bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time to Change’s social marketing campaign for a new target population: results from 2017-2019.
Authors: González-Sanguino Clara , Potts Laura C , Milenova Maria , Henderson Claire 
Published: December 2019

Abstract
Background. Since 2009 Time to Change has included among its strategies a social marketing campaign to tackle the stigma surrounding mental health problems. At the start of its third phase (2016-2021) the target group of the campaign was kept as people aged between mid-twenties and mid-forties but changed to middle-low income groups and the content was focused on men.
Methods. Participants (n = 3700) were recruited through an online market research panel, before and after each burst of the campaign. They completed an online questionnaire evaluating knowledge [Mental Health Knowledge Schedule (MAKS)]; attitudes [Community Attitudes toward Mental Illness (CAMI)]; and desire for social distance [Intended Behaviour subscale of the Reported and Intended Behaviour Scale (RIBS)]. Socio-demographic data and awareness of the campaign were also collected.
Results. For each of the 3 bursts, significant pre-post awareness differences were found (OR=2.83, CI=1.90 to 4.20, p<0.001; OR=1.72, CI=1.22 to 2.42, p=0.002; OR=1.41, CI=1.01 to 1.97, p=0.043),
and awareness at the end of the third burst was 33%. Demographic factors associated with awareness for one or more bursts included having children, familiarity with mental illness, male sex, being Black, Asian or other ethnic minorities and living in London or the East Midlands regions. An improvement across bursts in the “living with” subscale item of the RIBS, and in the “recover” and “advice to a friend” MAKS items were found. Familiarity with mental illness had the strongest association with all outcome measures, while the awareness of the campaign was also related with higher scores in MAKS and RIBS.
Conclusions. These interim results suggest that the campaign is reaching and having an impact on its target audience. While over the course of Time to Change we have found no evidence that demographic differences in stigma have widened, and indeed those by age group and region of England have narrowed, those for socioeconomic status, ethnicity and sex have so far remained unchanged. By targeting a lower socioeconomic group and creating relatively greater awareness among men and in Black and ethnic minority groups, the campaign is showing the potential to address these persistent differences in stigma.
Effects of alternate-day fasting on body weight and dyslipidaemia in patients with non-alcoholic fatty liver disease: a randomised controlled trial
Authors: Cai Hua , Qin Yue-Lan , Shi Ze-Ya , Chen Jin-Hui , Zeng Min-Jie , Zhou Wei , Chen Ru-Qun , Chen Zhi-Yuan 
Published: December 2019

Abstract
Background: Alternate-day fasting (ADF) is a novel diet therapy that may achieve reduction in body weight and improvement of dyslipidaemia, but the impact of this diet on patients with non-alcoholic fatty liver disease (NAFLD) remains unknown. The aim of this study was to evaluate the effects of ADF on the body weight and lipid profile of individuals with NAFLD.

Methods: NAFLD patients (n=271) were randomised to the ADF group, time-restricted feeding (TRF) group, or the control group and subjected to the respective diet for 12 weeks. Anthropometric measurements (body weight, fat mass/fat-free mass) were performed, and plasma lipids were analysed enzymatically.

Results: Within 4 weeks, the body weight decreased significantly (P<0.001) in the ADF group by 4.56±0.41 kg (6.1 ± 0.5%) and the TRF group by 3.62±0.65 kg (4.83±0.9%) compared to the control group, and it decreased even more after 12 weeks in both groups (ADF: -4.04±0.54 kg, 5.4±0.7%; TRF: -3.25±0.67 kg, 4.3±0.9%). Fat mass was significantly reduced by ADF (-3.49±0.37 kg; 11±1.2%) and TRF (-2.91±0.41 kg; 9.6±1.3%), with ADF leading to a further reduction in fat mass after 12 weeks (-3.48±0.38 kg; 11±1.2%). Total cholesterol was significantly decreased at both time points in the ADF group (-0.91±0.07 mmol/L; 18.5±1.5%) compared to the control and TRF groups. Both ADF (-0.64±0.06 mmol/L; 25±1.9%) and TRF (0.58±0.07 mmol/L; 20±1.7%) achieved a significant reduction in serum triglycerides (P<0.001) after 12 weeks. Changes in fat free mass, HDL, LDL, fasting insulin, glucose, liver stiffness, and systolic or diastolic blood pressure did not differ between the groups.

