bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of type of natural emulsifier and microfluidization conditions on Capsicum oleoresin nanoemulsions properties and stability
Authors: de Aguiar Ana Carolina , de Paula Julia Teixeira , Mundo Jorge Luis Muriel , Martínez Julian , McClements David Julian 
Published: February 2021

AbstractThere is a growing interest in the fabrication of colloidal delivery systems for bioactive compounds assembled from natural ingredients, particularly plant‐based ones. In this study, Capsicum oleoresin was encapsulated within oil‐in‐water nanoemulsions by high‐pressure microfluidization from natural emulsifiers: whey protein (WP), pea protein (PP), quillaja saponin (QS), and sunflower lecithin (SL). The influence of emulsifier, concentration, and microfluidization conditions (pressure and number of passes), on particle diameter and zeta‐potential of nanoemulsions was evaluated. Particle diameter decreased with increasing homogenization pressure and number of passes. All emulsifiers were capable of forming charged droplets with dimensions in the nanometer range at sufficiently high concentrations. The stability of nanoemulsions to environmental stresses (pH, ionic strength, and heating) and storage was studied. The pH and salt stabilities were dependent on the emulsifier type. Overall, natural emulsifiers were effective in producing Capsicum oleoresin‐loaded nanoemulsions with small particle size and capsaicin stability.
The HEAR‐VA Pilot Study: Hearing Assistance Provided to Older Adults in the Emergency Department
Authors: Chodosh Joshua , Goldfeld Keith , Weinstein Barbara E. , Radcliffe Kate , Burlingame Madeleine , Dickson Victoria , Grudzen Corita , Sherman Scott , Smilowitz Jessica , Blustein Jan 
Published: February 2021

BACKGROUND/OBJECTIVESPoor communication is a barrier to care for people with hearing loss. We assessed the feasibility and potential benefit of providing a simple hearing assistance device during an emergency department (ED) visit, for people who reported difficulty hearing.DESIGNRandomized controlled pilot study.SETTINGThe ED of New York Harbor Manhattan Veterans Administration Medical Center.PARTICIPANTSOne hundred and thirty‐three Veterans aged 60 and older, presenting to the ED, likely to be discharged to home, who either (1) said that they had difficulty hearing, or (2) scored 10 or greater (range 0–40) on the Hearing Handicap Inventory‐Survey (HHI‐S).INTERVENTIONSubjects were randomized (1:1), and intervention subjects received a personal amplifier (PA; Williams Sound Pocketalker 2.0) for use during their ED visit.MEASUREMENTSThree survey instruments: (1) six‐item Hearing and Understanding Questionnaire (HUQ); (2) three‐item Care Transitions Measure; and (3) three‐item Patient Understanding of Discharge Information. Post‐ED visit phone calls to assess ED returns.RESULTSOf the 133 subjects, 98.3% were male; mean age was 76.4 years (standard deviation (SD) = 9.2). Mean HHI‐S score was 19.2 (SD = 8.3). Across all HUQ items, intervention subjects reported better in‐ED experience than controls. Seventy‐five percent of intervention subjects agreed or strongly agreed that ability to understand what was said was without effort versus 56% for controls. Seventy‐five percent of intervention subjects versus 36% of controls said clinicians provided them with an explanation about presenting problems. Three percent of intervention subjects had an ED revisit within 3 days compared with 9.0% controls.CONCLUSIONVeterans with hearing difficulties reported improved in‐ED experiences with use of PAs, and were less likely to return to the ED within 3 days. PAs may be an important adjunct to older patient ED care but require validation in a larger more definitive randomized controlled trial.
Medication review interventions to reduce hospital readmissions in older people
Authors: Dautzenberg Lauren , Bretagne Lisa , Koek Huiberdina L. , Tsokani Sofia , Zevgiti Stella , Rodondi Nicolas , Scholten Rob J. P. M. , Rutjes Anne W. , Di Nisio Marcello , Raijmann Renee C. M. A. , Emmelot‐Vonk Marielle , Jennings Emma L. M. , Dalleur Olivia , Mavridis Dimitris , Knol Wilma 
Published: February 2021

