bluuebunny/crossref_metadata_2025_split huggingface dataset:
Direct-to-consumer Strategies to Promote Deprescribing in Primary Care: A Pragmatic Feasibility Study
Authors: Linsky Amy , Kressin Nancy R. , Stolzmann Kelly , Pendergast Jaquelyn , Rosen Amy K. , Bokhour Barbara G. , Simon Steven R. 
Published: June 2021

Abstract
Background – Deprescribing, or the intentional discontinuation or dose-reduction of medications, is a patient-centered approach to reduce harms associated with inappropriate medication use. We sought to determine how direct-to-patient educational materials impacted patient-provider discussion about and deprescribing of potentially inappropriate medications.Methods – We conducted a pre-post with historical control group pilot feasibility trial at an urban VA medical center. We included patients in one of two medication-based cohorts: 1) proton pump inhibitor (PPI), defined as use of any dose for 90 consecutive days, or 2) hypoglycemia risk, defined by diabetes diagnosis; prescription for insulin or sulfonylurea; hemoglobin A1c <7%; and age >65 years, renal insufficiency, or cognitive impairment. The intervention consisted of mailing medication-specific patient-centered EMPOWER (Eliminating Medications Through Patient Ownership of End Results) brochures, adapted to a Veteran patient population, two weeks prior to scheduled primary care appointments. Our primary outcome – deprescribing – was defined as clinical documentation of target medication discontinuation or dose-reduction. Our secondary outcome was documentation of a discussion about the target medication (yes/possible vs. no/absent). Covariates included age, sex, race, specified comorbidities, medications, and utilization. We used chi-square tests to examine the association of receiving brochures with each outcome.Results – The 348 subjects (253 intervention, 95 historical control) were primarily age >65 years, white, and male. Compared to control subjects, intervention subjects were more likely to have deprescribing (36 [14.2%] vs. 4 [4.2%], p=0.009) and discussions about the target medication (31 [12.3%] vs. 1 [1.1%], p=0.001). Conclusions – Targeted mailings of EMPOWER brochures temporally linked to a scheduled visit in primary care clinics are a low-cost, low-technology method that successfully increased both deprescribing and documentation of patient-provider medication discussions in a Veteran population. Leveraging the ability of patients to drive medication prescribing changes within clinical encounters has potential to reduce drug burden and decrease adverse drug effects and harms.
Comparative Study of Reactive and Non-reactive Spark Plasma Sintering Routes for The Production of TaB2-TaC Composites
Authors: Akarsu Melis Kaplan , Akin Ipek , Sahin Filiz , Goller Gultekin 
Published: June 2021

Abstract
The influence of two different spark plasma sintering-based processing routes (i.e., reactive SPS (RSPS) and non-reactive SPS) on the properties of TaB2-TaC composites was investigated. Ta2O5 and B4C powders were used as starting materials in the RSPS method, and synthesis and densification of TaB2-TaC composites were accomplished in a facile single step. The effect of sintering temperature and time on the microstructure and densification of the in-situ RSPS were investigated. The obtained results were compared with non-reactive spark plasma sintered TaB2-TaC composites. The highest densification (~ 99.5 %) was achieved for the TaB2-TaC composite with 6.64 vol% TaC after reactive sintering at 1550 °C under 40 MPa with a 5 min holding time. Although lower SPS temperature was used in the RSPS method, better densification and higher Vickers hardness were obtained compared to the non-reactive SPS. While platelet-shaped TaC formation was observed in both processes, the average grain size was smaller in the sample produced by the RSPS method. On the other hand, no significant difference was detected in fracture toughness and oxidation behavior of the composites produced by RSPS and non-reactive SPS.
Metabolites of Gut Microbiome Are Associated With Glucose Metabolism in Non-diabetic Obese Adults: A Chinese Monozygotic Twin Study
Authors: Yu Ke , Yu Cai-Guo , Yin Xing-Qi , Wang Zong-Wei , Wang Xiao-Bo , Wang Li-Li , Guo Shuang , An Ya-Xin , Zhao Dong 
Published: June 2021

