bluuebunny/crossref_metadata_2025_split huggingface dataset:
The fallacy of enzymatic hydrolysis for the determination of bioactive curcumin in plasma samples as an indication of bioavailability: a comparative study
Authors: Stohs Sidney J. , Chen C. Y. O. , Preuss Harry G. , Ray Sidhartha D. , Bucci Luke R. , Ji Jin , Ruff Kevin J. 
Published: November 2019

Abstract

Background
Numerous health benefits have been demonstrated for curcumin which is extracted from turmeric (Curcuma longa L). However, due to its poor absorption in the free form in the gastrointestinal tract and rapid biotransformation, various formulations have been developed to enhance its bioavailability. Previous studies indicate that the free form of curcumin is more bioactive than its conjugated counterparts in target tissues. Most curcumin pharmacokinetics studies in humans designed to assess its absorption and bioavailability have measured and reported total (free plus conjugated) curcumin, but not free, bioactive curcumin in the plasma because enzymatic hydrolysis was employed prior to its extraction and analysis. Therefore, the bioavailability of free curcumin cannot be determined.

Methods
Eight human subjects (4 male, 4 female) consumed a single dose of 400 mg curcumin in an enhanced absorption formulation, and blood samples were collected over 6 h. Plasma was treated either with or without glucuronidase/sulfatase prior to extraction. Curcumin and its major metabolites were analyzed using HPLC-tandem mass spectrometry. In addition, the literature was searched for pharmacokinetic studies involving curcumin using PubMed and Google Scholar, and the reported bioavailability data were compared based on whether hydrolysis of plasma samples was used prior to sample analysis.

Results
Hydrolysis of blood plasma samples prior to extraction and reporting the results as “curcumin” obscures the amount of free, bioactive curcumin and total curcuminoids as compared to non-hydrolyzed samples. As a consequence, the data and biological effects reported by most pharmacokinetic studies are not a clear indication of enhanced plasma levels of free bioactive curcumin due to product formulations, leading to a misrepresentation of the results of the studies and the products when enzymatic hydrolysis is employed.

Conclusions
When enzymatic hydrolysis is employed as is the case with most studies involving curcumin products, the amount of free bioactive curcumin is unknown and cannot be determined. Therefore, extreme caution is warranted in interpreting published analytical results from biological samples involving ingestion of curcumin-containing products.

Trial registration
ClinicalTrails.gov, trial identifying number NCT04103788, September 24, 2019. Retrospectively registered.
Bryophyllum pinnatum enhances the inhibitory effect of atosiban and nifedipine on human myometrial contractility: an in vitro study
Authors: Santos S. , Haslinger C. , Mennet M. , von Mandach U. , Hamburger M. , Simões-Wüst A. P. 
Published: November 2019

Abstract

Background
The herbal medicine Bryophyllum pinnatum has been used as a tocolytic agent in anthroposophic medicine and, recently, in conventional settings alone or as an add-on medication with tocolytic agents such as atosiban or nifedipine. We wanted to compare the inhibitory effect of atosiban and nifedipine on human myometrial contractility in vitro in the absence and in the presence of B. pinnatum press juice (BPJ).

Methods
Myometrium biopsies were collected during elective Caesarean sections. Myometrial strips were placed under tension into an organ bath and allowed to contract spontaneously. Test substances alone and at concentrations known to moderately affect contractility in this setup, or in combination, were added to the organ bath, and contractility was recorded throughout the experiments. Changes in the strength (measured as area under the curve (AUC) and amplitude) and frequency of contractions after the addition of all test substances were determined. Cell viability assays were performed with the human myometrium hTERT-C3 and PHM1–41 cell lines.

