. F. J. , Engels Yvonne ,   on behalf of the PACE trial group, Andreasen Paula , Barańska Ilona , Bassal Catherine , Moore Danni Collingridge , Finne-Soveri Harriet , Froggatt Katherine , Hammar Teija , Heikkilä Rauha , Hockley Jo , Honinx Elisabeth , van Hout Hein , Kijowska Violetta , Ten Koppel Maud , Kuitunen-Kaija Outi , Leppäaho Suvi , Mammarella Federica , Mercuri Martina , Miranda Rose , de Paula Emilie Morgan , Van Den Noortgate Nele , Oosterveld-Vlug Mariska , Pac Agnieszka , Pasman H. Roeline W. , Pautex Sophie , Payne Sheila , Piers Ruth , Pivodic Lara , Rossi Paola , Szczerbińska Katarzyna , Segat Ivan , van der Steen Jenny T. , Stodolska Agata , Tanghe Marc 
Published: September 2020

Abstract
Background
The number of residents in long-term care facilities (LTCFs) in need of palliative care is growing in the Western world. Therefore, it is foreseen that significantly higher percentages of budgets will be spent on palliative care. However, cost-effectiveness analyses of palliative care interventions in these settings are lacking. Therefore, the objective of this paper was to assess the cost-effectiveness of the ‘PACE Steps to Success’ intervention. PACE (Palliative Care for Older People) is a 1-year palliative care programme aiming at integrating general palliative care into day-to-day routines in LTCFs, throughout seven EU countries.

Methods
A cluster RCT was conducted. LTCFs were randomly assigned to intervention or usual care. LTCFs reported deaths of residents, about whom questionnaires were filled in retrospectively about resource use and quality of the last month of life. A health care perspective was adopted. Direct medical costs, QALYs based on the EQ-5D-5L and costs per quality increase measured with the QOD-LTC were outcome measures.

Results
Although outcomes on the EQ-5D-5L remained the same, a significant increase on the QOD-LTC (3.19 points, p value 0.00) and significant cost-savings were achieved in the intervention group (€983.28, p value 0.020). The cost reduction mainly resulted from decreased hospitalization-related costs (€919.51, p value 0.018).

Conclusions
Costs decreased and QoL was retained due to the PACE Steps to Success intervention. Significant cost savings and improvement in quality of end of life (care) as measured with the QOD-LTC were achieved. A clinically relevant difference of almost 3 nights shorter hospitalizations in favour of the intervention group was found. This indicates that timely palliative care in the LTCF setting can prevent lengthy hospitalizations while retaining QoL. In line with earlier findings, we conclude that integrating general palliative care into daily routine in LTCFs can be cost-effective.

Trial registration
ISRCTN14741671.
Echocardiographic reference intervals with allometric scaling of 823 clinically healthy rhesus macaques (Macaca mulatta)
Authors: Ueda Yu , Duler Laetitia M. M. , Elliot Kami J. , Sosa Paul-Michael D. , Roberts Jeffrey A. , Stern Joshua A. 
Published: September 2020

AbstractBackgroundEchocardiography is commonly used for assessing cardiac structure and function in various species including non-human primates. A few previous studies reported normal echocardiographic reference intervals of clinically healthy rhesus macaques under sedation. However, these studies were under-powered, and the techniques were not standardized. In addition, body weight, age, and sex matched reference intervals should be established as echocardiographic measurements are commonly influenced by these variables. The purpose of this study was to establish reference intervals for complete echocardiographic parameters based on a large cohort of clinically healthy rhesus macaques with wide ranges of weight and age distributions using allometric scaling.ResultsA total of 823 rhesus macaques (ages 6 months to 31 years old; body weights 1.4 to 22.6 kg) were enrolled. Of these rhesus macaques, 421 were males and 402 were females. They were assessed with a complete echocardiographic examination including structural and functional evaluation under sedation with ketamine hydrochloride. The reference intervals of the key echocardiographic parameters were indexed to weight, age, and sex by calculating the coefficients of the allometric eq. Y = aMb. On correlation matrix, body weight, age, sex, and heart rate were significantly correlated with various echocardiographic parameters and some of the parameters were strongly correlated with body weight and age. Multiple regression analysis revealed that heart rate and body weight statistically significantly predicted several echocardiographic parameters. Valve regurgitation including tricuspid, aortic, pulmonic, and mitral regurgitations without other cardiac structural and functional abnormalities are common in clinically healthy rhesus macaques under ketamine sedation.ConclusionsIn this study, the reference intervals of echocardiographic parameters were established by performing complete echocardiographic examinations on a large number of clinical healthy rhesus macaques. In addition, allometric scaling was performed based on their weight, and further indexed to age and sex. These allometrically scaled reference intervals can be used to accurately evaluate echocardiographic data in rhesus macaques and diagnose structural and functional evidence of cardiac disease.
Efficacy and safety of CHF6001, a novel inhaled PDE4 inhibitor in COPD: the PIONEER study
Authors: Singh Dave , Emirova Aida , Francisco Catherine , Santoro Debora , Govoni Mirco , Nandeuil Marie Anna 
Published: September 2020

Abstract
Background
This study evaluated the efficacy, safety and tolerability of the novel inhaled phosphodiesterase-4 inhibitor CHF6001 added-on to formoterol in patients with chronic obstructive pulmonary disease (COPD).

