bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of tongue coating removal methods: A preliminary study with a systematic review
Authors: Funahara Madoka , Nakamura Akari , Inho Soh , Honda Hiromi , Kojima Yuka , Soutome Sakiko , Umeda Masahiro , Hikiji Hisako 
Published: April 2020

Abstract
Background

It is known that tongue coating is one of the main causes of halitosis, as well as various diseases such as aspiration pneumonia. However, no method for removing tongue coating has been established.
Materials and methods

We first performed a systematic review of 32 papers that compared the effects of multiple tongue coating removal methods. Next, we conducted a preliminary, randomized controlled trial on the effect of three disinfectants on tongue cleaning. Thirty-two patients were randomly assigned to the following four groups; 1) benzethonium chloride group (BC group), 2) povidone iodine group (PI group), 3) hydrogen peroxide group (HP group), and 4) tap water group (TW group). Tongue cleaning was performed using a toothbrush with the 4 test drugs, and the number of bacteria on the dorsum of the tongue before and after tongue cleaning was measured using the Rapid Oral Bacteria Quantification System.
Results

The systematic review suggested that, 1) mechanical tongue cleaning reduced the tongue coating, 2) some antibacterial mouthwashes reduced the tongue coating, and 3) some diets, chewing gums and tablets also reduced the tongue coating. The randomized controlled trial showed that the number of bacteria decreased significantly when tongue brushing was done using povidone iodine and hydrogen peroxide solution, while, 0.2% benzethonium chloride and tap water did not decrease the bacterial count.
Conclusions

Tongue brushing with povidone iodine or hydrogen peroxide is the most effective method of reducing the bacterial count of tongue coating.
Trial Registration

The study was registered in the University Hospitals Medical Information Network Clinical Trials Registry (UMIN-CTR), UMIN000038544 on November 11, 2019: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000043924.
Research on pneumonia exacerbation in patients infected with SARS-CoV-2 in Wuhan, China
Authors: Yang Ling , Tang Yan-Ping , Chen Guo-Xi , Wang Lin , Lan Xing , Ji Chen , Li Xiao-Pan , An Ye , Zhang Di , Zeng Guang-Wang , Wang Ya-Ling , Huang Yang-Yang , Cai Yu-Yang , Huang Hai 
Published: April 2020

Abstract

Background

SARS-CoV-2 pneumonia occasionally exacerbates to critical condition that is hard to manage. We aim to describe exacerbations of SARS-CoV-2 pneumonia among inpatients.
Methods

We included confirmed SARS-CoV-2 patients with pneumonia exacerbation admitted to Wuhan Pulmonary Hospital, Hubei Province, China between January 6 and February 17, 2020 and discharged or died before February 25. Their demographic characteristics, clinical symptoms, laboratory tests, CT manifestations, complications and clinical outcomes were collected.
Results

A total of 158 patients were collected, among them 107 patients were stable and discharged after recovery, 24 patients were already critically severe at hospital admission. 14 patients were excluded for insufficient clinical data. Eventually, 13 confirmed cases were included. The mean age was 65 (± 9.81) years. Ten of the 13 (76.9%) patients were female. Nine (69.2%) had underlying comorbidities. Fever and cough were the most common symptoms (12/13, 92.3%). 10/13(76.9%) patients had their exacerbation in the second week of disease course. All patients had both negative and positive nucleic acid test (NAT) results during the course. Increased range of ground-glass opacity (GGO) on CT imaging are consistent to disease exacerbation. ARDS, MODS, respiratory failure were found in 5/13(38.5%), 3/13(23.1%), 6/13(46.2%) patients respectively. Five (38.5%) patients did not survive.
Conclusions

SARS-CoV-2 pneumonia exacerbations often occurs in the second week of disease course. Negative NAT result could not exclude exacerbation. CT manifestation is consistent with disease progression. Early admissions have positive effects on reducing complications and mortality.
Determining the reasons for unmet medical needs in Korea: A secondary data analysis
Authors: Ha In-Hyuk , Jung Boyoung 
Published: April 2020