Abstract
BackgroundEvidence suggests gut microbiome is associated with diabetes. However, it’s unclear whether this association remains in non-diabetic subjects. We conducted a monozygotic twin study, in which the participants are without diabetes, and are not taking any medications, to explore the potential association.MethodsNine pairs of adult monozygotic twins were enrolled and divided into two twin-pair groups (a and b). Clinical and laboratory measurements were conducted. Visceral adipose tissue (VAT) was assessed. Fecal samples were collected to analyze the microbiome composition by 16S rDNA gene amplicon sequencing. Liquid chromatography mass spectrometry was performed to detect the metabolites. ResultsThe participants aged 53 years old averagely, with 8 (88.9%) pairs were women. All the participants were obese with VAT higher than 100 cm2 (152.2±31.6). There was no significant difference of VAT between the twin groups (153.6±30.4 cm2 vs. 150.8±29.5 cm2, p=0.54). Other clinical measurements, including BMI, lipid profiles, fasting insulin and blood glucose, were also not significantly different between groups (p≥0.056), whereas HbA1c level of group a is significantly higher than group b(5.8±0.3 % vs. 5.6±0.2 %, p=0.008). The number and richness of OUTs are relatively higher in group a, and 13 metabolites were significantly different between two groups. Furthermore, several of the 13 metabolites could be significantly linked to special taxons. The potential pathway involved drug metabolism-other enzymes, Tryptophan metabolism and Citrate cycle.Conclusion﻿Gut microbiome composition and their metabolites may modulate glucose metabolism in obese adults without diabetes, through Tryptophan metabolism, Citrate cycle and other pathways.
Influence of SiO2 nanofillers on polymer-based ZnO nanocomposite flexible sheets as high dielectric and thermally stable materials
Authors: Pervaiz S. , Kanwal N. , Rasheed A. , Khan Ijaz Ahmad , Saleem M. 
Published: June 2021

Abstract
Polymer-based nanocomposite (NCs) with high dielectric constant and low-loss factor have remarkable applications in light emitting and energy storage devices. Flexible sheets of polymer-based zinc oxide silica (PB-ZnO-SiO 2 ) NCs are synthesized by co-precipitation method. The development of ZnO and SiO 2 planes confirms the synthesis of polycrystalline PB-ZnO-SiO 2 NCs. Peak intensity of ZnO planes is decreased with increasing wt.% of SiO 2 nanofillers. Surface morphology of synthesized PB-ZnO-SiO 2 NCs is associated with increasing wt.% of nanofillers. EDX spectrum confirms the presence of C, O, Zn and Si in the synthesized sheets. FTIR analysis confirms the presence of chemical bounding between the involved elements. Above 450 o C, the weight loss of S-1 is found to be 90.42% which is decreased to 49.32% for sample S-6. Dielectric properties like dielectric permittivity (13.71) with low loss factor (0.025), impedance (Z′=0.16 MΩ) and large AC conductivity (19.92 mS/m) are observed for sample S-6. The values of dielectric constant, low loss factor, low impedance and high AC conductivity of S-6 are 5.11, 0.53, 0.029 and 2.98 times higher than the value of S-1 respectively. These finding confirm that the synthesized flexible sheets are promising candidates for better light emitting and energy storage devices at high temperature.
Bifidobacterium Bifidum Isolated From Chicken Intestine Along With Polyvinylpyrrolidone Showed Synergistic Effects on Reduction of AFB1 Contamination- in Vitro Study
Authors: Aalipanah sorour , Fazeli Mohhammad Reza , Sepahi Abbas Akhavan , Shariatmadari Farid 
Published: June 2021

Abstract
Background: Food contamination with aflatoxin is one of the most important concerns of health professionals. One of the best ways to reduce aflatoxin content in food is to use probiotics. Therefore, this study was performed to isolate Bifidobacterium from the chick intestine and its probiotic activities and also its application with Polyvinylpyrrolidone (PVP) to reduce aflatoxin B1 (AFB1) toxin in the medium were investigated.Results: Samples were isolated from the chicken intestine. Biochemical and molecular evaluations indicated isolation of Bifidobacterium bifidum strain from chicken intestine. To measure probiotic activities, pH, bile, and salt tolerance tests were used. The selected B. bifidum had good probiotic activity. Then, the antimicrobial activity of isolate against gastrointestinal pathogens and the antibiotic susceptibility test were done. The selected strain showed antimicrobial activities on S. enterica, E. coli, and P. vulgaricus and was found to be resistant against Amikacin, Ampicillin, Erythromycin, and Ceftazidine antibiotics. Then, the effect of selected isolate and PVP on reducing AFB1 in the medium was studied using ELISA and HPLC. The selected strain showed the ability to reduce the concentration of AFB1 in the medium (50% reduction) and when used in combination with PVP showed the synergistic effects in reducing the concentration of AFB1 from the medium (up to 90%).Conclusion: In conclusion, it was found that selected B. bifidum strain together with PVP could have synergistic effects in reducing AFB1 toxin in medium up to 90%.
Algorithm for Sample Availability Prediction in a Hospital based Epidemiological Study: Spreadsheet-based Sample Availability Calculator
Authors: Sudershan Amrit , Kumar Parvinder , Mahajan kanak 
Published: June 2021