Results
BPJ (2.5 μg/mL), atosiban (0.27 μg/mL), and nifedipine (3 ng/mL), moderately reduced the strength of spontaneous myometrium contractions. When BPJ was added together with atosiban or nifedipine, inhibition of contraction strength was significantly higher than with the tocolytics alone (p = 0.03 and p < 0.001, respectively). In the case of AUC, BPJ plus atosiban promoted a decrease to 48.8 ± 6.3% of initial, whereas BPJ and atosiban alone lowered it to 70.9 ± 4.7% and to 80.9 ± 4.1% of initial, respectively. Also in the case of AUC, BPJ plus nifedipine promoted a decrease to 39.9 ± 4.6% of initial, at the same time that BPJ and nifedipine alone lowered it to 78.9 ± 3.8% and 71.0 ± 3.4% of initial. Amplitude data supported those AUC data. The inhibitory effects of BPJ plus atosiban and of BPJ plus nifedipine on contractions strength were concentration-dependent. None of the test substances, alone or in combination, decreased myometrial cell viability.

Conclusions
BPJ enhances the inhibitory effect of atosiban and nifedipine on the strength of myometrial contractions, without affecting myometrium tissue or cell viability. The combination treatment of BPJ with atosiban or nifedipine has therapeutic potential.
Increased average number of medical publications per interviewee from 2009 to 2018: a study of 100 interviewees to an academic gastroenterology fellowship program
Authors: Imam Zaid , Cappell Mitchell S. 
Published: November 2019

Abstract

Background
Gastroenterology fellowship candidates may strive to improve their qualifications for this extremely competitive fellowship.

Objective
To analyze whether extreme competitiveness of gastroenterology fellowship positions has affected fellowship interview selection by statistically analyzing 13 parameters of interviewees to identify statistically significant time changes during last 10 years.

Methods
Retrospective time-trend-analyses (performed 2018) on thirteen prospectively-obtained-parameters of 47 interviewees (2009–2011) vs. 53 interviewees (2016–2018) for gastroenterology fellowship. SETTING: William-Beaumont-Hospital, Royal-Oak: academic fully-accredited gastroenterology fellowship, teaching hospital of Oakland-University-William-Beaumont-School-of-Medicine, tertiary-care hospital, GI fellowship since 1973.

Results
Statistically significant increases occurred from 2009 to 2011 vs. 2016–2018 in number of publications, including mean number of: abstracts (1.69 ± 0.37 vs. 7.54 ± 1.16, p < 0.0001); peer-reviewed articles (1.48 ± 0.30 vs. 6.13 ± 1.29, p < 0.0001); and total publications (3.17 ± 0.48 vs. 12.76 ± 1.99, p < 0.0001). Increased publications were associated with graduating from foreign medical schools (correlation coefficient = 0.26, p = .03), and were, surprisingly, correlated with lower letters-of-recommendation-scores (Kruskal-Wallis-statistic = 5.82, p = .002). USMLE-Step-1 scores significantly increased from 2009 to 2011 to 2016–2018 (235 ± 14.1 vs. 244.9 ± 13.5, p = 0.001) (previously reported finding). Nine other parameters did not significantly change with time.

Conclusions
Current report of >four-fold-increase in publications by gastroenterology fellowship interviewees at one academic-medical-center is novel. Increased focus on scholarship by applicants may be explained by their having only three parameters to improve their credentials during residency: publications, letters-of-recommendation, and honors awarded during residency (other parameters determined before residency and immutable). Current findings may benefit medical residents/medical-residency-program-directors by focusing more on publications for applications. Association between research productivity and medical promotions likely strongly motivates medical research of residents and may motivate academic faculty. Increased exposure to research/publications may improve the clinical acumen of GI fellowship applicants by enhancing their skills in critically reading the medical literature.
Perceptions about trust: a phenomenographic study of clinical supervisors in occupational therapy
Authors: Lundh Pernilla , Palmgren Per J. , Stenfors Terese 
Published: November 2019

Abstract

Background
Finding the best way to facilitate student learning in clinical practice can be challenging for clinical supervisors. While high levels of trust might jeopardize patient safety, low trust might hinder student learning; however, carrying out professional activities is necessary for students to develop professional competence. There is a dearth of scholarly literature regarding the concept of trust among clinical supervisors in occupational therapy education. A better understanding of how trust is created between the supervisor and student may thus aid in facilitating student learning. The aim of this study, therefore, was to explore occupational therapy clinical supervisors’ perception of trust and how it is formed.

Methods
A qualitative method deploying a phenomenographic approach was chosen. Twelve clinical supervisors were interviewed, and the data were analyzed according to the seven-step phenomenographic approach.