Methods
Randomised, double-blind, placebo- and active-controlled, parallel-group study. Eligible patients had symptomatic COPD, post-bronchodilator forced expiratory volume in 1 s (FEV1) 30–70% predicted, and history of ≥1 moderate/severe exacerbation. Patients were randomised to extrafine CHF6001 400, 800, 1200 or 1600 μg twice daily (BID), budesonide, or placebo for 24 weeks. Primary objectives: To investigate CHF6001 dose-response for pre-dose FEV1 after 12 weeks, and to identify the optimal dose. Moderate-to-severe exacerbations were a secondary endpoint.

Results
Of 1130 patients randomised, 91.9% completed. Changes from baseline in pre-dose FEV1 at Week 12 were small in all groups (including budesonide), with no CHF6001 dose-response, and no significant treatment–placebo differences. For moderate-to-severe exacerbations, CHF6001 rate reductions versus placebo were 13–28% (non-significant). In post-hoc analyses, CHF6001 effects were larger in patients with a chronic bronchitis phenotype (rate reductions versus placebo 24–37%; non-significant), and were further increased in patients with chronic bronchitis and eosinophil count ≥150 cells/μL (49–73%, statistically significant for CHF6001 800 and 1600 μg BID). CHF6001 was well tolerated with no safety signal (including in terms of gastrointestinal adverse events).

Conclusions
CHF6001 had no effect in the primary lung function analysis, although was well-tolerated with no gastrointestinal adverse event signal. Post-hoc analyses focused on exacerbation risk indicate specific patient subgroups who may receive particular benefit from CHF6001.

Trial registration
ClinicalTrials.gov (NCT02986321). Registered 8 Dec 2016.
Garden-based interventions and early childhood health: an umbrella review
Authors: Skelton Kara R. , Lowe Chenery , Zaltz Daniel A. , Benjamin-Neelon Sara E. 
Published: September 2020

AbstractBackgroundGarden-based interventions show promise for improving not only child nutrition, but other indicators of child health. Yet, existing systematic reviews of garden-based interventions often focus on one particular health outcome or setting, creating a need to holistically summarize review-level evidence on the role of garden-based interventions in early childhood. To fill this gap, we performed an umbrella review of garden-based interventions to examine their role in early childhood health promotion for children ages 6 years and younger, examining effective components of garden-based interventions and critically evaluating existing evidence.MethodsWe searched the following databases: PubMed, PubMed, PsycINFO, ERIC, CINAHL, Embase, Scopus, OVID-Agricola, and CAB Direct, limiting to reviews published from 1990 to August 2019. Of the 9457 references identified, we included a total of 16 unique reviews for analysis.ResultsAcross reviews, garden based-interventions were most effective at improving nutrition-related outcomes for children, including nutritional status and fruit and vegetable consumption. Few reviews examined child health outcomes of garden-based interventions that were not nutrition related, such as physical activity, or academic performance. Across settings, there was the most evidence in support of garden-based interventions conducted in home gardens, compared to evidence from early care and education or community settings. We were unable to report on most effective components of garden-based interventions due to limitations of included reviews.ConclusionsExisting evidence is difficult to interpret due to methodological limitations at both the review and primary study level. Therefore, the lack of evidence for certain child health outcomes should not necessarily be interpreted as an absence of an effect of garden-based interventions for specific outcomes, but as a product of these limitations. Given the breadth of evidence for garden-based interventions to improve a number of dimensions of health with older children and adult populations, we highlight areas of future research to address evidence gaps identified in this umbrella review. Further research on the role of garden-based interventions, including their impact on non-nutrition early childhood health outcomes and how effectiveness differs by setting type is necessary to fully understand their role in early childhood health promotion.PROSPERO registrationCRD42019106848.
Synergic effects of decellularized bone matrix, hydroxyapatite, and extracellular vesicles on repairing of the rabbit mandibular bone defect model
Authors: Emami Asrin , Talaei-Khozani Tahereh , Tavanafar Saeid , Zareifard Nehleh , Azarpira Negar , Vojdani Zahra 
Published: September 2020

AbstractBackgroundExtracellular vesicles (ECV) and bone extracellular matrix (ECM) have beneficial effects on the treatment of some pathological conditions. The purpose of this study was to find the synergic effects of decellularized bone (DB) ECM and ECVs on the repair of rabbit.MethodsThe quality of decellularized sheep bones was confirmed by H&E, Hoechst, DNA quantification, immunohistochemistry, histochemical staining, and scanning electron microscopy (SEM). Osteoblast-derived ECVs were evaluated by internalization test, Transmission electron microscopy, Dynamic light scattering, and flow cytometry for CD9, CD63, CD81 markers. The hydrogel containing DB and hydroxyapatite (HA) with or without ECVs was evaluated for osteoblast functions and bone repair both in vitro and in vivo.ResultsThe data indicated ECM preservation after decellularization as well as cell depletion. In vitro assessments revealed that mineralization and alkaline phosphatase activity did not improve after treatment of MG63 cells by ECVs, while in vivo morphomatrical estimations showed synergic effects of ECVs and DB + HA hydrogels on increasing the number of bone-specific cells and vessel and bone area compared to the control, DB + HA and ECV-treated groups.ConclusionsThe DB enriched with ECVs can be an ideal scaffold for bone tissue engineering and may provide a suitable niche for bone cell migration and differentiation.