Conclusions: ADF appears to be an effective diet therapy for individuals with NAFLD that can achieve weight loss and improvement of dyslipidaemia within a relatively short period of time (4 to 12 weeks). Potential preventive effects of ADF on cardiovascular disease need to be confirmed by future investigations.

Trial registration: ChiCTR1900024411, this trial was retrospectively registered on July 10, 2019
Long-term effects of group exercise intervention on maximal step-up height in female primary care patients with cardio-metabolic risk factors
Authors: Nyberg Lillemor Amanda , Sundberg Carl Johan , Wändell Per , Kowalski Jan , Hellenius Mai-Lis 
Published: December 2019

Abstract
Background: Low physical performance is a predictor of morbidity and mortality. This study looks at long-term effects of an exercise intervention on maximal step-up height (MSH) in individuals with low physical function. Furthermore, we studied correlates to changes in MSH. Methods: Female patients (n = 101), mean (SD) age of 52 (11) years, were recruited for a 3-month group exercise intervention including 2-3 sessions/week of mixed aerobic fitness and strength training. MSH, weight, body mass index (BMI), waist circumference, maximal oxygen consumption (VO 2 -max), self-reported health (SF-36) and physical activity (PA) were measured at baseline (T0), after 3 months (T1) and after 14-30 (mean 22) months (T2). Relationships between changes in MSH (cm) and age, baseline MSH, time to follow-up, changes in anthropometric measurements, VO 2 -max, SF-36 and PA were studied with regression analyses. Results: MSH, significantly, increased from T0 to T1, 27.2 (5.7) to 29.0 (5.5) cm and decreased to 25.2 (5.5) cm at T2. Time to follow-up (B = -0.42, p < 0.001) and change in BMI (B = -0.29, p = 0.012) correlated significantly to changes in MSH. Waist circumference, VO 2 -max, PF and exercise/physical activity levels were significantly improved at T2, while BMI did not change. In a univariate logistic regression model, maintenance of MSH correlated to the extent of mixed training (OR 3.33, 95% CI 1.25-8.89). In a multivariate logistic regression model adjusted for important factors the correlation was not significant. However, MSH was significantly higher in individuals participating in 2-3 session per week compared to one session. Conclusions: A 3-month group exercise intervention increased MSH, improved fitness, decreased risk in female patients with elevated cardio-metabolic risk. After an average of 22 months MSH was reduced while positive effects remained for waist circumference, VO 2 -max, physical function and physical activity. However, regular group exercise 2-3 times per week with mixed aerobic fitness and strength training was associated with maintenance of MSH in a subgroup of patients. We suggest that such an intervention including regular support from healthcare professionals is a successful approach for maintaining improved leg-muscle strength among primary care patients.
Optimization of the antibiotic management of diabetic foot infections - Protocol for two randomized controlled trials
Authors: Waibel Felix WA , Berli Martin , Catanzaro Sabrina , Sairanen Kati , Schöni Madlaina , Böni Thomas , Burkhard Jan , Holy Dominique , Huber Tanja , Bertram Maik , Laeubli Karin , Frustaci Dario , Rosskopf Andrea , Botter Sander , Uçkay Ilker 
Published: December 2019

Abstract
Background: Few studies address the appropriate duration of antibiotic therapy for diabetic foot infections (DFI); with or without amputation. We will perform two randomized clinical trials (RCT) to reduce the antibiotic use and associated adverse events in DFI.
Methods: We hypothesize that shorter durations of post-debridement systemic antibiotic therapy are non-inferior (10% margin, 80% power, ɑ 5%) to existing (long) durations and we will perform two unblinded RCTs with a total of 400 DFI episodes (randomization 1:1) from 2019 to 2022. The primary outcome for both RCT is “remission of infection” after a minimal follow-up of two months. The secondary outcomes for both RCT are the incidence of adverse events and the overall treatment costs. The First RCT will allocate the total therapeutic amputations in two arms of 50 patients each: 1 vs. 3 weeks of antibiotic therapy for residual osteomyelitis (positive microbiological samples of the residual bone stump); or 1 vs. 4 days for remaining soft tissue infection. The Second RCT will randomize the conservative approach (only surgical debridement without in toto amputation) in two arms with 50 patients each: 10 vs. 20 days of antibiotic therapy for soft tissue infections; and 3 vs. 6 weeks for osteomyelitis. All participants will have professional wound debridement, adequate off-loading, angiology evaluation, and a concomitant surgical, re-educational, podiatric, internist and infectiology care. During the surgeries, we will collect tissues for BioBanking and future laboratory studies.
Discussion: Both parellel RCTs will repond to frequent questions regarding the duration of antibiotic use in the both major subsets of DFIs, to assure the quality of care, and to avoid unnecessary excesses in terms of surgery and antibiotic use.
Trial registration: ClinicalTrial.gov NCT04081792. Registered on 4th September 2019.
Protocol version: 2 (15th July 2019)
Fear-avoidance beliefs are associated with exercise adherence: Secondary analysis of a randomised controlled trial (RCT) among female healthcare workers with recurrent low back pain
Authors: Taulaniemi Annika , Kankaanpää Markku , Rinne Marjo , Tokola Kari , Parkkari Jari , Suni Jaana Helena 
Published: December 2019

