bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reallocations in Acne Healthcare: Exploring the Possible Roles and Added Value of Non-physicians by a Mixed-Methods Study Design
Authors: de Vries Femke , Welbie Marlies , Tjin Esther , Driessen Rieke , de Kerkhof Peter van 
Published: January 2021

Abstract
Background A highly promoted opportunity for optimizing healthcare services is to expand the role of non-physician care providers by care reallocation. Reallocating care from physicians to non-physicians can play an important role in solving systemic healthcare problems such as care delays, hospital overcrowding, long waiting lists, high work pressure and expanding healthcare costs. Dermatological healthcare services, such as the acne care provision, are well suited for exploring the opportunities for care reallocation as many different types of care professionals are involved in the care process. In the Netherlands, acne care is mainly delivered by general practitioners and dermatologists. The Dutch healthcare system also recognizes non-physician care providers, among which dermal therapists and beauticians are the most common professions. However, the role and added value of non-physicians is still unclear. The present study aimed to explore the possibilities for reallocating care to non-physicians and identify drivers for and barriers to reallocation. Methods A mixed-method design was used combining quantitative and qualitative data. 224 questionnaires were completed and 24 semi-structured interviews were conducted.Results A broad spectrum of non-physician tasks and responsibilities were delineated. Interviewed physicians considered acne as a low-complexity skin condition which made them willing to explore the possibilities for reallocating. A majority of all interviewees saw a key role for non-physicians in counselling and supporting patients during treatment, which they considered an important role for increasing patients’ adherence to proposed treatment regimes, contributing to successful clinical outcome. Also, the amount of time non-physicians spend on patients was experienced as driver for reallocation. Legislation and regulations, uncertainties about the extent of scientific evidence and proper protocols use within the non-physician clinical practice were experienced as barriers influencing the possibilities for reallocation. Conclusion Delineated roles and drivers demonstrate there is room and potential for reallocation between physicians and non-physicians within acne healthcare, when barriers are adequately addressed.
Inflammogenic Effect of Polyacrylic Acid in Rat Lung Following Intratracheal Instillation
Authors: Nishida Chinatsu , Tomonaga Taisuke , Izumi Hiroto , Wang Ke-Yong , Ishidao Toru , Takeshita Jun-ichi , Ono Ryohei , Sumiya Kazuki , Fujii Shota , Mochizuki Shinichi , Sakurai Kazuo , Yamasaki Kei , Yatera Kazuhiro , Morimoto Yasuo 
Published: January 2021

Abstract
BackgroundOrganic chemicals are known to cause allergic diseases such as bronchial asthma and hypersensitivity pneumonitis, and it has been considered that they do not cause irreversible pulmonary fibrosis. It has recently been reported, however, that cross-linked acrylic acid-based polymer, an organic chemical, might cause serious interstitial lung diseases, including pulmonary fibrosis. We investigated whether or not intratracheal instillation exposure to cross-linked polyacrylic acid (CL-PAA) can cause lung disorder in rats.MethodsMale F344 rats were intratracheally instilled with dispersed CL-PAA at low (0.2 mg/rat) and high (1.0 mg/rat) doses, and were sacrificed at 3 days, 1 week, 1 month, 3 months and 6 months after exposure to examine inflammatory and fibrotic responses and related gene expressions in the lungs. Rat lungs exposed to crystalline silica, asbestos (chrysotile), and NiO and CeO2 nanoparticles were used as comparators.ResultsPersistent increases in total cell count, neutrophil count and neutrophil percentage, and in the concentration of the cytokine-induced neutrophil chemoattractants (CINC)-1, CINC-2 and C-X-C motif chemokine 5 (CXCL5) (which had the highest expression of all chemokines by cDNA microarray using the lung tissue) were observed in bronchoalveolar lavage fluid (BALF) from 3 days until at least 1 month following CL-PAA intratracheal instillation. Persistent increases in heme oxygenase-1 (HO-1) in the lung tissue were also observed from 3 days to 6 months after exposure. Histopathological findings of the lungs demonstrated that extensive inflammation at 3 days was greater than that in exposure to silica, NiO nanoparticles and CeO2 nanoparticles, and equal to or greater than that in asbestos (chrysotile) exposure, and the inflammation continued until 1 month. Fibrotic changes also progressed after 1 month postexposure. Conclusion﻿Our results suggest that CL-PAA may potentially cause strong neutrophil inflammation in the rat and human lung.
Episodic Headaches with Spontaneous Hypothermia Reveal Shapiro’s Syndrome with Effectiveness of Clonidine Therapy
Authors: AUBIGNAT Mickael , Tir Melissa , Krystkowiak Pierre , Andriuta Daniela 
Published: January 2021

