bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symbiotic microbiome Staphylococcus aureus from human nasal mucus modulates IL-33-mediated type 2 immune responses in allergic nasal mucosa
Authors: Jeon Yung Jin , Gil Chan Hee , Won Jina , Jo Ara , Kim Hyun Jik 
Published: September 2020

Abstract
Background: The host-microbial commensalism can shape the innate immune responses in respiratory mucosa and nasal microbiome also modulates front-line immune mechanism in the nasal mucosa. Inhaled allergens encounter the host immune system first in the nasal mucosa, and microbial characteristics of nasal mucus directly impact the mechanisms of initial allergic responses in nasal epithelium. However, the roles of the nasal microbiome in allergic nasal mucosa remain uncertain. We sought to determine the distribution of nasal microbiomes in allergic nasal mucosa and elucidate the interplay between nasal microbiome Staphylococcus species and Th2 cytokines in allergic rhinitis (AR) models.Results: Staphylococcus aureus (AR-SA) and S. epidermidis (AR-SE) were isolated from the nasal mucosa of patients with AR. The influence of nasal microbiome Staphylococcus species on allergic nasal mucosa was also tested with in vitro and in vivo AR models. Pyrosequencing data showed that colonization by S. epidermidis and S. aureus was more dominant in nasal mucus of AR subjects. The mRNA and protein levels of IL-33 and TSLP were significantly higher in AR nasal epithelial (ARNE) cells which were cultured from nasal mucosa of AR subjects, and exposure of ARNE cells to AR-SA reduced IL-33 mRNA and secreted protein levels. Particularly, ovalbumin-driven AR mice inoculated with AR-SA by intranasal delivery exhibited significantly reduced IL-33 in their nasal mucosa. In the context of these results, allergic symptoms and Th2 cytokine levels were significantly downregulated after intranasal inoculation of AR-SA in vivo AR mice. Conclusion: Colonization by Staphylococcus species was more dominant in allergic nasal mucosa, and nasal commensal S. aureus from subjects with AR mediates anti-allergic effects by modulating IL-33-dependent Th2 inflammation. The results demonstrate the role of host-bacterial commensalism in shaping human allergic inflammation.
Efficacy of Orbital Radiotherapy in Moderate-to-Severe Active Graves’ Orbitopathy Including Long-lasting Disease
Authors: Choi Jin Hwa , Lee Jeong Kyu 
Published: September 2020

Abstract
Background: We aimed to explore the efficacy of orbital radiotherapy (RT) in patients with moderate-to-severe active Graves’ orbitopathy (GO), including long-lasting disease, and to determine the predictive factors associated with treatment response.Methods: This was a retrospective study of 62 moderate-to-severe active GO patients treated with RT. Demographic data and ophthalmic findings prior to RT and at 3 and 6 months afterward were analyzed. Computed tomography was performed before and after RT to compare orbital volume change. We used logistic regression to determine the predictive factors for treatment response. Subjects were divided into early- and late-active phase groups based on GO duration of 24 months and treatment outcomes were compared with each other to observe the effects of RT timing on treatment response.Results: Forty (64.5%) and forty-six (74.1%) patients experienced improvements in GO at 3 and 6 months after radiotherapy, respectively. Ocular parameters such as clinical activity score (CAS), proptosis, extraocular muscle (EOM) limitation, and compressive optic neuropathy (CON) were improved by RT. Volumes of EOM significantly decreased after RT. The enlargement of EOMs and EOM limitation were predictive factors for a good response to RT. At 6 months after RT, 22 (68.8%) patients of late-active phase group exhibited improvement in GO, which is comparable to the number of 24 (80.0%) patients of early-active phase group. In the late-active phase group, CAS, diplopia, and visual acuity were improved significantly, but there was no change in EOM limitation.Conclusions: In moderate-to-severe active GO patients, orbital RT may help improve high CAS, proptosis, EOM limitation, and CON. The orbital RT in long-lasting active GO patients may be considered as treatments for the relief of symptoms including high CAS and poor visual acuity.
Circulating Cytokine Profiles of Polyparasitized Individuals in Gabon.
Authors: M'Bondoukwé Noé Patrick , Moutongo Reinne , Gbédandé Komi , Ngomo Jacques Mari Ndong , Hountohotegbe Tatiana , Adamou Rafiou , Lengongo Jeanne Vanessa Koumba , Bello Kowir Pambo , Mawili-Mboumba Denise Patricia , Luty Adrian John Frederick , Bouyou-Akotet Marielle Karine 
Published: September 2020

