bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adaptation and validation of the Berlin questionnaire of competence in evidence-based dentistry for dental students: a pilot study
Authors: Imorde Laura , Möltner Andreas , Runschke Maren , Weberschock Tobias , Rüttermann Stefan , Gerhardt-Szép Susanne 
Published: May 2020

Abstract
Background
The purpose of this pilot study was to create a valid and reliable set of assessment questions for examining Evidence-based Dentistry (EbD) knowledge. For this reason, we adapted and validated for dental students the Berlin Questionnaire (BQ), which assesses Evidence-based Medicine (EbM) abilities.

Methods
The Berlin Questionnaire was validated with medical residents. We adapted it for use in a dentistry setting. An expert panel reviewed the adapted BQ for content validity. A cross-sectional cohort representing four training levels (EbD-novice dental students, EbD-trained dental students, dentists, and EbM−/EbD-expert faculty) completed the questionnaire. A total of 140 participants comprised the validation set. Internal reliability, item difficulty and item discrimination were assessed. Construct validity was assessed by comparing the mean total scores of students to faculty and comparing proportions of students and faculty who passed each item.

Results
Among the 133 participants (52 EbD-novice dental students, 53 EbD-trained dental students, 12 dentists, and 16 EbM-/ EbD-expert faculty), a statistically significant (p < 0.001) difference was evident in the total score corresponding to the training level. The total score reliability and psychometric properties of items modified for discipline-specific content were acceptable. Cronbach’s alpha was 0.648.

Conclusion
The adapted Berlin Questionnaire is a reliable and valid instrument to assess competence in Evidence-based Dentistry in dental students. Future research will focus on refining the instrument further.
A stepped wedge trial of efficacy and scalability of a virtual clinical pharmacy service (VCPS) in rural and remote NSW health facilities
Authors: Allan Julaine , Nott Shannon , Chambers Brett , Hawthorn Ged , Munro Alice , Doran Chris , Oldmeadow Chris , Coleman Clare , Saksena Teesta 
Published: May 2020

Abstract
Background
Medication errors are a leading cause of mortality and morbidity. Clinical pharmacy services provided in hospital can reduce medication errors and medication related harm. However, few rural or remote hospitals in Australia have a clinical pharmacy service. This study will evaluate a virtual clinical pharmacy service (VCPS) provided via telehealth to eight rural and remote hospitals in NSW, Australia.

Methods
A stepped wedge cluster randomised trial design will use routinely collected data from patients’ electronic medical records (n = 2080) to evaluate the VCPS at eight facilities. The sequence of steps is randomised, allowing for control of potential confounding temporal trends. Primary outcomes are number of medication reconciliations completed on admission and discharge. Secondary outcomes are length of stay, falls and 28 day readmissions. A cost-effectiveness analysis (CEA) and cost-benefit analysis (CBA) will be conducted. The CEA will answer the question of whether the VCPS is more cost-effective compared to treatment as usual; the CBA will consider the rate of return on investing in the VCPS. A patient experience measure (n = 500) and medication adherence questionnaire (n = 100 pre and post) will also be used to identify patient responses to the virtual service. Focus groups will investigate implementation from hospital staff perspectives at each site.
Analyses of routine data will comprise generalised linear mixed models. Descriptive statistical analysis will summarise patient experience responses. Differences in medication adherence will be compared using linear regression models. Thematic analysis of focus groups will identify barriers and facilitators to VCPS implementation.

Discussion
We aim to demonstrate the effectiveness of virtual pharmacy interventions for rural populations, and inform best practice for using virtual healthcare to improve access to pharmacy services. It is widely recognised that clinical pharmacists are best placed to reduce medication errors. However, pharmacy services are limited in rural and remote hospitals. This project will provide evidence about ways in which the benefits of hospital pharmacists can be maximised utilising telehealth technology. If successful, this project can provide a model for pharmacy delivery in rural and remote locations.