Abstract
Background Exercise is recommended for the treatment and management of low back pain (LBP) and the prevention of chronicity. Exercise adherence has proved to be only modest in intervention studies among people with musculoskeletal pain. Fear-avoidance beliefs (FABs) are known to affect exercise adherence.The purpose was twofold: to examine which bio-psycho-social factors contributed to exercise adherence during a 6-month neuromuscular exercise intervention among female healthcare workers with recurrent LBP, and to investigate how exercising affects FABs at 6 and 12 months’ follow-up.Methods In original RCT study, 219 healthcare workers aged 30–55 years with mild-to-moderate re-current non-specific LBP were allocated into: 1) exercise, 2) counselling, 3) combined exercise and counselling, and 4) control groups. In the present secondary analysis, groups 1 and 3 (exercise only and exercise+counselling) were merged to be exercisers and groups 2 and 4 were merged to be non-exercisers. Baseline variables of the exercise compliers (≥24 times over 24 weeks; n=58) were compared to those of the non-compliers (<1 time/week, 0–23 times; n=52). The effects of the exercise programme on FABs were analysed by a generalised linear mixed model according to the intention-to-treat principle (exercisers; n= 110 vs non-exercisers; n=109) at three measurement points (baseline, 6, and 12 months). A per-protocol analysis compared the more exercised to the less exercised and non-exercisers.Results A low education level (p=0.026), shift work (p=0.023), low aerobic (p=0.048) and musculoskeletal (p=0.043) fitness level, and high FABs related to physical activity (p=0.019) at the baseline contributed to lower exercise adherence. The exercise programme reduced levels of both physical activity- and work-related FABs, and there was a dose response: FABs reduced more in persons with better exercise adherence.Conclusion Healthcare workers who had lower education and fitness levels, worked shifts, and had high physical activity-related FABs had a lower adherence to the 6-month neuromuscular exercise programme. Exercising with good adherence reduced levels of FABs, which are known to be linked with prolonged LBP. In exercise interventions, motivational strategies should be targeted at persons with low education and fitness levels and high FABs in order to achieve better exercise adherence.
Dual-energy Spectral CT Quantitative Parameters for the Differentiation of Glioma Recurrence from Treatment-Related Changes: A Preliminary Study
Authors: Lv Yanchun , Zhou Jian , Lv Xiaofei , Tian Li , He Haoqiang , Liu Zhigang , Wu Yi , Han Lujun , Sun Meili , Yang Yadi , Guo Chengcheng , Li Cong , Zhang Rong , Xie Chuanmiao , Chen Yinsheng , Chen Zhong-ping 
Published: December 2019