Abstract
Background: Malaria, blood-borne filarial worms and intestinal parasites are all endemic in Gabon. This geographical co-distribution leads to polyparasitism and consequently, the possibility of immune-mediated interactions between different parasite species. Intestinal protozoa and helminths could modulate anti-malarial immunity, for example, thereby potentially increasing or reducing susceptibility to malaria. Methods: Blood and stool samples were collected during cross-sectional surveys in five provinces of Gabon. Parasitological diagnosis was performed to detect plasmodial parasites, Loa loa, Mansonella perstans, intestinal helminths (STH) and protozoan parasites. Nested PCR was used to detect submicroscopic plasmodial infection in individuals with negative blood smears. Cytometric Bead Array was used to quatify interleukin (IL)-6, IL-10 and Tumor Necrosis Factor (TNF)-α in plasma of subjects with different parasitological profiles. Results: Median IL-6 and IL-10 levels and the median IL-10/TNF- α ration were all significantly higher among individuals with Plasmodium (P.) falciparum infection compared to other groups ( P ≤0.0001). The median TNF-α level and IL-10/IL-6 ratio were higher in subjects with STH ( P =0.09) and P. falciparum -intestinal protozoa co-infection ( P =0.04), respectively. IL-6 (r=-0.37; P ≤0.01) and IL-10 (r=-0.37; P ≤0.01) levels, and the IL-10/TNF-α ratio (r=-0.37; P ≤0.01) correlated negatively with age. Among children under five years old, the IL-10/TNF-α and IL-10/IL-6 ratios were higher in those with intestinal protozoan infections compared to uninfected children. The IL-10/TNF-α ratio was also higher in children aged 5-15 years and in adults harbouring blood-borne filariae compared to their control counterparts, whereas the IL-10/IL-6 ratio was lower in those aged 5-15 years with filariae and intestinal parasites but higher in adults with intestinal parasitic infections. Conclusion: Asymptomatic malaria is associated with a strong polarization towards a regulatory immune response, presenting high circulating levels of IL-10. P. falciparum/intestinal protozoa co-infections are associated with an enhanced IL-10 response. Immunity against malaria could differ according to age and carriage of other parasites.
Dental Students’ Notetaking: a Thematic, Material-based Interview Study
Authors: Lindberg Viveca , Jounger Sofia Louca , Christidis Maria , Christidis Nikolaos 
Published: September 2020

Abstract
Background: The transition from upper secondary to higher education and from higher education to professional practice requires that students need to adapt to new literacy practices, academic and professional. The aim of this study was to identify what characterizes dental students’ notetaking and secondarily to determine what dental students express regarding their notetaking.Methods: Three undergraduate dental students participated in this material-based, semi-structured interview study, that was framed within a New Literacy Studies approach. To analyze the outcome of the interviews a thematic analysis was used. Results: Eight themes that relate to what, how and for what purpose students write were discerned. These include a) what: T1-Professional vocabulary; T2-Core content; T3-Clinical example; b) how: T4-Multimodal accentuation; T5-Synthesis; and c) for what purpose: T6-Mnemonic strategies; T7-Academic purposes; and T8 professional purposes.Conclusions: Findings from the interviews indicate that the digital development, offering a variety of available tools, has expanded the notion of notetaking. Thus, this study identified that dental students’ notetaking has changed during their education from initially just being synchronous, to now also include both multimodal and asynchronous writing, making the notetaking more of a writing practice. Further, students’ writing practices seem to be motivated by their knowledge formation in relation to a subject matter, but also in relation to their experiences during clinical training. Although our hypothesis was that the main purpose of notetaking and writing was to pass their course examinations, this study showed that students, half-way through their dental education, are aware that literacy practices are not only for passing their exams, but also for learning for their future profession.
Clinical characteristics and manifestations in older patients with COVID-19
Authors: Wei Chenchen , Liu Ya , Liu Yapeng , Zhang Kai , Su Dezhen , Zhong Ming , Meng Xiao 
Published: September 2020