Trial registration
Australian New Zealand Clinical Trials Registry (ANZCTR) -ACTRN12619001757101 Prospectively registered on 11 December 2019. Record available from: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378878&isReview=true
The three numbers you need to know about healthcare: the 60-30-10 Challenge
Authors: Braithwaite Jeffrey , Glasziou Paul , Westbrook Johanna 
Published: May 2020

AbstractBackgroundHealthcare represents a paradox. While change is everywhere, performance has flatlined: 60% of care on average is in line with evidence- or consensus-based guidelines, 30% is some form of waste or of low value, and 10% is harm. The 60-30-10 Challenge has persisted for three decades.Main bodyCurrent top-down or chain-logic strategies to address this problem, based essentially on linear models of change and relying on policies, hierarchies, and standardisation, have proven insufficient. Instead, we need to marry ideas drawn from complexity science and continuous improvement with proposals for creating a deep learning health system. This dynamic learning model has the potential to assemble relevant information including patients’ histories, and clinical, patient, laboratory, and cost data for improved decision-making in real time, or close to real time. If we get it right, the learning health system will contribute to care being more evidence-based and less wasteful and harmful. It will need a purpose-designed digital backbone and infrastructure, apply artificial intelligence to support diagnosis and treatment options, harness genomic and other new data types, and create informed discussions of options between patients, families, and clinicians. While there will be many variants of the model, learning health systems will need to spread, and be encouraged to do so, principally through diffusion of innovation models and local adaptations.ConclusionDeep learning systems can enable us to better exploit expanding health datasets including traditional and newer forms of big and smaller-scale data, e.g. genomics and cost information, and incorporate patient preferences into decision-making. As we envisage it, a deep learning system will support healthcare’s desire to continually improve, and make gains on the 60-30-10 dimensions. All modern health systems are awash with data, but it is only recently that we have been able to bring this together, operationalised, and turned into useful information by which to make more intelligent, timely decisions than in the past.
Why do graduates choose to work in a less attractive specialty? A cross-sectional study on the role of personal values and expectations
Authors: Nguyen Van Anh Thi , Könings Karen D. , Wright E. Pamela , Kim Giang Bao , Luu Hoat Ngoc , Scherpbier Albert J. J. A. , van Merriënboer Jeroen J. G. 
Published: May 2020

Abstract
Background
Primary health care (PHC), of which preventive medicine (PM) is a subspecialty, will have to cope with a deficiency of staff in the future, which makes the retention of graduates urgent. This study was conducted in Vietnam, where PM is an undergraduate degree in parallel to medical training. It aims to identify facilitating and hindering factors that impact recruitment and retention of PM graduates in the specialty.

Methods
A cross-sectional study enrolled 167 graduates who qualified as PM doctors from a Vietnamese medical school, between 2012 and 2018. Data were collected via an online questionnaire that asked participants about their motivation and continuation in PM, the major life roles that they were playing, and their satisfaction with their job. Multiple regression analyses were used to identify which life roles and motivational factors were related to the decision to take a PM position and to stay in the specialty, as well as how these factors held for subgroups of graduates (men, women, graduates who studied PM as their first or second study choice).

Results
Half of the PM graduates actually worked in PM, and only one fourth of them expressed the intention to stay in the field. Three years after qualification, many graduates had not yet decided whether to pursue a career in PM. Satisfaction with opportunities for continuous education was rated as highly motivating for graduates to choose and to stay in PM. Responsibility for taking care of parents motivated male graduates to choose PM, while good citizenship and serving the community was associated with the retention of graduates for whom PM was their first choice.

Conclusions
The findings demonstrate the importance of social context and personal factors in developing primary care workforce policy. Providing opportunities for continued education and enhancing the attractiveness of PM as an appropriate specialty to doctors who are more attached to family and the community could be solutions to maintaining the workforce in PM. The implications could be useful for other less popular specialties that also struggle with recruiting and retaining staff.
PDK1 regulates the survival of the developing cortical interneurons
Authors: Wei Yongjie , Han Xiaoning , Zhao Chunjie 
Published: May 2020