Results
Three qualitatively different ways of thinking about trust were found: (1) that trust is about the student and is rather static; (2) trust as a dynamic process based on student performance; and (3) trust as something mutual and interrelated. The findings indicate that trust can be understood in various ways, such as being something inherent in the student or, alternatively, about the student, the supervisor, the relationship between them, and the surrounding context, including the tasks performed. Furthermore, the study shows that trust can be seen either as something static or as a dynamic process.

Conclusions
This study contributes to a deeper understanding of the variation of ways in which the concept of trust is understood among clinical supervisors in occupational therapy. The study corroborates the prior research finding that trust can be understood as a multifaceted construct. It contributes novel insights about the role of the supervisor as an influential factor in the trust-building process. A deep understanding of the possible differences in the ways of conceptualizing something can help supervisors support learning by building on this understanding. The results from this study contribute to our knowledge of the drivers behind entrusted decisions in clinical education in various professional contexts. We suggest that the results be used in the continuing professional development of clinical supervisors.
Identifying risks areas related to medication administrations - text mining analysis using free-text descriptions of incident reports
Authors: Härkänen Marja , Paananen Jussi , Murrells Trevor , Rafferty Anne Marie , Franklin Bryony Dean 
Published: November 2019

Abstract

Background
Some medications carry increased risk of patient harm when they are given in error. In incident reports, names of the medications that are involved in errors could be found written both in a specific medication field and/or within the free text description of the incident. Analysing only the names of the medications implicated in a specific unstructured medication field does not give information of the associated factors and risk areas, but when analysing unstructured free text descriptions, the information about the medication involved and associated risk factors may be buried within other non-relevant text. Thus, the aim of this study was to extract medication names most commonly used in free text descriptions of medication administration incident reports to identify terms most frequently associated with risk for each of these medications using text mining.

Method
Free text descriptions of medication administration incidents (n = 72,390) reported in 2016 to the National Reporting and Learning System for England and Wales were analysed using SAS® Text miner. Analysis included text parsing and filtering free text to identify most commonly mentioned medications, followed by concept linking, and clustering to identify terms associated with commonly mentioned medications and the associated risk areas.

Results
The following risk areas related to medications were identified: 1. Allergic reactions to antibacterial drugs, 2. Intravenous administration of antibacterial drugs, 3. Fentanyl patches, 4. Checking and documenting of analgesic doses, 5. Checking doses of anticoagulants, 6. Insulin doses and blood glucose, 7. Administration of intravenous infusions.

Conclusions
Interventions to increase medication administration safety should focus on checking patient allergies and medication doses, especially for intravenous and transdermal medications. High-risk medications include insulin, analgesics, antibacterial drugs, anticoagulants, and potassium chloride. Text mining may be useful for analysing large free text datasets and should be developed further.
Intracranial haemorrhage detected by cerebral computed tomography after falls in hospital acute medical wards
Authors: Stephen Shiny , Wong Elena W. W. , Idris Adam M. , Lim Andy K. H. 
Published: November 2019

AbstractBackgroundThere is little published data on brain imaging and intracranial haemorrhage after hospital inpatient falls. Imaging protocols for inpatient falls have been adopted from head injury guidelines developed from data in patients presenting to the Emergency Department. We sought to describe the use of brain computed tomography (CT) following inpatient falls, and determine the incidence and potential risk factors for intracranial haemorrhage.MethodsWe identified inpatient falls in acute medical wards at Monash Health, a large hospital network in the southeast region of Melbourne in Australia, from the incident reporting system during a 32 month period. We examined the post-fall medical assessment form, neurological observation chart and the diagnostic imaging system for details of the fall and brain CT findings. We used survival analysis to evaluate the timeliness of brain imaging and determined potential risk factors for intracranial haemorrhage by logistic regression.ResultsFrom 934 falls in 789 medical inpatients, 191 brain CT scans were performed. The median age of patients was 77 years. Only 55% of falls were from standing height and 24% experienced a head strike. Less than 10% of patients received an urgent scan within one hour, and timeliness of imaging was influenced by anticoagulation status rather than guideline determination of urgency. The overall incidence of intracranial haemorrhage was 0.9%. The factors associated with intracranial haemorrhage were head strike, anticoagulation, loss of consciousness or amnesia, drop in Glasgow Coma Scale and advanced chronic kidney disease.ConclusionsThe incidence of intracranial haemorrhage was low as most inpatient falls were at low risk for head injury. Research is needed to determine if guidelines specific for hospital inpatients may reduce unnecessary scans without compromising case detection, and improve timeliness of urgent scans.
Molecular epidemiology of canine parvovirus type 2 in Italy from 1994 to 2017: recurrence of the CPV-2b variant
Authors: Battilani Mara , Modugno Francesco , Mira Francesco , Purpari Giuseppa , Di Bella Santina , Guercio Annalisa , Balboni Andrea 
Published: November 2019