Abstract

Background: Unmet medical need which are indicators used globally to assess healthcare accessibility is a condition in which no satisfactory method of prevention, diagnosis, and treatment exists. The purpose of this study is to analyze factors related to unmet medical needs among Korean adults. Methods: We used a retrospective cross-sectional study design. This nationwide-based study included the data of 26,598 participants aged 19 years and older, obtained from the Korea National Health and Nutrition Examination Survey for 2013–2017. Using multiple logistic regression models, we analyzed the associations between factors that influence unmet medical needs and participants’ subgroups.Results: Despite Korea’s universal health-insurance system, we found that in 2017, 9.5% of Koreans experienced unmet needs. In the young adult group, men had a higher odds ratio of experiencing unmet medical needs compared to women (Males: OR = 1.83, 95% CI = 1.35-2.48; Females: OR = 1.42, 95% CI = 1.12-1.81). ). In particular, unlike men, women’s unmet medical needs increased as their incomes decreased (1Q OR = 1.55, 2Q OR =1.29, 3Q OR=1.26). Men and women showed a tendency to have more unmet medical needs with less exercise, worse subjective health state, worse pain, and a higher degree of depression.Conclusions: In conclusion, unmet medical needs contributing factors included having a low socioeconomic status, high stress, severe pain, or severe depression. Considering our findings, we suggest improving health-care access with low socioeconomic status.
Factors contributing to discrepant estimated glomerular filtration values measured by creatinine and cystatin C in patients with rheumatoid arthritis
Authors: Kawano Mitsuhiro , Nakashima Akikatsu , Horita Shigeto , Matsunaga Takahiro , Inoue Ryo , Zoshima Takeshi , Mizushima Ichiro , Hara Satoshi , Ito Kiyoaki , Fujii Hiroshi , Nomura Hideki 
Published: April 2020

Abstract

Background This study aimed to clarify the factors underlying the discrepancy that has been noted between estimated glomerular filtration ratio (eGFR) measured using serum creatinine (Cr) and eGFR using serum cystatin C (CysC) in patients with rheumatoid arthritis (RA) and to identify those patients whose renal function should be evaluated using CysC.Methods We retrospectively evaluated clinical features, disease activity, radiological grading, and co-morbidities (diabetes mellitus, hypertension, dyslipidemia) in 238 RA patients. eGFR using serum creatinine (eGFR-Cr) and eGFR using serum cystatin C (eGFR-CysC) were calculated using the new Japanese coefficient-modified Modification of Diet in Renal Disease study equation. To clarify the cause(s) of differences of 20% or more between the two eGFRs, we divided our RA patients into Group A (eGFR-Cr/eGFR-CysC ≥ 1.2), with eGFR-Cr more than 20% higher than eGFR-CysC, and Group B (eGFR-Cr/eGFR-CysC < 1.2), and compared various clinical parameters between them.Results Forty-five patients (18.9%) were assigned to Group A, and 193 (81.1%) to Group B. Group A were older (73.8 ± 12.5 vs 63.2 ± 13.6 years), and had a longer disease duration (17.7 ± 14.0 vs 10.4 ± 9.5 years), lower body mass index (BMI) (20.0 ± 2.9 vs 22.4 ± 3.6 kg/m2), higher frequencies of hypertension and diabetes mellitus (55.6% vs 30.1% and 35.6% vs 11.0%, respectively), higher DAS28-ESR (3.1 ± 1.3 vs 2.6 ± 1.0), lower hemoglobin (Hb) (11.8 ± 1.8 vs 12.8 ± 1.4 g/dl), lower creatine kinase (CK) (63.9 ± 36.0 vs 92 ± 79 IU/L), higher frequency of Steinbrocker stage 4 (46.7% vs. 15.3%), and a lower frequency of nonsteroidal anti-inflammatory drugs (NSAID) use (13.3% vs 30.6%), all significantly (p < 0.01) by a univariate analysis. BMI (Odds Ratio [OR] 0.820, 95% confidence interval [CI] 0.675–0.996), Hb (OR 0.633, 95% CI 0.433–0.926), CK (OR 0.773 per 10 units, 95% CI 0.644–0.933), NSAID use (OR 0.099, 95% CI 0.020–0.494), diabetes mellitus (OR 6.024, 95% CI 1.508–24.390) and stage 4 Steinbrocker radiological grade (OR 10.309, 95% CI 2.994–35.714) were identified as independent relevant factors for Group A by a multifactorial analysis.Conclusion Renal function in RA patients with low BMI, diabetes, anemia and low CK may be overestimated using eGFR-Cr alone, and such patients need to be evaluated using eGFR-CysC.
Cognitive tics in Gilles de la Tourette syndrome
Authors: Dunalska Anna , Janik Piotr , Szejko Natalia , Jakubczyk Andrzej 
Published: April 2020