Abstract
Background: To investigate the clinical characteristics and manifestations of older patients with coronavirus disease 2019 (COVID-19).Methods: In this retrospective study, 566 patients with confirmed COVID-19 were enrolled and the clinical characteristics, laboratory findings, complications and outcome data were collected and analyzed.Results: Among the 566 patients (median age, 61.5 years) with COVID-19, 267 (47.2%) patients were male and 307 (54.2%) were elderly. Compared with younger patients, older patients had more underlying comorbidities and laboratory abnormalities. A higher rate of acute respiratory distress syndrome (ARDS), acute cardiac injury and heart failure was observed in the older group as compared with younger and middle-aged groups, particularly those oldest-old patients (>75 years) had more multi-organ damage. Older patients with COVID-19 were more likely to suffer from acute cardiac injury in cases with preexistenting cardiovascular diseases, while there was no difference among the three groups when patients had no history of cardiovascular diseases. Older patients present more severe with the mortality of 18.6%, which was higher than that in younger and middle-aged patients (P<0.05). Multivariable analysis showed that age, lymphopenia, ARDS, acute cardiac injury, heart failure and skeletal muscle injury were associated with death in older patients, while glucocorticoids may be harmful.Conclusions: Older patients, especially the oldest-old patients were more likely to exhibit significant systemic inflammation, pulmonary and extrapulmonary organ damage and a higher mortality. Advanced age, lymphopenia, ARDS, acute cardiac injury, heart failure and skeletal muscle injury were independent predictors of death in older patients with COVID19 and glucocorticoids should be carefully administered in older patients.
Clinical educator self-efficacy, self-evaluation and its relationship with student evaluations of clinical teaching
Authors: Vaughan Brett 
Published: September 2020

Abstract
Background

In a whole-of-system approach to evaluation of teaching across any degree, multiple sources of information can help develop an educators’ understanding of their teaching quality. In the health professions, student evaluations of clinical teaching are commonplace however, self-evaluation of teaching is less common, and exploration of clinical educators’ self-efficacy even less so. The aim of the study was to evaluate how a clinical educator’s self-evaluation of teaching intersects with their self-efficacy, to ascertain if that matches student evaluation of their teaching. This information may assist in facilitating targeted professional development to improve teaching quality.

Methods

Clinical educators in the osteopathy program at Victoria University (VU) were invited to complete: a) self-evaluation version of the Osteopathy Clinical Teaching Questionnaire (OCTQ); and b) the Self-Efficacy in Clinical Teaching (SECT) questionnaire. Students in the VU program completed the OCTQ for each of the clinical educators they worked with during semester 2, 2017.

Results

Completed OCTQ and SECT were received from 37 clinical educators. These were matched with 308 student evaluations (mean of 6 student ratings per educator). Three possible educator cohorts were identified: a) high clinical eductor self-OCTQ with low student evaluation; b) low clinical educator self-evaluation and high student evaluations; and, c) no difference between self- and student evaulations. Clinical educators in the first cohort demonstrated significantly higher SECT subscale scores (effect size >0.42) than their colleagues. Age, gender, teaching qualification, and years practicing or years as a clinical educator were not associated with clinical educator OCTQ scores or the SECT subscales.