AbstractInhibitory interneurons are critical for maintaining the excitatory/inhibitory balance. During the development cortical interneurons originate from the ganglionic eminence and arrive at the dorsal cortex through two tangential migration routes. However, the mechanisms underlying the development of cortical interneurons remain unclear. 3-Phosphoinositide-dependent protein kinase-1 (PDK1) has been shown to be involved in a variety of biological processes, including cell proliferation and migration, and plays an important role in the neurogenesis of cortical excitatory neurons. However, the function of PDK1 in interneurons is still unclear. Here, we reported that the disruption of Pdk1 in the subpallium achieved by crossing the Dlx5/6-Cre-IRES-EGFP line with Pdk1fl/fl mice led to the severely increased apoptosis of immature interneurons, subsequently resulting in a remarkable reduction in cortical interneurons. However, the tangential migration, progenitor pools and cell proliferation were not affected by the disruption of Pdk1. We further found the activity of AKT-GSK3β signaling pathway was decreased after Pdk1 deletion, suggesting it might be involved in the regulation of the survival of cortical interneurons. These results provide new insights into the function of PDK1 in the development of the telencephalon.
Genetic alteration, RNA expression, and DNA methylation profiling of coronavirus disease 2019 (COVID-19) receptor ACE2 in malignancies: a pan-cancer analysis
Authors: Chai Peiwei , Yu Jie , Ge Shengfang , Jia Renbing , Fan Xianqun 
Published: May 2020

AbstractThe novel coronavirus (2019-nCoV) is an emerging causative agent that was first described in late December 2019 and causes a severe respiratory infection in humans. Notably, many of affected patients of COVID-19 were people with malignancies. Moreover, cancer has been identified as an individual risk factor for COVID-19. In addition, the expression of angiotensin converting enzyme 2 (ACE2), the receptor of COVID-19, were aberrantly expressed in many tumors. However, a systematic analysis of ACE2 aberration remained to be elucidated in human cancers. Here, we analyzed genetic alteration, RNA expression, and DNA methylation of ACE2 across over 30 tumors. Notably, overexpression of ACE2 have been observed in including colon adenocarcinoma (COAD), kidney renal papillary cell carcinoma (KIRP), pancreatic adenocarcinoma (PAAD), rectum adenocarcinoma (READ), stomach adenocarcinoma (STAD), and lung adenocarcinoma (LUAD). In addition, hypo DNA methylation of ACE2 has also been identified in most of these ACE2 highly expressed tumors. Conclusively, our study for the first time curated both genetic and epigenetic variations of ACE2 in human malignancies. Notably, because our study is a bioinformatics assay, further functional and clinical validation is warranted.
The HOME Study: Statistical and economic analysis plan for a randomised controlled trial comparing the addition of Proactive Psychological Medicine to usual care, with usual care alone, on the time spent in hospital by older acute hospital inpatients
Authors: Magill Nicholas , White Ian R. , Walker Jane , Burke Katy , Toynbee Mark , van Niekerk Maike , Yang Fan , Walker Simon , Sculpher Mark , Sharpe Michael , Frost Chris 
Published: May 2020

AbstractBackgroundProlonged acute hospital stays are a problem for older people and for health services. Failure to effectively manage the psychological and social aspects of illness is an important cause of prolonged hospital stay. Proactive Psychological Medicine (PPM) is a new way of providing psychiatry services to medical wards which is proactive, focussed, intensive and integrated with medical care. The primary aim of PPM is to reduce the time older people spend in hospital because of unmanaged psychological and social problems. The HOME Study will test the effectiveness and cost-effectiveness of PPM.Methods/designThe study is a two-arm, parallel-group, randomised, controlled superiority trial with linked health economic analysis and an embedded process evaluation. The target population is people aged 65 years and older admitted to acute hospitals. Participants will be randomly allocated to either usual care plus PPM or usual care alone. The primary outcome is the number of days spent as an inpatient in a general hospital in the month following randomisation. Secondary outcomes include quality of life, cognitive function, independent functioning, symptoms of anxiety and depression, and experience of hospital stay. The cost-effectiveness of usual care plus PPM compared with usual care alone will be assessed using quality-adjusted life-years as an outcome as well as costs from the NHS perspective.DiscussionThis update to the published trial protocol gives a detailed plan of the statistical and economic analysis of The HOME Study.Trial registrationISRCTN registry,ISRCTN86120296. Registered on 3 January 2018.
IgG4-related aortitis/periaortitis and periarteritis: a distinct spectrum of IgG4-related disease
Authors: Peng Linyi , Zhang Panpan , Li Jieqiong , Liu Zheng , Lu Hui , Zhu Liang , Wang Xiaorong , Teng Fei , Li Xuemei , Guo Huifang , Fei Yunyun , Zhang Wen , Zhao Yan , Zeng Xiaofeng , Zhang Fengchun 
Published: May 2020

Abstract
Background
Large vessels could be involved in immunoglobulin (Ig)-G4-related disease (IgG4-RD). This study aimed to clarify the clinical features and evaluate the treatment efficacy for IgG4-RD with aortitis/periaortitis and periarteritis (PAO/PA).