AbstractObjectiveTo assess the efficacy of medication review as an isolated intervention and with several co‐interventions for preventing hospital readmissions in older adults.MethodsOvid MEDLINE, Embase, The Cochrane Central Register of Controlled Trials and CINAHL were searched for randomized controlled trials evaluating the effectiveness of medication review interventions with or without co‐interventions to prevent hospital readmissions in hospitalized or recently discharged adults aged ≥65, until September 13, 2019. Included outcomes were “at least one all‐cause hospital readmission within 30 days and at any time after discharge from the index admission.”ResultsTwenty‐five studies met the inclusion criteria. Of these, 11 studies (7,318 participants) contributed to the network meta‐analysis (NMA) on all‐cause hospital readmission within 30 days. Medication review in combination with (a) medication reconciliation and patient education (risk ratio (RR) 0.45; 95% confidence interval (CI) 0.26–0.80) and (b) medication reconciliation, patient education, professional education and transitional care (RR 0.64; 95% CI 0.49–0.84) were associated with a lower risk of all‐cause hospital readmission compared to usual care. Medication review in isolation did not significantly influence hospital readmissions (RR 1.06; 95% CI 0.45–2.51). The NMA on all‐cause hospital readmission at any time included 24 studies (11,677 participants). Medication review combined with medication reconciliation, patient education, professional education and transitional care resulted in a reduction of hospital readmissions (RR 0.82; 95% CI 0.74–0.91) compared to usual care. The quality of the studies included in this systematic review raised some concerns, mainly regarding allocation concealment, blinding and contamination.ConclusionMedication review in combination with medication reconciliation, patient education, professional education and transitional care, was associated with a lower risk of hospital readmissions compared to usual care. An effect of medication review without co‐interventions was not demonstrated. Trials of higher quality are needed in this field.
Nursing home oversight during the COVID‐19 pandemic
Authors: Stevenson David G. , Cheng Audrey K. 
Published: February 2021

AbstractBackground/objectivesRegulatory oversight has been a central strategy to assure nursing home quality of care for decades. In response to COVID‐19, traditional elements of oversight that relate to resident care have been curtailed in favor of implementing limited infection control surveys and targeted complaint investigations. We seek to describe the state of nursing home oversight during the pandemic to facilitate a discussion of whether and how these activities should be altered going forward.Design and settingIn a retrospective study, we describe national oversight activities in January–June 2020 and compare these activities to the same time period from 2019. We also examine state‐level oversight activities during the peak months of the pandemic.ParticipantsUnited States nursing homes.DataPublicly available Quality, Certification, and Oversight Reports (QCOR) data from the Centers for Medicare and Medicaid Services (CMS).MeasurementsNumber of standard, complaint, and onsite infection surveys, number of deficiencies from standard and complaint surveys, number of citations by deficiency tag, and number and amount of civil monetary penalties.ResultsThe number of standard and complaint surveys declined considerably in the second quarter of 2020 relative to the same time frame in 2019. Deficiency citations generally decreased to near zero by April 2020 with the exception of infection prevention and control deficiencies and citations for failure to report COVID‐19 data to the national health safety network. Related enforcement actions were down considerably in 2020, relative to 2019.ConclusionIn the months since COVID‐19 first impacted nursing homes, regulatory oversight efforts have fallen off considerably. While CMS implemented universal infection control surveys and targeted complaint investigations, other routine aspects of oversight dropped in light of justifiable limits on nursing home entry. Going forward, we must develop policies that allow regulators to balance the demands of the pandemic while fulfilling their responsibilities effectively.
Barriers to implementation of STRIDE, a national study to prevent fall‐related injuries
Authors: Reckrey Jennifer M. , Gazarian Priscilla , Reuben David B. , Latham Nancy K. , McMahon Siobhan K. , Siu Albert L. , Ko Fred C. 
Published: February 2021