Abstract

BACKGROUND

Gilles de la Tourette syndrome (GTS) is characterized by motor and vocal tics. Cognitive tics (CTs) have been rarely recognized as part of GTS symptomatology and their prevalence and associates have not been systematically investigated.
OBJECTIVES

The aim of the study was to assess the incidence and clinical associations of CTs in a group of patients with GTS.
METHODS

We examined 227 consecutive GTS patients aged 5–50 years old (78.4% males). The median duration of GTS was 4 years (IQR: 3–7) in children and 18 years (IQR: 12–23) in adults. The patients were evaluated for GTS and comorbid mental disorders according to the DSM-IV-TR and DSM-5. CTs were defined as brief, sudden, recurring involuntary thoughts, analogous to typically recognized complex vocal tics and diagnosed during the interview. Correlations between CTs and clinical variables were evaluated in two analyses, lifetime and current. Children and adult groups were compared.
RESULTS

Lifetime CTs were reported by 48 patients (21.1%), in 33 of the cases at the time of evaluation. The median age at onset of CTs was 13.5 years (IQR 9.3–16). Five mental phenomena were evaluated: echolalia (n = 17), coprolalia (n = 16), palilalia (n = 13), counting (n = 11), repeating of words in mind (n = 7). In the multivariable analysis of lifetime CTs, tic severity (p = 0.025) and significant social skill problems (p = 0.050) demonstrated correlation, while for current CTs only tic severity (p = 0.028) and anxiety disorder (p = 0.028) remained significant. In logistic regression model for age groups, in children only age was a factor significantly associated with lifetime CTs (p = 0.033), whereas in adults there were no statistically significant associations with lifetime CTs. For current CTs, none of the variables reached statistical significance in children, while only anxiety disorder was a predictor of current CTs in adults (p = 0.018).
CONCLUSIONS

CTs are a part of tic spectrum with a substantial impact of comorbid psychiatric disorders. CTs are a late and age-related symptom of GTS.
The impact of antenatal care on child mortality in Ethiopia: a difference-in-differences analysis
Authors: Oduse Samuel , Zewotir Temesgen , North Delia 
Published: April 2020

Abstract
Background This article examines the impact of antenatal care on child health outcome. We specifically investigated if women visits to antenatal care services has a positive effect in the reduction of under-five mortality. Methods We employ a difference-in-differences design with propensity score matching to identify direct causal effects of antenatal care on under-five mortality based on the Ethiopian Demographic Health Survey data of 2011 and 2016. Our sample includes 22 295 women between the ages of 14-49 years who have at least one antenatal care visit before delivery (treatment group) or had no antenatal care visit before delivery (control group). Results The study revealed 1 481 cases of reported under-five mortality. 83.7% of that is by women who never had any antenatal care visit while the remaining 16.3% are by women who had at least one antenatal visit during their pregnancy. Antenatal care visit decreases the likelihood of under-five mortality in Ethiopia by 29% (CI = 1.3-56%, P= 0.04). Conclusions To achieve significant reduction in under-five mortality rate, Intervention programs that encourages antenatal care visits should be considered. This will improve child survival and help in attaining sustainable Development Goal target.
A novel Swollenin from Talaromyces leycettanus JCM12802 exhibits cellulase activity and enhanced cellulase hydrolysis towards various substrates
Authors: Zhang Honghai , Wang Yuan , Brunecky Roman , Yao Bin , Xie Xiangming , Zheng Fei , Luo Huiying 
Published: April 2020