Abstract
Looking at population’s behavior by taking samples is quite uncertain due to its big and dynamic structure and unimaginable variability. All quantitative sampling approaches aim to draw representative sample from the population so that the results of the studying samples can then be generalized back to the population. The probability of detecting a true effect of a study largely depends on the sample size and if taking small samples will give lowers statistical power, thus having higher risk of missing a meaningful underlying difference. There have lot of online sample size calculators which are based on population size, allele frequency which tell us about the number of samples required for the study but none will help in setting a threshold for the availability of the sample from a single hospital in a particular period. This study aims to provide an efficient calculation method for setting a threshold for the availability of samples during a specific period of a research study which is an important question to be answered during the research study design. So we have designed a spreadsheet-based sample availability calculator tool implemented in MS-Excel 2007.
Modeling Price Volatility for Selected Agricultural Commodities in Ethiopia: The Application of GARCH Models
Authors: Tirngo  
Published: June 2021

Abstract
The purpose of this study was to model and forecast volatility of returns for selected agricultural commodities prices using generalized autoregressive conditional heteroskedasticity (GARCH) models in Ethiopia. GARCH family models, specifically GARCH, threshold generalized autoregressive conditional heteroskedasticity (TGARCH) and exponential generalized autoregressive conditional heteroskedasticity (EGARCH) were employed to analyze the time varying volatility of selected agricultural commodities prices from 2011to 2021. The data analysis results revealed that, out of the GARCH specifications, TGARCH model with Normal distributional assumption of residuals was a better fit model for the price volatility of Teff and Red Pepper in which their return series reacted differently to the good and the bad news. The study indicated the presence of leverage effect which implied that the bad news could have a larger effect on volatility than the good news of the same magnitude, and the asymmetric term was found to be significant. Also, TGARCH model was found to be the accurate model for forecasting price return volatility of the same commodities, namely Teff and Red Pepper. In short, the study concludes that TGARCH was to be the best fit to model and forecast price return volatility of Teff and Red Pepper in the Ethiopian context.
Official Development Aid: Plaster in A Wound? Evidence Using Data From Ethiopia
Authors: Meaza Cherkos 
Published: June 2021

Abstract
The flow of aid to developing countries has increased massively and they receive billions of dollars per year in the form of aid from bilateral and multilateral donors. However, the economic growth achieved by many developing countries in general has not been satisfactory. Poverty is still there and resulted in a custom of aid dependence and foster the opportunity for the corrupted political leader. The conclusion on aid effectiveness is doubtful among economists, found to be inconclusive.This paper intends to see how ethiopian economy is reacting to the flow of foreign aid coming from rest of the world viz-a-viz the current most prestigous and influential arguments against and pro-effectiveness of aid. A time series on important parameters extending from 1981 to the most current 2017 is used and an econometrics techniques ECM is employed to examine the short run dynamics and long run relationship among the variables.The result of the short run dynamics showed that aid has a negative and statistically significant impact on economic growth. However, the impacts turns to be positive in the long run. economic growth measured by the real GDP adjusts to its long run equilibrium with an average speed of about 25.7 percent annually and it will roughly take it about 4 years to restore back to equilibrium, ceteris paribus.
Practical Strategies to Enhance Resident Engagement in Clinical Quality Improvement
Authors: Koller James P. , Cochran Kelly A. , Headrick Linda A. 
Published: June 2021