Abstract
Background: Episodic headaches with spontaneous hypothermia constitute an uncommon association and is not well recognized in the International Classification of Headache Disorders (ICHD-3). Spontaneous periodic hypothermia, also called Shapiro’s syndrome, is a rare disease characterized by hypothermia attacks associated or not with hyperhidrosis without any triggering factor.Case presentation: We report a rare case of Shapiro’s syndrome revealed by episodes of headache with spontaneous hypothermia with effectiveness of clonidine therapy in a 76-year-old Parkinson’s disease woman.Conclusions: In the literature, apart from Shapiro’s syndrome, headaches with hypothermia seem to occur very rarely. These symptoms may be considered as a very rare non-motor fluctuation of Parkinson’s disease.
Spatiotemporal Variation of the Indoor Mycobiome in Daycare Centers
Authors: Estensmo Eva Lena , Morgado Luis , Maurice Sundy , Martin-Sanchez Pedro Maria , Engh Ingeborg Bjorvand , Mattsson Johan , Kauserud Håvard , Skrede Inger 
Published: January 2021

Abstract
Background: Children spend considerable time in daycare centers in parts of the world, and are exposed to the indoor micro- and mycobiomes of these facilities. The level of exposure to microorganisms varies within and between buildings, depending on occupancy, climate and season. In order to evaluate indoor air quality, and the effect of usage and seasonality, we investigate the spatiotemporal variation in the indoor mycobiomes of two daycare centers. We collected dust samples from different rooms throughout a year and analyzed their mycobiomes using DNA metabarcoding. Results: The fungal community composition in rooms with limited occupancy (auxiliary rooms) was similar to the outdoor samples, and clearly different from the rooms with higher occupancy (main rooms). The main rooms had higher abundance of Ascomycota, while the auxiliary rooms contained comparably more Basidiomycota. We observed a strong seasonal pattern in the mycobiome composition, mainly structured by the outdoor climate. Most markedly, basidiomycetes of the orders Agaricales and Polyporales, mainly reflecting typical outdoor fungi, were more abundant during summer and fall. In contrast, ascomycetes of the orders Saccharomycetales and Capnodiales were dominant during winter and spring. Conclusions: Our findings provide clear evidences that the indoor mycobiome in daycare centers are structured by occupancy as well as outdoor seasonality. We conclude that the temporal variability should be accounted for in indoor mycobiome studies and in the evaluation of indoor air quality of buildings.
Ecology Impacts The Decrease of Spirochaetes and Prevotella In The Fecal Gut Microbiota of Urban Humans
Authors: Thingholm Louise B. , Bang Corinna , Rühlemann Malte C. , Starke Annika , Sicks Florian , Kaspari Verena , Jandowsky Anabell , Fröhlich Kai , Ismer Gabriele , Bernhard Andreas , Bombis Claudia , Struve Barbara , Rausch Philipp , Franke Andre 
Published: January 2021

Abstract
Background: Compared to the huge microbial diversity in most mammals, human gut microbiomes have lost diversity while becoming specialized for animal-based diets – especially compared to chimps, their genetically closest ancestors. The lowered microbial diversity within the gut of westernized populations has also been associated with different kinds of chronic inflammatory diseases in humans. To further deepen our knowledge on phylogenetic and ecologic impacts on human health and fitness, we established the herein presented biobank as well as its comprehensive microbiota analysis. In total, 424 stool samples from 40 different animal species, including Homo sapiens, belonging to four diverse mammalian orders were collected at seven different locations and analyzed by 16S rRNA gene amplicon sequencing. Comprehensive data analysis was performed to (i) determine the overall impact of host phylogeny vs. diet, location, and ecology and to (ii) examine the general pattern of fecal bacterial diversity across captive mammals and humans.Results: By using a controlled study design with captive mammals we could verify that host phylogeny is the most dominant driver of mammalian gut microbiota composition. However, the effect of ecology appears to be able to overcome host phylogeny and should therefore be studied in more detail in future studies. Most importantly, our study could observe a remarkable decrease of Spirochaetes and Prevotella in urban humans and New World monkeys, which is probably not only due to diet, but also to the social behavior of these communities.Conclusion: Our study highlights the importance of phylogenetic relationship and ecology within the evolution of mammals’ fecal microbiota composition. Particularly, the observed decrease of Spirochaetes and Prevotella in urban communities might be associated to lifestyle dependent rapid evolutionary changes, potentially involved in the establishment of dysbiotic microbiomes promoting the etiology of chronic diseases.
Clinical Study of Unilateral Extraforaminal Lumbar Interbody Fusion (ELIF) Revision For Lumbar Disc Herniation After Primary Discectomy
Authors: Lu Qilin , Tang Jin , Chen Long , Wang Xiao-zhen , Zhu Yi-liang , YANG Ao-fei 
Published: January 2021