Abstract
Background

Swollenins are present in some fungal species involved in the biodegradation of cellulosic substrates. They appear to promote a rearrangement in the network of non-covalent interactions between the cell wall polysaccharides, thus making it more accessible for degradation by hydrolytic enzymes. Here, we have reported a detailed characterization of a recombinant swollenin with respect to its disruptive activity on cellulosic substrates and synergistic effect with cellulases.
Results

In the present study, a novel swollenin gene Tlswo consisting of an open reading frame encoding 503 amino acids was identified from Talaromyces leycettanus JCM12802 and successfully expressed in Trichoderma reesei and Pichia pastoris. Similar to other fungal swollenins, TlSWO contained a N-terminal family 1 carbohydrate binding module (CBM1) followed by a Ser/Thr rich linker connected to expansin-like domain which includes a family 45 endoglucanase-like domain and group-2 grass pollen allergen domain. TlSWO demonstrated disruptive activity on Avicel and displayed a high synergistic effect with cellobiohydrolases, enhancing its hydrolytic performance up to 132%. The activity of TlSWO on various substrates and biomass was also examined. It was shown that TlSWO could release reducing sugars from lichenan, barley β-glucan, carboxymethyl cellulose sodium (CMC-Na) and laminarin. The specific activity of TlSWO towards the substates above is 9.0 ± 0.100 U/mg, 8.9 ± 0.100U/mg, 2.3 ± 0.002 U/mg and 0.79 ± 0.002 U/mg respectively. Moreover, TlSWO exhibits maximum activity at pH 4.0 and 50 ℃.
Conclusion

This study reported on a novel swollenin with highly efficient for biomass conversion. It also reveals the functional diversity of swollenin with activity on various substrates. Although the exact mechanism of swollenin catalytic action activity still remains unknown, the functional diversity of TlSWO makes it a good candidate for industrial applications.
Motivational Interviewing to Improve Self-efficacy in Type 2 Diabetes Management
Authors: Maslakpak Masumeh Hemmati , Parizad Naser , Ghahremani Amir , Alinejad Vahid 
Published: April 2020

Abstract
Background

Self-efficacy predicts adherence to treatment in patients with diabetes. Motivational interviewing could be a promising intervention to increase the patients’ motivation to follow therapeutic recommendations. The present study aimed to assess the effects of motivational interviewing on self-efficacy in type 2 diabetes management.
Methods

This quasi-experimental study with a pretest-posttest design was conducted on 60 patients with type 2 diabetes, who were members of the Bukan Diabetes Association in Iran. The patients were selected using a random number table and were randomly allocated into intervention (n = 30) and control (n = 30) groups. Five motivational interviewing sessions (30–45 minutes) were held for the intervention group (two sessions per week). Data were collected using a demographic questionnaire and the diabetes management self-efficacy scale (DMSES). Data were analyzed with SPSS software version 14.0 using descriptive and inferential statistics.
Results

Sixty patients entered the analysis. A significant difference was observed in the mean score of diabetes management self-efficacy between the two groups before and after the intervention (P = 0.014). The mean score of self-efficacy in diabetes management was increased significantly in the intervention group after MI (P = 0.001).
Conclusions

Motivational interviewing improved self-efficacy in diabetes management. Thus, this approach is recommended to be used in patients with type 2 diabetes in order to increase their self-efficacy.
Prevalence And Associated Risk Factors Of Bacterial Vaginosis Among Pregnant Women In Africa: A Systematic Review
Authors: Tesfay Gebrehiwet , Deekonda Karthik , Paramasivam Ragul , Muthupandian Saravanan 
Published: April 2020