Abstract
BackgroundEngaging residents in meaningful QI is difficult. Challenges include competing demands, didactics which lack connection to meaningful work, suboptimal experiential learning, unclear accountability, absence of timely and relevant data, and lack of faculty coaches and role models. This paper describes practical strategies to address common challenges to resident engagement in QI, illustrated through the experience of one residency education program.Methods62 categorical residents in the University of Missouri Internal Medicine residency participated in a longitudinal QI curriculum integrated into residency clinic assignments with dedicated QI work sessions and brief just-in-time didactics with mentorship from faculty coaches. Residents completed at least two PDSA cycles for their projects. The experience included clear expectations and tools for accountability. Project criteria included importance to patients, residents and the institution. Residents had access to data related to their own practice. A pre-post survey asked residents to self-assess their level of interest and engagement in QI on a 5-point Likert scale, with 1=least desired and 5=most desired result. Data were analyzed by paired t-test. ResultsAll 62 residents participated in the program as members of ten teams. 40/62 residents completed both pre- and post-surveys. Items related to self-assessment of QI in clinical work all changed in the desired direction: likelihood of participation (3.7 to 4.1, p=0.03), frequency of QI use (3.3 to 3.9, p=0.001), and opinion about using QI in clinical work (3.9 to 4.0, p=0.21). Resident assessment of QI priority in clinical work did not change.ConclusionsWe implemented practical strategies to overcome common challenges to successfully engaging residents in clinical quality improvement. These strategies included QI work integrated into routine clinical assignments, just-in-time didactics, experiential learning with clear expectations and strategic project selection, timely and pertinent data from the residents’ own practice, and real-time faculty coaching.
PROGNOSTIC ROLE OF MOLECULAR SUBTYPES OF COLON CANCER. A CURRENT VIEW ON THE PROBLEM
Authors: Sinyansky L. E. , Vtorushin S. V. , Patalyak S. V. , Afanasyev S. G. 
Published: June 2021

Purpose of the study: to review the available data on the heterogeneity of colon cancer and to assess the prognostic significance of colon cancer subtypes.Material and Methods. Medline, PubMed, Cochrane library, elibrary databases were used to identify studies that characterized the current view on the problem of choosing the optimal postoperative treatment for colon cancer.Results. the review showed the results of international studies of colon cancer subtypes based on complex multomics characteristics. Particular attention was paid to the description of modern studies on the search for prognostic markers for colon cancer. The relevance of the study of immunohistochemical markers was confirmed by the analysis of the world literature. the outcomes will make it possible to classify colon cancer into molecular subtypes in real clinical practice and, as a consequence, significantly improve the effectiveness of adjuvant therapy.
INFECTIOUS COMPLICATIONS AFTER RECONSTRUCTIVE SURGERIES IN BREAST CANCER PATIENTS: A CASE REPORT
Authors: Grigoryevskaya Z. V. , Dokolin R. M. , Tereshchenko I. V. , Sobolevsky V. A. , Dmitrieva N. V. , Vinnikova V. D. , Vershinskaya V. A. , Petukhova I. N. , Bagirova N. S. 
Published: June 2021

Introduction. Currently, there is no global consensus regarding the management of breast cancer patients with implant-associated infections. Some studies clearly recommend their removal and surgical debridement with consecutive antimicrobial treatment, while others prefer long-term antibacterial therapy (at least 1 month) with the effectiveness of such conservative approach of 36–73 %.Case description. A 43-year-old patient suffering from brca1-positive right breast cancer t2n0m0 (invasive carcinoma of non-specific type g3, er – 8, pgr – 0, her-2/neu – 0, ki67 (%) – less than 20 %), underwent radical skin-preserving mastectomy on the right with simultaneous implant reconstruction and preventive subcutaneous mastectomy on the left with simultaneous implant reconstruction. Peri-implant infection in the left breast was observed on the 21st day after surgery.Results. The patient received empirical therapy with cefepim. Microbiological examination of the punctate revealed the causative agent of infection – methicillin-resistant staphylococcus aureus (mrsa) (1×105cfu/ml). Daptomycin 6 mg/kg/day was added to therapy. After 8 weeks, the patient received oral moxifloxacin 400 once daily, for another 3 weeks. A complete response was achieved. The patient has no signs of infection for 3 years.Conclusion. Long-term etiotropic antibacterial therapy with daptomycin followed by oral moxifloxacin resulted in a stable clinical effect.
LONG-LASTING CONTROL OF HER-2 POSITIVE DISSEMINATED BREAST CANCER IN A REPRODUCTIVE AGED PATIENT
Authors: Vazhenin A. V. , Voroshina N. V. , Tereshin O. S. , Dubrovskaya N. S. 
Published: June 2021