AbstractBackground/ObjectivesEvaluations of complex models of care for older adults may benefit from simultaneous assessment of intervention implementation. The STRIDE (Strategies To Reduce Injuries and Develop confidence in Elders) pragmatic trial evaluated the effectiveness of a multifactorial intervention to reduce serious fall injuries in older adults. We conducted multi‐level stakeholder interviews to identify barriers to STRIDE intervention implementation and understand efforts taken to mitigate these barriers.DesignQualitative interviews with key informants.SettingTen clinical trial sites affiliated with practices that provided primary care for persons at increased risk for fall injuries.ParticipantsSpecially trained registered nurses working as Falls Care Managers (FCMs) who delivered the intervention (n = 13 individual interviews), Research Staff who supervised trial implementation locally (n = 10 group interviews, 23 included individuals), and members of Central Project Management and the National Patient Stakeholder Council who oversaw national implementation (n = 2 group interviews, six included individuals).MeasurementsA semi‐structured interview guide derived from the consolidated framework for implementation research (CFIR).ResultsWe identified eight key barriers to STRIDE intervention implementation. FCMs navigated complex relationships with patients and families while working with Research Staff to implement the intervention in primary care practices with limited clinical space, variable provider buy‐in, and significant primary care practice staff and provider turnover. The costs of the intervention to individual patients and medical practices amplified these barriers. Efforts to mitigate these barriers varied depending on the needs and opportunities of each primary care setting.ConclusionThe many barriers to implementation and the variability in how stakeholders addressed these locally may have affected the overall STRIDE intervention's effectiveness. Future pragmatic trials should incorporate simultaneous implementation aims to better understand how research interventions translate into clinical care that improves the lives of older adults.
Three‐dimensional product circularity
Authors: Boyer Robert H. W. , Mellquist Ann‐Charlotte , Williander Mats , Fallahi Sara , Nyström Thomas , Linder Marcus , Algurén Peter , Vanacore Emanuela , Hunka Agnieszka D. , Rex Emma , Whalen Katherine A. 
Published: February 2021

AbstractUnderstanding product circularity as “three‐dimensional” could anchor the Circular Economy to common principles while affording its followers flexibility about how to measure it in their specific sectors and disciplines and within their organization's means. Inspired by a heuristic developed for the urban planning profession to cope with the inherent conflicts of Sustainable Development, this article argues that measuring product‐level circularity should consider ways to achieve (1) high material recirculation, (2) high utilization, and (3) high endurance in products and service offerings. Achieving all three dimensions ensures that material flowing through the economy is recovered from prior use phases, that it is used intensely, and that it retains its value in spite of exogenous changes. The article argues further that these three dimensions ought to be measured and reported separately rather than as a composite metric and that certain applications will have opportunities to improve circularity through certain dimensions better than others. The article also explains how researchers at RISE (Research Institutes of Sweden AB) are working with industry and government partners to measure the three dimensions and how diverse actors interested in the Circular Economy can use the three dimensions to take the first steps in their transition to circularity.
History of sunscreen: An updated view
Authors: Ma Yangmyung , Yoo Jinah 
Published: February 2021

AbstractBackgroundWith the global sunscreen market expected to reach $24.4 billion worldwide by 2029, this demonstrates the increasing awareness of the damaging effects of sunlight. Sunscreen has been gradually evolving, and new photoprotective ingredients are continuing to be produced in response to growing scientific evidence on the effect of solar radiation on the skin.AimsThis literature review aims to provide an updated view of the history of sunscreens.MethodsA literature search was conducted with the keywords “Sunscreen, history, regulation, ultraviolet A, ultraviolet B, visible light” from PubMed, Medline, and online search engines.ResultsHumankind has always found ways to provide photoprotection since 4000BC. Only in the last century, evidence‐based sunscreens have existed. The first ultraviolet B filters were produced in 1928, its evidence of efficacy and safety discovered in 1956 and development of sun protection factor in 1974. Similarly, sunscreen containing ultraviolet A filters was released in 1980 and the ultraviolet A star rating system developed in 1992. Regulatory bodies for sunscreen were introduced in the 1970s and have sought to review the safety and efficacy of ingredients. With the rising number of researches on the effects of visible light on hyperpigmentation over the past decade, the need for photoprotection beyond ultraviolet has been increasing.ConclusionTo provide consumers with evidence‐based sunscreen, challenges remain in acquiring further evidence, regulation, and rating systems.
Evaluating the safety of dienogest in women with adenomyosis: A retrospective analysis
Authors: Ono Natsumi , Asano Ryoko , Nagai Koichi , Sugo Yoshinobu , Nakamura Tomomi , Miyagi Etsuko 
Published: February 2021