Conclusions

Targeted professional development directed towards fostering self-efficacy may provide an avenue for engaging those clinical educators whose self-efficacy is low and/or those who did not receive high student evaluations. Given there is no gold standard measure of clinical teaching quality, educators should engage with multiple sources of feedback to benchmark their current performance level, and identify opportunities to improve. Student and self-evaluations using the OCTQ and evaluation of self-efficacy using the SECT, are useful tools for inclusion in a whole-of-system approach to evaluation of the clinical learning environment.
Views of advanced cancer patients, families, and oncologists on initiating and engaging in advance care planning: a qualitative study
Authors: Toguri James Thomas , Grant-Nunn Lindsay , Urquhart Robin 
Published: September 2020

Abstract
Background: Advance care planning (ACP) is a process by which patients reflect upon their goals, values and beliefs to allow them to make decisions about their future medical treatment that align with their goals and values, improving patient-centered care. Despite this, ACP is underutilized and is reported as one of the most difficult processes of oncology. Aims: To 1) explore patients’ and families’ understanding, experience and reflections on ACP, as well as what they need from their physicians during the process; 2) explore physicians’ views of ACP, including their experiences with initiating ACP and views on ACP training. Design and setting: Qualitative descriptive study in Nova Scotia, Canada with oncologists, advanced cancer out-patients and their family members. Methods: Semi-structured interviews with advanced cancer out-patients and their family members (n=4 patients, 4 family members) and oncologists (n=10) were conducted; each participant was recruited separately. Data were analyzed using constant comparative analysis, which entailed coding, categorizing, and identifying themes recurrent across the datasets. Results: Themes were identified from the patient / family and oncologist groups, four and five respectively. Themes from patients / families included: 1) positive attitudes towards ACP; 2) healthcare professionals (HCPs) lack an understanding of patients’ and families’ informational needs during the ACP process; 3) limited access to services and supports; and 4) poor communication between HCPs. Themes from oncologists included: 1) initiation of ACP discussions; 2) navigating patient-family dynamics; 3) limited formal training in ACP; 4) ACP requires a team approach; and 5) lack of coordinated systems hinders ACP. Conclusion: Stakeholders believe ACP for advanced cancer patients is important. Patients and families desire earlier and more in-depth discussion of ACP, additional services and supports, and improved communication between their HCPs. In the absence of formal training or guidance, oncologists have used clinical acumen to initiate ACP and a collaborative healthcare team approach.
Influence of X ray computed tomography (CT) exposure and reconstruction parameters on positron emission tomography (PET) quantitation.
Authors: Shon Ivan Ho , Reece Christopher , Hennessy Thomas , Horsfield Megan , McBride Bruce 
Published: September 2020

Abstract
Background: The CT of PET CT provides diagnostic information, anatomic localisation and attenuation correction (AC). When only AC is required very lose dose CT is desirable. CT iterative reconstruction (IR) improves image quality with lower exposures however there is little data on very low dose IR CT for AC of PET. This work assesses the impact of CT exposure and reconstruction algorithm on PET voxel values.Method: An anthropomorphic torso phantom was filled with physiologically typical [18]F concentrations in heart, liver and background compartments. A 17mm diameter right lung “tumour” filled with [18]F was included (surrounding lung contained no 18[F]). PET was acquired followed by 24 CT acquisitions with varying CT exposures (15 - 50mAs, 80 – 120kVp, pitch 0.671 or 0.828). Each CT was reconstructed twice using filtered back projection (FBP) or IR and these used for AC of PET. The reference PET reconstruction (RR) used CT acquired at 50mAs, 120kVp, pitch 0.828, IR, all others were test PET reconstructions (TR). Regions of interest (ROIs) were drawn in liver, soft tissue and over “tumour” on each TR and compared with the RR. Voxel values in each TR were compared to the RR using a paired t-test and by calculating which and what proportion of voxels in each TR differed by a quantitatively significant difference (QSD) from the RR.Results: TRs reconstructed using lower dose CTs underestimated mean and maximum ROI activity relative to the RR; greater with IR than FBP. Once CT dose index (CTDI) increased to 1 mGy, differences were less than QSD. On voxel analysis all TRs were significantly different to the RR (p <0.0001). TRs reconstructed at the lowest CT exposure with IR had 6% of voxels that differed by greater than QSD. Differences were reduced with increasing CTDI and FBP reconstruction. Voxels which exceeded the QSD were spatially localised to regions of high activity, interfaces between different attenuation and areas of CT beam hardening.Conclusions: Very low dose CT exposures are feasible for accurate PET AC. Scanner and reconstruction specific validation should be employed prior very low dose CT AC for PET.
Housing conditions, level of feeding and presence of antibiotics in the feed shape rabbit cecal microbiota
Authors: Velasco-Galilea María , Guivernau Miriam , Piles Miriam , Viñas Marc , Rafel Oriol , Sánchez Armand , Ramayo-Caldas Yuliaxis , González-Rodríguez Olga , Sánchez Juan P. 
Published: September 2020