Methods
This study prospectively enrolled 587 patients with IgG4-RD with a follow-up time of more than 6 months. The distribution of IgG4-related PAO/PA was classified into four types: type 1, thoracic aorta; type 2a, abdominal aorta; type 2b, abdominal aorta and iliac artery; type 2c, iliac artery; type 3, thoracic and abdominal aorta; and type 4, other arteries. Patient’s demographic data, clinical characteristics, laboratory parameters, and treatment efficacy were analyzed.

Results
Of 587 IgG4-RD patients, 89 (15.2%) had PAO/PA. The average age was 58.3 ± 11.1 years, with male predominance (85.4%). Vessels affected were as follows: abdominal aorta (83.1%), iliac artery (70.8%), thoracic aorta (13.5%), and other vessels (13.5%). The most prevalent distribution type of IgG4-related PAO/PA was type 2b, with 74 (83.1%) patients, followed by type 2a, type 2c, type 3, and type 1. Fifty-five (61.8%) PAO/PA patients had hydronephrosis, with renal insufficiency occurring in 43 (48.3%), and 31 (34.8%) PAO/PA patients had D-J stent drainage due to severe ureteral obstruction. After treatment with a glucocorticoid and immunosuppressants, 82% patients achieved remission with shrinking of the perivascular mass by more than 30%.

Conclusions
IgG4-RD with PAO/PA was distinct from non-PAO/PA in demographic features, organ involvement distribution, inflammatory markers, and serum IgG4 and IgE. The most common affected vessel was the abdominal aorta, and most patients responded well with treatment.
The use of cyclic dipeptide producing LAB with potent anti-aflatoxigenic capability to improve techno-functional properties of clean-label bread
Authors: Ebrahimi Maryam , Sadeghi Alireza , Mortazavi Seyed Ali 
Published: May 2020

Abstract
Purpose
The aim of the present study was to evaluate the antifungal activity, anti-aflatoxigenic capability, and technological functionality of the selected lactic acid bacteria (LAB) isolated from wheat sourdough.

Methods
The preselected LAB isolates were screened based on their antifungal activities and acidification capacities. Then, the antifungal compounds were identified using gas chromatography/mass spectrometry in the selected LAB culture filtrate obtained from its preparative thin-layer chromatography. The HPLC-based analysis was also used to investigate the anti-aflatoxigenic potentials of the selected LAB isolate. Finally, controlled sourdough (containing selected LAB isolate as starter culture) was used to produce loaf bread, and properties of the product were evaluated in terms of hardness, phytic acid content, overall acceptability, and surface moldiness.

Results
Molecular approaches led to the identification of Pediococcus pentosaceus as the selected LAB isolate. In vitro and in situ antifungal activities of the selected LAB against Aspergillus niger were verified. Antifungal metabolites of the LAB included fatty acid ester, hydroxylated fatty acid ester, an antimicrobial compound, and cyclic dipeptide. Potent anti-aflatoxigenic capabilities of the LAB isolate and cyclic dipeptide (which was identified in the antifungal fraction of the LAB) were also verified. To our best knowledge, the cyclic dipeptide detected in the present study has never been shown before to possess anti-aflatoxigenic effect. Furthermore, the results revealed that controlled sourdough improved the techno-functional properties of the produced loaf wheat bread.

Conclusion
Altogether, our findings indicate that the selected P. pentosaceus isolate exhibiting proper characteristics can be used as a bio-preservative and bio-improver in the processing of clean-label breads.
Prospects of Indole derivatives as methyl transfer inhibitors: antimicrobial resistance managers
Authors: Tha Suprim , Shakya Sapana , Malla Rajani , Aryal Pramod 
Published: May 2020

Abstract
Background
It is prudent that novel classes of antibiotics be urgently developed to manage the WHO prioritized multi-drug resistant (MDR) pathogens posing an unprecedented medical crisis. Simultaneously, multiple essential proteins have to be targeted to prevent easy resistance development.

Methods
An integration of structure-based virtual screening and ligand-based virtual screening was employed to explore the antimicrobial properties of indole derivatives from a compound database.