AbstractAimDienogest (DNG) is highly effective for relieving pain caused by endometriosis and adenomyosis. However, women with severe uterine swelling due to adenomyosis who take DNG usually experience metrorrhagia. This study aimed to examine the safety of DNG usage in women with adenomyosis.MethodsThis study included 20 women who were prescribed DNG for adenomyosis in our hospital from January 2016 to December 2016. We retrospectively analyzed women's clinical background characteristics (age, the use of the gonadotropin‐releasing hormone agonist as pre‐treatment of DNG, the uterus size [major axis, minor axis, maximum thickness in the myometrium, and length of the uterine body] by transvaginal ultrasonography [TVUS], hemoglobin level, and the presence of metrorrhagia during treatment). These variables were compared between the DNG continuation and discontinuation groups using the Mann–Whitney U test.ResultsThirteen women continued DNG, and seven discontinued DNG within 12 months because of metrorrhagia. The uterine size was significantly larger in the discontinuation group than in the continuation group. All uterine measurements had high Spearman rank correlation coefficients (ρ > 0.8, P < 0.05). In six of seven cases in the discontinuation group, adenomyosis was in the anterior wall. Measuring the uterus size and locating adenomyosis by TVUS are simple methods of predicting DNG discontinuation.ConclusionWe consider that DNG can be safely administered in women with adenomyosis if the uterine size is <6 cm in the minor axis and the main lesion of adenomyosis is located in the posterior uterine wall.
Single‐dose pharmacokinetics of mycophenolic acid following administration of immediate‐release mycophenolate mofetil in healthy Beagle dogs
Authors: Klotsman Michael , Sathyan Gayatri , Anderson Wayne H. 
Published: February 2021

AbstractMycophenolic acid (MPA) is an immunomodulating agent commonly used in human medicine for the treatment of immune‐mediated diseases. There is growing evidence that the immunomodulating properties of mycophenolate mofetil (MMF), a prodrug of MPA, are therapeutically beneficial for the treatment of immune‐mediated diseases in dogs. A narrow therapeutic index and high inter‐and intra‐patient pharmacokinetic (PK) variability complicate the use of MMF. A better characterization of MPA pharmacokinetics is needed to help establish dosing regimens and standardized treatment protocols for canine patients. The purpose of this study was to evaluate the pharmacokinetics of MPA in dogs. MMF oral suspension (10 mg/kg) was administered to five healthy beagle dogs. Serial blood samples were collected from 0 to 18 hours after administration. The simultaneous quantification of MPA, and its metabolites MPA‐7‐O‐glucuronide (MPAG), and acyl glucuronide (AcMPAG) was determined by liquid chromatography (LC)‐mass spectrometry (MS)/MS. MPA peak concentrations were achieved rapidly (median Tmax of 0.5 h). Concentrations fell through 3 hours post‐dose and then plateaued around 20% of Cmax. The mean elimination half‐life was rapid (5.8 hours) and notable variability was observed in all PK parameters. The PK profiles for the MPAG and AcMPAG metabolites followed a similar pattern as MPA concentration. Future repeat‐dose studies will be needed to evaluate steady‐state PK parameters and to define therapeutic MPA dose levels.
Estimating a bilateral J‐curve between the UK and the Euro area: An asymmetric analysis
Authors: Bahmani‐Oskooee Mohsen , Karamelikli Huseyin 
Published: February 2021

AbstractThe J‐curve outlines the path of movement in the trade balance after a currency is devalued or depreciated, deteriorating in the short run but improving in the long run. One study in this journal investigated the concept between the UK and each of its 10 large partners from the EU. The study found support for the J‐curve effect in the UK trade balance with Belgium, Germany, France, Italy and Netherlands. However, the findings were based on sign misinterpretation. If correctly interpreted, the findings actually support the inverse J‐curve, i.e., long‐run deterioration in the bilateral trade balances. The results were based on using the linear ARDL approach. We revisit the issue and use the Nonlinear ARDL approach. We find support for the asymmetric J‐curve effect in the bilateral trade balance between the UK and France, Greece, Portugal and Spain and an asymmetric inverse J‐curve in the case of Finland.
The multidisciplinary team perspectives on agitation management in critical care: A qualitative study
Authors: Freeman Samantha , Yorke Janelle , Dark Paul 
Published: February 2021