Abstract
Background: the effect of the production environment and different management practices in rabbit cecal microbiota remains poorly understood. While previous studies have proved the impact of the age or the feed composition, research in the housing conditions and other animal management aspects, such as the presence of antibiotics in the feed or the level of feeding, is still needed. Characterization of microbial diversity and composition of growing rabbits raised under different conditions could help better understand the role these practices play in cecal microbial communities and how it may result in different animal performance.Results: four hundred twenty-five meat rabbits raised in two different facilities, fed under two feeding regimes (ad libitum or restricted) with feed supplemented or free of antibiotics, were selected for this study. A 16S rRNA gene-based assessment through the MiSeq Illumina sequencing platform was performed on cecal samples collected from these individuals at slaughter. Different univariate and multivariate approaches were conducted to unravel the influence of the different factors on microbial alpha diversity and composition at phylum, genus and OTU taxonomic levels. The animals raised in the facility harboring the most stable environmental conditions had greater, and less variable, microbial richness and diversity. Bootstrap univariate analyses of variance and sparse partial least squares-discriminant analyses endorsed that farm exerted the largest influence on rabbit microbiota since the relative abundances of many taxa were found differentially represented between both facilities at all taxonomic levels characterized. Furthermore, only five OTUs were needed to achieve a perfect classification of samples according to the facility where animals were raised. The level of feeding and the presence of antibiotics did not modify the global alpha diversity but had an impact on some bacteria relative abundances, albeit in a small number of taxa compared with farm, which is consistent with the lower sample classification power according to these factors achieved using microbial information.Conclusions: this study reveals different degrees of influence attributable to environment and animal management. It highlights the importance of offering a controlled breeding environment that reduces differences in microbial cecal composition that could be causative of different animal performance.
Effect of dapsone alone and in combination with intracellular antibiotics against the biofilm form of B. burgdorferi&nbsp;
Authors: Horowitz Richard Ira , Murali Krithika , Gaur Gauri , Freeman Phyllis R. , Sapi Eva 
Published: September 2020

Abstract
Objective: Lyme disease is a tick-borne, multisystemic disease caused by Borrelia burgdorferi. Standard treatments for early Lyme disease include short courses of oral antibiotics but relapses often occur after discontinuation of treatment. Several studies have suggested that ongoing symptoms may be due to a highly antibiotic resistant form of B. burgdorferi called biofilms. Our recent clinical study reported the successful use of an intracellular mycobacterium persister drug used in treating leprosy, diaminodiphenyl sulfone (dapsone), in combination therapy for the treatment of Lyme disease. In this in vitro study, we evaluated the effectiveness of dapsone individually and in combination with cefuroxime and/or other antibiotics with intracellular activity including doxycycline, rifampin, and azithromycin against Borrelia biofilm forms utilizing crystal violet biofilm mass, and dimethyl methylene blue glycosaminoglycan assays combined with Live/Dead fluorescent microscopy analyses. Results: Dapsone, alone or in various combinations with doxycycline, rifampin and azithromycin produced a significant reduction in the mass and protective glycosaminoglycan layer and overall viability of B. burgdorferi biofilm forms. This in vitro study strongly suggests that dapsone combination therapy could represent a novel and effective treatment option against the biofilm form of B. burgdorferi.