Abstract
Background: Differentiating glioma recurrence from treatment-related changes can be challenging on conventional imaging. We evaluated the use of dual-energy spectral computed tomographic (CT) quantitative parameters for this differentiation.
Methods: Twenty-eight patients were examined by dual-energy spectral imaging CT. The slope of the spectral Hounsfield unit curve (λHU), effective atomic number (Zeff), normalized effective atomic number (Zeff-N), iodine concentration (IC), and normalized iodine concentration (ICN) in the post-treatment enhanced areas were calculated. Pathological results or clinicoradiologic follow-up of ≥2 months were used for final diagnosis. Nonparametric and t-tests were used to compare quantitative parameters between glioma recurrence and treatment-related changes. Positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated; sensitivity and specificity were calculated using receiver operating characteristic (ROC) curves. ROC curves were generated using predictive probabilities to evaluate the diagnostic value.
Results: There were no significant differences in quantitative parameters based on examination of pre-contrast λHU, Zeff, Zeff-N, IC, ICN and venous phase ICN (P>0.05). Venous phase λHU, Zeff, Zeff-N, and IC in glioma recurrence were higher than in treatment-related changes (P<0.001). The optimal venous phase threshold was 1.03, 7.75, 1.04, and 2.85 mg/cm3, achieving 66.7%, 91.7%, 83.3%, and 91.7% sensitivity; 100.0%, 77.8%, 88.9%, and 77.8% specificity; 100.0%, 73.3%, 83.3%, and 73.3% PPV; 81.8%, 93.3%, 88.9%, and 93.3% NPV; and 86.7%, 83.3%, 86.7%, and 83.3% accuracy, respectively. The areas under the curve (AUC) were 0.912, 0.912, 0.931, and 0.910 in glioma recurrence and treatment-related changes, respectively.
Conclusions: Dual-energy spectral CT imaging may provide quantitative values to aid in differentiation of glioma recurrence from treatment-related changes.
Cyniclomyces guttulatus is an opportunistic pathogen in rabbits with coccidiosis
Authors: Shi Tuanyuan , Sun Hongchao , Fu Yuan , Hao Lili , Zhou Yongxue , Liu Yan , Bao Guolian , Suo Xun 
Published: December 2019

Abstract
Background: Cyniclomyces guttulatus is a common inhabitant of the gastrointestinal tract in rabbits, and large numbers are often present in feces of diarrheic rabbits. However, its relation with rabbit diarrhea has not been clearly identified. Relationship between C. guttulatus and the rabbit are identified in this paper.Methods: YPG (pH 1.5) medium and 96-well culture plate were used to isolate C. guttulatus from rabbit. Automatic microbial growth curve analyser and optical density scanner were used to optimized culture conditions of the C. guttulatus strain in the YPG medium. Microscope observation, PCR and gene sequencing were used to identify the C. guttulatus strain. Animal inoculation with the C. guttulatus strain or co-inoculation with E. intestinalis were used identify relationship between C. guttulatus and the rabbit. Results: A C. guttulatus Zhejiang strain was isolated from a rabbit with diarrhea and the culture conditions in YPG medium were optimized. The sequenced 18S and 26S ribosomal DNA fragments were 1559bp and 632bp, respectively, and showed 99.8% homology with the 18S ribosomal sequence of the NRRL Y-17561 isolate from the dog and 100% homology with the 26S ribosomal sequence of the DPA-CGR1 and CGDPA-GP1 isolates from the rabbit and guinea pig. Our isolate was not pathogenic to healthy SPF rabbits. Instead, rabbits inoculated with the yeast had a slightly better body weight gain and higher food intake. Rabbits co-inoculated with C. guttulatus and the coccidian, E. intestinalis developed more severe coccidiosis as shown by clinical signs, and decreased body weight gain, diarrhea and death, associated with significantly higher fecal output of C. guttulatus vegetative cells but lower coccidian oocysts output than the rabbits inoculated with C. guttulatus or E. intestinalis alone. We also surveyed the prevalence of C. guttulatus in rabbits and found a positive rate of 83% in Zhejiang province. Conclusions: Our results indicate that C. guttulatus alone is not pathogenic to healthy rabbits and seems a probiotic microorganism in rabbits, but could become an opportunistic pathogen when the digestive tract is damaged by other pathogens such as coccidia.
Semi-supervised Method for Image Texture Classification of Pituitary Tumors via CycleGAN and Optimized Feature Extraction
Authors: ZHU Hong , FANG Qianhao , HUANG Yihe , XU Kai 
Published: December 2019