Results
Whole-genome sequences of the target pathogens were aligned exploiting DNA alignment potential of MAUVE to identify putative common lead target proteins. S-adenosyl methionine (SAM) biosynthesizing MetK was taken as the lead target and various literature searches revealed that SAM is a critical metabolite. Furthermore, SAM utilizing CobA involved in the B12 biosynthesis pathway, Dam in the regulation of replication and protein expression, and TrmD in methylation of tRNA were also taken as drug targets. The ligand library of 715 indole derivatives chosen based on kinase inhibition potential of indoles was created from which 102 were pursued based on ADME/T scores. Among these, 5 potential inhibitors of MetK in N. gonorrhoeae were further expanded to molecular docking studies in MetK proteins of all nine pathogens among which 3 derivatives exhibited inhibition potential. These 3 upon docking in other SAM utilizing enzymes, CobA, Dam, and TrmD gave 2 potential compounds with multiple targets. Further, docking with human MetK homolog also showed probable inhibitory effects however SAM requirements can be replenished from external sources since SAM transporters are present in humans.

Conclusions
We believe these molecules 3-[(4-hydroxyphenyl)methyl]-6-(1H-indol-3-ylmethyl)piperazine-2,5-dione (ZINC04899565) and 1-[(3S)-3-[5-(1H-indol-3-ylmethyl)-1,3,4-oxadiazol-2-yl]pyrrolidin-1-yl]ethanone (ZINC49171024) could be a starting point to help develop broad-spectrum antibiotics against infections caused by N. gonorrhoeae, A. baumannii, C. coli, K. pneumoniae, E. faecium, H. pylori, P. aeruginosa, S. aureus and S. typhi.
First record of Diaeretus leucopterus (Haliday) (Hymenoptera, Braconidae, Aphidiinae), the parasitoid of the aphid species, Eulachnus agilis (Kaltenbach) (Hemiptera, Aphididae) in North Africa
Authors: Ben Halima Kamel Monia , Kavallieratos Nickolas G. , Starý Petr , Rakhshani Ehsan 
Published: May 2020

AbstractA survey of pine-associated aphids and their parasitoids was carried out in the arboretum ofPinus halepensisMiller in the Higher Agronomic Institute Chott Mariem (ISA CM, Tunisia) during 2010–2011 and 2018. The survey revealed the presence of the aphid parasitoid species,Diaeretus leucopterus(Haliday) (Hymenoptera, Braconidae, Aphidiinae). This is the first record ofD. leucopterusfrom Tunisia and the African continent. The parasitoid emerged from the spotted green pine needle aphid,Eulachnus agilis(Kaltenbach) (Hemiptera, Aphididae, Lachninae), onP. halepensis. The generalist hyperparasitoid,Asaphes suspensus(Nees) (Hymenoptera, Pteromalidae), was also found attackingD. leucopterus. The diagnosis of the primary parasitoid, on the basis of relevant illustrations, was provided, and the possible routes of its transportation into North Africa were discussed.
Percutaneous removal of air-bullet gunshot: case report and literature review
Authors: Alakhfash Ali A. , Alqwaee Abdullah , Almesned Abdulrahman 
Published: May 2020

AbstractBackgroundCardiac air bullet injuries are rare but can be associated with significant morbidity and mortality.Case presentationWe are presenting a young male child who sustained an accidental injury to the chest by an air rifle. Bullet entered the right ventricle from the anterior part of the chest and was identified in the RV side of the interventricular septum by echocardiography and chest CT scan. There was mild pericardial effusion but no valvular injury. The bullet was removed in the cath lab, and the patient was discharged home on the second day.ConclusionsIt is reasonable to try foreign body removal in the cath lab, for certain cases, and avoid cardiac surgery.
Safe and informed prescribing of psychotropic medication during the COVID-19 pandemic
Authors: Luykx Jurjen J. , van Veen Sisco M. P. , Risselada Arne , Naarding Paul , Tijdink Joeri K. , Vinkers Christiaan H. 
Published: May 2020

SummaryTreatment with psychotropic medication may sometimes be jeopardised because of the COVID-19 pandemic. One underlying reason is the lack of COVID-19-specific psychopharmacology guidelines. Here, we discuss five considerations arising from our clinical experience and pharmacological background knowledge to enable safe and well-informed psychopharmacotherapy during the COVID-19 pandemic.