Abstract
Background: Bacterial vaginosis is the most common form of vaginitis which causes abnormal vaginal discharge in woman of childbearing age, which predispose to various gynecological and obstetric problems. In Africa sub-continent, the prevalence of BV among pregnant women is different among different countries. This review aimed to show the overall prevalence and to describe the different risk factors associated with BV among pregnant women in Africa. Methods: PubMed, Medline, science direct, Google scholar and other relevant databases were searched from January 2008 to December 2018. Article retrieval and screening was done using standard procedural steps and strict inclusion/exclusion criteria. The total articles included in this review were 31 and cumulative prevalence was drawn from each country. Results: This review addressed the prevalence of BV and its associated risk factors among pregnant women and its associated risk factors conducted in 31 eligible studies from 15 different countries of Africa, in which most of the studies were from Nigeria 22.6% (7/31), Kenya 16% (5/31) and Ethiopia 13% (4/31). Samples from a total of 19,354 pregnant women 4795 were positive for BV with the overall prevalence of 24.8% (4795/19,354), and the highest cumulative prevalence was reported from two studies conducted in more than two countries (1113/2349, 47.4%). Fifteen out of 31 articles or studies (48.4%) are significantly associated with different risk factors. Out of the 15 articles 33.3% (5/15) of the associated risk factors are HIV followed by age and previous BV/STI (20%). Conclusion: The prevalence of BV among pregnant women was different in all regions of Africa with the pooled prevalence of 24.8%. HIV infected pregnant women and sexually active women (mostly in the age group of 20-30 years) were at high risk for BV and in some studies reported BV positive women are also at high risk of acquiring HIV infection.
Main challenges in utilization of the consultations services of hospital ethics committees: a systematic review of the literature
Authors: Khodayari-Zarnaq Rahim , Moosavi Mir Sajad Seyyed , Hajizadeh Alireza 
Published: April 2020

Abstract
Background : To responding ethical issues in clinical practice, hospital ethics committees (HEC) provide the ethics consultation for healthcare professionals. There are numerous challenges in the consultations services of HEC that can impact healthcare professionals and patients, families in the health care setting. This review aimed to identifies main challenges in utilization the consultations services of HEC and proposed possible solutions.Methods : This systematic review was conducted through searching electronic databases including PubMed, Scopus, Science Direct, ProQuest and Embase. Inclusion criteria included studies related to the purpose of the review, publish in English language, were published in a peer-reviewed journal, from 2000 to 2019 and clearly defined the design, method and results of study. Studies selection, quality assessments, data extraction and analysis were completed on all included studies by two researchers independently. Quality assessment was based on the Mixed Methods Appraisal Tool (MMAT) checklist. Finally, thematic analysis method was used to analyses the data.Results : The search originally yielded 1204 articles and 6 of these included to evidence analyses. After analyses the included studies, challenges were categorized in 9 themes: (a) personal views and believes in healthcare professionals, (b) sense of fear in the healthcare professionals, (c) medical culture, (d) environmental factors, (e) managerial and structural factors, (f) characteristics of HEC members, (g) factors related to HEC, (h) problematic process for HEC consultations, and (i) weakness in knowledge about HEC. Accordingly, proposed solutions were organized according to five themes of reforms in the HEC executive processes, creating the appropriate communications, developing awareness about HEC, improving the competences of HEC members, and (e) supporting from HEC consultations.Conclusions : This review highlights that proposed solutions serve as instances of strategies that attempted to solve challenges related in utilization the consultations services of HEC by healthcare professionals.
Eating Disorders on College Campuses in the United States: Current Insight on Screening, Prevention, and Treatment
Authors: Grammer Anne C. , Fitzsimmons-Craft Ellen E. , Laing Olivia , De Pietro Bianca , Wilfley Denise E. 
Published: April 2020

Background:Eating disorders are prevalent on college campuses and pose significant risks to student health, well-being, and academic performance. However, few students receive access to evidence-based prevention and treatment.Objective:The present review synthesizes the recent literature on ED screening, prevention, and treatment approaches on college campuses in the United States. We provide an overview of ED screening efforts on college campuses, including relevant screening tools, summarize the extant literature on prevention programming, as well psychological and pharmacological treatment approaches, and outline limitations of current programming and provide future directions for research.Conclusion:Recent advances in ED screening, prevention, and treatment efforts highlight the importance of early detection and intervention. Innovative approaches to screening and dissemination of evidence-based prevention and treatment programs on college campuses are warranted. Implications for future research are discussed.