Background. Breast cancer ranks as the second most common cancer (14.9 %) and the most common female cancer (20.9 %) in Russia. at the time of diagnosis, 11.0 % of patients have already developed metastases, and 10.3 % of patients die within the first year of diagnosis from disease progression. distant metastasis is the leading cause of death from breast cancer, and brain metastasis is a significant prognostic factor for poor survival.Case description. We report the case of a long-lasting control of advanced breast cancer with brain metastases in a 32-year-old woman. low grade tubular breast carcinoma was histologically confirmed. immunohistochemical study: eR-ts-4 points, PR-ts – 3 points, Her-2 positive, Ki67 – 35.0 %. BRCa1 5382ins C mutation was not detected. the long-term use of therapy with lapatinib and capecitabine was described.Conclusion. this case demonstrates the feasibility of long-term (31 months) control over Her-2 positive disseminated breast cancer with multiple metastases to the brain and bones, while maintaining the quality of life and social activity of a young patient. despite the risks associated with whole brain radiotherapy, no cognitive impairment was observed. therapy with lapatinib and capecitabine was effective for 28 months with good tolerance.
INFLUENCE OF RISK FACTORS FOR DISEASE PROGRESSION ON TREATMENT RESULTS IN PATIENTS WITH PROSTATE CANCER
Authors: Isargapov R. M. , Vozdvizhensky M. O. , Gorbachev A. L. 
Published: June 2021

The purpose of the study was to optimize treatment of patients with prostate cancer at high risk of disease progression using a quantitative assessment of risk factors and the treatment method.Material and methods. Immediate outcomes were analyzed in 107 patients with pt3a-bn0m0g2–4 prostate cancer, who were treated in samara regional clinical oncological dispensary between 2010 and 2012. All patients were divided into 2 groups. Group i patients underwent surgery alone and group ii patients underwent surgery followed by radiation therapy. All patients were at high risk of disease progression according to the d’amico classification. Onlyone risk factor was identified in 64 patients, two risk factors in 37 patients, and three risk factors in 6 cases. The overall survival, cancer-specific survival and disease-free survival were analyzed.Results. In cases with one and two risk factors, the overall, disease-free and cancer-specific survival rates were statistically higher than in cases with three risk factors in the entire cohort (p<0.05). In the subgroups with one, two, and three risk factors, there were no statistically significant differences in overall and cancer-specific survival rates (p>0.05). Disease-free survival rates in the presence of one factor were not statistically different (p=0.920). In the presence of two and three factors, the relapse-free survival rates were statistically higher in group ii patients (surgical with adjuvant radiation therapy, p=0.049, p=0.025).Conclusion. The presence of three risk factors significantly increased the likelihood of a poor prognosis compared with one or two factors. Adjuvant radiation therapy improved survival rates in prostate cancer patients.
THE IMPORTANCE OF GROWTH FACTORS IN THE DIAGNOSIS OF COLON CANCER
Authors: Volkov S. V. , Lobanov S. V. , Tereshkov P. P. 
Published: June 2021

Objective: to determine the level of growth factors in the blood serum of patients with left-sided colon cancer and to assess the feasibility of using these findings in the tumor detection.Material and Methods. The study group included 63 patients aged 20 to 75 years who underwent surgery for left-sided colon adenocarcinoma (descending, sigmoid, rectosigmoid) with stage i (t1–2n0m0), ii (t3–4an0m0), and iii (t1–2n1m0). Only 5 patients developed metastases in one regional lymph node. The remaining patients had no regional metastases. In all patients, before hospitalization, the tumor was confirmed by colonoscopy followed by histological examination. The group of comparison consisted of 25 patients with chronic hemorrhoids without exacerbation, who underwent colonoscopy. In patients of the study group, blood tests were drawn on the day of surgery before its starting. In patients of the comparison group, blood was taken after excluding colon cancer (after colonoscopy). Blood tests were carried out using a test system (Biolegend): multiplex set for determining growth factors (angiopoietin-2, (ang-2), egf, epo, FGF-basic, G-csf, GM-csf, HGF, M-csf, pdgf-aa, pdgf-BB, scf, tgf-α, vegf).Results. In cancer patients, the levels of egf, HGF, M-csf, pdgf-aa, and pdgf-BB were several times higher than in the control group (p <0.05). The level of pdgf-aa was 10 times higher in cancer patients than in controls. In addition to quantitative changes, statistically significant differences were observed between the vegf level and sex of the patients; angio protein-2, G-csf, epo, M-csf, pdgf-aa, pdgf-BB, vegf levels and the age of the patients; tgf-α, HGF levels and the histological grade of the tumor.Conclusion. It was found that changes in the level of biologically active substances that occur in colon cancer can serve as additional diagnostic markers for cancer detection.