Abstract
Background: Lumbar disc herniation (LDH) is a common spinal disorder. The discectomy with non-fusion operation is widely used. When the revision is needed, the options for revision way is still controversial. This study aims to introduce unilateral extraforaminal lumbar interbody fusion (ELIF) revision surgery, and to investigate the clinical efficacy and complication of Unilateral Extraforaminal Lumbar Interbody Fusion (ELIF) in revising primary discectomy for lumbar disc herniation. Methods:16 patients with incomplete removal and recurrence herniation of lumbar disc after minimally invasive treatment without fixation were treated by ELIF with unilateral pedicle screw(UPS) from April 2016 to October 2020. All those patietns including 11 male and 5 female aged 29-65 years were analyzed retrospectively. The clinical effects were evaluated by operation time, intraoperative blood loss, postoperative blood volume of drainage and complications. The Visual Analogue Scale(VAS), Oswestry Disability Index (ODI) were documented before, after surgery and at last follow--up. Results: The operation time was 95.73±10.5 min, the bleeding volume was 201.5±27.6 ml. Postoperative blood volume of drainage was 50.7±6.3 ml. 2 patients suffered dura tear. All patients were followed up for 12-26 months with 15.7 on average. VAS and ODI scores significantly improved at the preoperative, postoperative and the 12th month’s follow up (P < 0.05). Conclusion: The application of ELIF with unilateral fixation is a satisfied way to revise primary discectomy for lumbar disc herniation. However, the dura tear induced by scar tissue adhesion needs to be noticed.
Lower Grip Strength and Insufficient Physical Activity Can Increase Depressive Symptoms Among Middle-Aged and Older European Adults
Authors: Zheng Han , Jia Chongqi 
Published: January 2021

Abstract
Objectives: The present study aimed to explore the interaction between grip strength and physical activity on depression, and investigate the association of physical activity with the change in depression by different grip strength groups among middle-aged and older European adults.Methods: A total of 13936 participants aged 50 years or older from the Survey of Health, Ageing and Retirement in Europe 2007-2017 were included in this study. Group-based trajectory modeling was used to identify the low, middle and high group of grip strength by gender. Generalized estimated equations were fitted to analyze the interaction effect.Results: Significant interactions between grip strength group and physical inactivity were found (O interaction=16.70, p<0.001). Significant interactions between physical inactivity and time on depression were identified in low (b interaction=22.15, p<0.001) and moderate (j interaction=22.85, p<0.001) grip strength, but a similar result was not found in high grip strength (e interaction=3.20, p=0.526). Participants in the physical inactivity group had higher depression scores in the low and moderate grip strength group.Conclusions: Grip strength and physical inactivity have interaction with depression. Lower grip strength and insufficient physical activity could increase depressive symptoms. People with lower grip strength and physical inactivity should pay special attention to the prevention of depression.
The Clinical Characteristics and Risk Factors for Poor Prognosis Among HIV Patients with Talaromyces Marneffei Bloodstream Infection
Authors: Sun Jianjun , Sun Weiwei , Tang Yang , Zhang Renfang , Liu Li , Shen Yinzhong , Wang Jiangrong , Chen Jun , Qi Tangkai , Wang Zhenyan , Song Wei , Lin Yixiao , Xu Shuibao , Lu Hong-zhou 
Published: January 2021

Abstract
Background Talaromyces marneffei(TM) bloodstream infection is common in AIDS patients with extreme immunodeficiency in Southeast Asia and South China, however, clinical case study on TM bloodstream infection is scarce. We retrospectively analyze the clinical characteristics of TM bloodstream infection in hospitalized AIDS patients and determine the outcomes of hospitalization after diagnosis in our hospital over the past 5 years.Methods From January 2015 to July 2020, cases of TM detected by blood culture in patients admitted to our center were sorted and analyzed. The admission complaints, blood cells, biochemistry, CD4/CD8 count and 1,3-β-D-glucan, procalcitonin, CRP level on the day of blood culture test, and outcomes during hospitalization were analyzed. Logistic regression analysis was performed for the risk factors for poor prognosis. Spearman correlation analysis was used to analyze the correlation between peripheral blood cells, albumin and the time required for TM to become positive in blood culture. The difference was statistically significant when the P value was <0.05. Results A total of 87 patients were collected, with a median age of 34 years, a median hemoglobin of 94 g/L and CD4 count of 7/µl. The rate of TM bloodstream infection among all in-hospital patients increased from 0.99% in 2015 to 2.09% in 2020(half year). Patients with TM bloodstream infection with a CD8 count <200/µl had a 12.6-fold higher risk of poor prognosis than those with a CD8 count >200/µl (p=0.04), and those with 1,3-β-D-glucan <100 pg/mL had a 34.9-fold higher risk of poor prognosis than those with 1,3-beta-D-glucan >100 pg/mL (p=0.01).Conclusions TM bloodstream infection is becoming more common in advanced AIDS patients in endemic areas. For those patients with extremely low CD4 and CD8 cell counts below 200/µl, the 1,3-β-D-glucan <100 pg/mL are with an increased risk of poor prognosis.
Malnutrition According to GLIM Criteria Acts as a Risk Factor for Survival of Nasopharyngeal Carcinoma Patients Undergoing Radiotherapy : A Retrospective Study Highlighting the Nutritional Management in Radiotherapy
Authors: Wan Meng , Zhang Lichuan , Chen Changshun , Zhao Dan , Zheng Baomin , Xiao Shaowen , Liu Weixin , Xu Xiaolong , Wang Yujie , Zhuang Bing , Zhang Tong , Jin Sanli , Wang Weihu , Lu Qian , Sun Yan 
Published: January 2021