Abstract
Background: Accurately determining the softness level of pituitary tumors preoperatively by using their image textures can provide a basis for surgical options and prognosis. Existing methods for this problem require manual intervention, which could hinder the efficiency and accuracy considerably.Methods: we present an automatic method for diagnosing the texture of pituitary tumors using unbalanced sequence image data. Firstly, for the small sample problem in our pituitary tumor MRI image dataset where T1 and T2 sequence data are unbalanced (due to data missing) and under-sampled, our method uses a CycleGAN model for domain conversion to obtain fully sampled MRI spatial sequence. Then, it uses a DenseNet-ResNet based Autoencoder framework to optimize the feature extraction process for pituitary tumor image data. Finally, to take advantage of sequence data, it uses a CRNN model to classify pituitary tumors based on their predicted softness levels.Results: Experiments show that our method is the best in terms of efficiency and accuracy(91.78%) compared to other methods.Conclusions: We propose a semi-supervised method for grading pituitary tumor texture. This method can accurately determine the softness level of pituitary tumors, which provides convenience for surgical selection and prognosis, and improves the diagnostic efficiency of pituitary tumors.
The use of olanzapine as an antiemetic in palliative medicine: a systematic review of the literature
Authors: Saudemont Gaëtan , Prod'Homme Chloé , Silva Arlette Da , Villet Stephanie , Reich Michel , Penel Nicolas , Gamblin Vincent 
Published: December 2019

Abstract
Background: Olanzapine is an atypical antipsychotic that has affinity for many central nervous system receptors. Its efficacy is supported by several studies in the prevention and treatment of chemotherapy-induced nausea and vomiting. No recommendations exist on the antiemetic use of olanzapine in the palliative care setting. The aim of this work is to complete the initial work of Fonte et al. published in 2015, to determine whether the literature supports the use of olanzapine as an antiemetic in palliative situations and, in practice, to propose a therapeutic schema adapted to the palliative setting. Methods: Systematic review of the literature according to the PRISMA criteria. We searched the PubMed, Cochrane, RefDoc, EMBase databases and the gray literature databases. The bibliographic search was conducted between November 2016 and August 2017. Results: Thirteen articles were included: 2 case studies, 3 case series, 3 retrospective studies, 2 prospective studies, 2 literature reviews. All studies concluded on the efficacy of olanzapine as an antiemetic in the palliative care setting. No serious adverse effects were reported. Based on the data from the literature review, we propose a therapeutic scheme adapted to the palliative care context. Conclusion: Action of olanzapine on many receptors and its tolerance profile make it an interesting antiemetic treatment in palliative medicine. But to date, studies are scarce and have a low statistical power. Further investigation is therefore needed to determine the benefit of this treatment in palliative care patients, compared to usual treatments.
Isolation, characterization and application of theophylline-degrading Aspergillus fungi
Authors: ZHOU Bin-Xing , Ma Cunqiang , Xia Tao , Li Xiaohong , Zheng Chengqin , Wu Tingting , Liu Xiaohui 
Published: December 2019

Abstract
Background: Caffeine, theobromine and theophylline are main purine alkaloid in tea. Theophylline is the downstream metabolite and stays a very low level in Camellia sinensis. In our previous study, Aspergillus sydowii could convert caffeine into theophylline in solid-state fermentation of tea through N-demethylation. In this study, tea-derived fungi caused theophylline degradation in the solid-state fermentation. The aim of this study was isolate theophylline-degrading fungi and to investigate their application in production of methylxanthines with theophylline as feedstock through microbial conversion. Results: Of seven tea-derived fungi collected and identified by ITS, β-tubulin and calmodulin gene sequences, Aspergillus ustus, Aspergillus tamarii, Aspergillus niger and Aspergillus sydowii associated with solid-state fermentation of pu-erh tea have shown ability to degrade theophylline. A. ustus and A. tamarii could degrade theophylline highly significantly (p < 0.01) in liquid culture. 1,3-Dimethyluric acid, 3-methylxanthine, 3-methyluric acid, xanthine and uric acid were detected consecutively by HPLC in A. ustus and A. tamarii respectively. The data from absolute quantification analysis suggest that 3-methylxanthine and xanthine were main degraded metabolites in A. ustus and A. tamarii respectively. 129.48 ± 5.81 mg/L of 3-methylxanthine and 159.11 ± 10.8 mg/L of xanthine were produced by A. ustus and A. tamarii respectively in 300 mg/L of theophylline liquid medium. Conclusions: For the first time, we confirmed that isolated Aspergillus ustus, Aspergillus tamarii degrade theophylline through N-demethylation and oxidation. We were able to biologically produce 3-methylxanthine and xanthine efficiently from theophylline through a new microbial synthesis platform with A. ustus and A. tamarii as appropriate starter strains.