Abstract

Background
Canine parvovirus type 2 (CPV-2) is the most important enteric virus infecting canids. It is a rapidly evolving virus; after its emergence in the 1970s, new antigenic variants (called CPV-2a, 2b and 2c) emerged and replaced the original antigenic type. The three antigenic variants are globally distributed with different frequencies and levels of genetic variability. This study focused on VP2 gene sequence analysis and the phylodynamics of CPV-2 which were detected in 123 dogs showing clinical signs of gastroenteritis collected in Italy from 1994 to 2017.

Results
For the most part, the sick dogs were young, and a third of them (32.5%) had been vaccinated. No statistical association was found between the CPV-2 antigenic variants, and sex, age, breed and vaccination status. Sequence analysis showed that all three antigenic types circulated in Italy; the CPV-2a type was the prominent genotype, followed by CPV-2c and CPV-2b, with notable differences regarding regional bases and significant fluctuations over time. Nucleotide sequence data showed high genetic heterogeneity with 67 nucleotide sequence types (ntSTs) identified, corresponding to 21 amino acid sequence types (aaSTs). The aaSTs and ntSTs obtained were distributed differently among the three CPV-2 antigenic variants: CPV-2a grouped 12/21 (57.1%) aaSTs and 41/67 (61.2%) ntSTs; CPV-2b grouped 5/21 (23.8%) aaSTs and 6/67 (8.9%) ntSTs, and CPV-2c grouped 4/21 (19.1%) aaSTs and 20/67 (29.9%) ntSTs. Canine parvovirus 2a was characterised by the highest genetic variability while CPV-2c was characterised by notable stability with a predominant amino acid profile during the entire sampling time. Canine parvovirus 2b re-emerged in recent years, showing a new and distinctive amino acid profile of the VP2 protein.

Conclusions
The findings of the present study provided new insights regarding the phylodynamics and evolution of CPV-2 in Italy, pointing out notable differences at the local level in the distribution of the CPV-2 variants and the selection of genetic subtypes. The evolution of CPV-2 has raised questions regarding the efficacy of vaccination; therefore, continuous monitoring regarding the evolution and spread of new CPV-2 variants should be a key aim of ongoing research.
Genetic characterisation of staphylococci of food-producing animals in Senegal. PVL detection among MSSA
Authors: Mama Olouwafemi Mistourath , Dieng Modou , Hanne Bocar , Ruiz-Ripa Laura , Diop Codou Gueye Mar , Torres Carmen 
Published: November 2019

Abstract

Background
Food-producing animals can be a vehicle for staphylococcal species as well as their virulence and antimicrobial resistance genes. This work aimed to analyse the diversity of staphylococcal species in food-producing animals in Dakar/Senegal, and to determine the antimicrobial resistance phenotype/genotype and virulence factors of recovered isolates. Nasal samples of 149 cows and 199 chickens (348 animals) were collected from one slaughterhouse and a local market respectively, and were inoculated on selective media for staphylococci recovery. For S. aureus isolates, molecular typing (spa-type, MLST) was performed by PCR/sequencing, and the presence of 27 virulence genes (exfoliative and toxic shock toxins, PVL, haemolysins and enterotoxins) as well as the gene scn were analysed by PCR. Susceptibility to twelve antibiotics was studied by disc-diffusion method for all staphylococci; the resistance genes involved were screened by PCR.