AbstractBackgroundPeople who are experiencing a period of critical illness frequently experience severe agitation. The presence of agitation can pose risks to the patient, family, and clinical team.Aims and objectivesTo capture the views and opinions of critical care multidisciplinary teams concerning the approaches in the management of agitation, and to understand and identify the perceived risks and benefits of current management strategies.DesignA descriptive qualitative design.MethodsData were gathered using semi‐structured interviews with multidisciplinary teams from adult critical care units from one region in the United Kingdom.FindingsA total of 19 participants participated between February to September 2017. There were two group interviews (GIs) (n = 12, GI 1 n = 8, GI 2 n = 4) and seven one‐to‐one interviews, across four hospital organisations with one participant working via an agency. The mean length (± SD) of each interview, one to one or group, was 58.86 minutes (5.81 minutes). Three major themes were generated about the complex clinical decision‐making required to manage an agitated patient. These themes represented: the burden of care, continuity of clinical decision‐making, and uncertainty and indecision experienced by participants.ConclusionParticipants described caring for an agitated patient as challenging and stressful. Staff sought clarification on what level of restrictive practice is allowed. Feelings of anxiety and stress generated by the decisions made may have an impact on staff, particularly those who are more inexperienced, which in the longer term could lead to fatigue or moral distress. Relevance to clinical practice. The study has emphasised the challenges faced by multidisciplinary teams and how decision‐making may impact on individuals within the team.
Of bowels, brain and behavior: A role for the gut microbiota in psychiatric comorbidities in irritable bowel syndrome
Authors: Wilmes Lars , Collins James M. , O'Riordan Kenneth J. , O’Mahony Siobhain M. , Cryan John F. , Clarke Gerard 
Published: February 2021

AbstractBackgroundThe gastrointestinal microbiota has emerged as a key regulator of gut‐brain axis signalling with important implications for neurogastroenterology. There is continuous bidirectional communication between the gut and the brain facilitated by neuronal, endocrine, metabolic, and immune pathways. The microbiota influences these signalling pathways via several mechanisms. Studies have shown compositional and functional alterations in the gut microbiota in stress‐related psychiatric disorders. Gut microbiota reconfigurations are also a feature of irritable bowel syndrome (IBS), a gut‐brain axis disorder sharing high levels of psychiatric comorbidity including both anxiety and depression. It remains unclear how the gut microbiota alterations in IBS align with both core symptoms and these psychiatric comorbidities.MethodsIn this review, we highlight common and disparate features of these microbial signatures as well as the associated gut‐brain axis signalling pathways. Studies suggest that patients with either IBS, depression or anxiety, alone or comorbid, present with alterations in gut microbiota composition and harbor immune, endocrine, and serotonergic system alterations relevant to the common pathophysiology of these comorbid conditions.Key resultsResearch has illustrated the utility of fecal microbiota transplantation in animal models, expanding the evidence base for a potential causal role of disorder‐specific gut microbiota compositions in symptom set expression. Moreover, an exciting study by Constante and colleagues in this issue highlights the possibility of counteracting this microbiota‐associated aberrant behavioral phenotype with a probiotic yeast, Saccharomyces boulardii CNCM I‐745.Conclusions and inferencesSuch data highlights the potential for therapeutic targeting of the gut microbiota as a valuable strategy for the management of comorbid psychiatric symptoms in IBS.
Circular RNAs in metabolism and metabolic disorders
Authors: Zeng Yongzhi , Zheng Zhi , Liu Fengtao , Yi Guanghui 
Published: February 2021

SummaryMetabolic syndrome (MetS) is a serious health condition triggered by hyperglycemia, dyslipidemia, and abnormal adipose deposition. Recently, circular RNAs (circRNAs) have been proposed as key molecular players in metabolic homeostasis due to their regulatory effects on genes linked to the modulation of multiple aspects of metabolism, including glucose and lipid homeostasis. Dysregulation of circRNAs can lead to metabolic disorders, indicating that circRNAs represent plausible potential targets to alleviate metabolic abnormalities. More recently, a series of circulating circRNAs have been identified to act as both essential regulatory molecules and biomarkers for the progression of metabolism‐related disorders, including type 2 diabetes mellitus (T2DM or T2D) and cardiovascular disease (CVD). The findings of this study highlight the function of circRNAs in signaling pathways implicated in metabolic diseases and their potential as future therapeutics and disease biomarkers.