Results
Staphylococcus spp. was present in 3 and 26.8% of chicken and cow nasal samples, respectively. Seven S. aureus isolates and forty isolates of other staphylococcal species were identified. S. aureus isolates were recovered from cow (n = 6) and chicken (n = 1) samples, belonging to four genetic lineages: t084/ST15 (n = 1); t10579/ST291 (n = 3); t355, t4690/ST152 (n = 2); and t6618/ST6 (n = 1). All S. aureus were methicillin-susceptible, penicillin-resistant (blaZ), and two of them were also tetracycline-resistant [tet(K)]. All the isolates carried at least one of the virulence genes tested. The PVL genes were detected in three ST15 and ST152 isolates. They all harboured haemolysins encoding genes and lacked the scn gene. The other staphylococci recovered were S. sciuri (n = 16), S. simulans (n = 11), S. hyicus (n = 5), S. haemolyticus (n = 4), S. chromogenes (n = 3), and S. hominis (n = 1); they were all methicillin-susceptible and 27.5% tetracycline-resistant [tet(K) and tet(L)].

Conclusions
A low prevalence of S. aureus was detected among food-producing animals, all susceptible to methicillin. However, the presence of virulence genes (lukF/lukS-PV, eta, tst, sea and see) is worrisome to the extent that they could be transferred to derived food and therefore, to humans.
Beyond defense: regulation of neuronal morphogenesis and brain functions via Toll-like receptors
Authors: Chen Chiung-Ya , Shih Yi-Chun , Hung Yun-Fen , Hsueh Yi-Ping 
Published: November 2019

Abstract
Toll-like receptors (TLRs) are well known as critical pattern recognition receptors that trigger innate immune responses. In addition, TLRs are expressed in neurons and may act as the gears in the neuronal detection/alarm system for making good connections. As neuronal differentiation and circuit formation take place along with programmed cell death, neurons face the challenge of connecting with appropriate targets while avoiding dying or dead neurons. Activation of neuronal TLR3, TLR7 and TLR8 with nucleic acids negatively modulates neurite outgrowth and alters synapse formation in a cell-autonomous manner. It consequently influences neural connectivity and brain function and leads to deficits related to neuropsychiatric disorders. Importantly, neuronal TLR activation does not simply duplicate the downstream signal pathways and effectors of classical innate immune responses. The differences in spatial and temporal expression of TLRs and their ligands likely account for the diverse signaling pathways of neuronal TLRs. In conclusion, the accumulated evidence strengthens the idea that the innate immune system of neurons serves as an alarm system that responds to exogenous pathogens as well as intrinsic danger signals and fine-tune developmental processes of neurons.
Using Google Earth™ and Geographical Information System data as method to delineate sample domains for an urban household surveys: the case of Maroua (Far North Region-Cameroon)
Authors: Ngom Vougat Ronald R. B. , Chouto Steven , Aoudou Doua Sylvain , Garabed Rebecca , Zoli Pagnah André , Gonne Bernard 
Published: November 2019

Abstract

Background
Getting a random household sample during a survey can be expensive and very difficult especially in urban area and non-specialist. This study aimed to test an alternative method using freely available aerial imagery.

Methods
A gridded map and random selection method was used to select households for interviews. A hundred numbered of points were put along the edges of an updated map of Maroua. Then two numbers were randomly draw at a time and a line was drawn between those two numbers. A lot of different kinds of shapes of different sizes obtained were numbered. Ten shapes were randomly draw and the one selected were considered as ‘neighbourhoods’. A grid of 30 m × 30 m was drawn over each and then numbered. 202 grids considered here as households were randomly selected from the ten neighbourhoods for interviews.

Results
Out of 202 households visited, only 4 were found to be something other than a house. In addition, 30 sampled households (14.85%) were abandoned or the occupants had relocated elsewhere. This method resulted in an accuracy level of 72%, its advantage is the ability to generate efficient random sample at relatively low cost as well the time required.

Conclusions
The method proposed in this study was efficient and cost-effective when compared to the infield generation of a household inventory or Global Positioning System (GPS) tracking of households. It can then be used by researchers in low-incomes countries where funding for research is a challenge. However, this method needs to train the investigators on how to use the GPS.