Abstract
Background Nutritional status of nasopharyngeal carcinoma (NPC) patients lying at a high risk of nutrition defect to a great extent determines the post-treatment outcomes, which deserves thorough observation. However, limited ever-conducted studies regarding the NPC patients’ malnutrition by effective methods like the Global Leadership Initiative in Malnutrition (GLIM) criteria heavily obstructed this prospect. Our study aimed to investigate the incidence of malnutrition in NPC cancer patients using GLIM criteria and explore the relationships between malnutrition and adverse effects, survival status.Methods A retrospective chart review of 113 patients with NPC from December 2016 to October 2019. The nutritional status of NPC undergoing radiotherapy (RT) was determined by GLIM criteria at three-time points: pre-RT, in the middle of RT, and at the end of RT. The adverse effects were graded according to the Radiation Therapy Oncology Group (RTOG) scoring criteria. Kaplan–Meier method was used to compare survival outcomes, and the differences were evaluated using the log-rank test.ResultsNineteen cases (16.8%) were malnutrition before radiotherapy; overall stage (p=0.017) and induction chemotherapy(p=0.002) contributed to pre-radiotherapy malnourishment, and the nutritional status worsened with radiotherapy. Of the phenotypic GLIM criteria, low fat free mass index (FFMI) before radiotherapy was associated with mucositis and radiodermatitis (p<0.05). With a median follow-up of 28.3 months, the Kaplan-Meier curve indicated that malnutritional patients had significantly poorer Progress Free survival (PFS); 2-year PFS was 88.9% in the well-nourishment group vs. 62.1% in the malnutrition group (p=0.015). In multivariate analysis, nutritional status and gender were independent prognostic factors of poorer PFS (HR 3.387, 95%CI 1.299-8.834, p=0.013 and HR 5.698, 95%CI 1.290-25.168, p=0.022).Conclusion Malnutrition is common in NPC patients, and it increases significantly during radiotherapy. Malnutrition, according to GLIM criteria, is correlated with survival. Our study could justify the effectiveness and usability of GLIM for NPC patients undergoing RT. Appropriate nutritional guidance or nutritional support should be taken to improve the NPC patients’ nutritional status during radiotherapy.
Outcomes and Limitations of Endoscopic Ultrasound-guided Hepaticogastrostomy in Malignant Biliary Obstruction
Authors: Jagielski Mateusz , Zieliński Michał , Piątkowski Jacek , Jackowski Marek 
Published: January 2021

Abstract
Background: Transpapillary biliary drainage in ERCP is an established method for symptomatic treatment of patients with irresectable malignant biliary obstruction. Percutaneous transhepatic biliary drainage frequently remains the treatment of choice when the transpapillary approach proves ineffective. Recently, EUS-guided extra-anatomical anastomoses of bile ducts to the gastrointestinal tract have been reported as an alternative to percutaneous biliary drainage. To assess the usefulness of extra-anatomical intrahepatic biliary duct anastomoses to the gastrointestinal tract as endotherapy for irresectable malignant biliary obstruction and to determine factors affecting the efficacy of treatment. Methods: A prospective analysis of the treatment results of all patients with irresectable biliary obstruction treated with endoscopic hepaticogastrostomy at our institution in the years 2016–2019. Results: Transmural intrahepatic biliary drainage (endoscopic hepaticogastrostomy) was performed due to the ineffectiveness of ERCP in 53 patients (38 males, 15 females; mean age 74.66 [56–89] years) with irresectable biliary obstruction. Technical success of endoscopic hepaticogastrostomy was achieved in 52/53 (98.11%) patients. Complications of endoscopic treatment were observed in 10/53 (18.87%) patients. Clinical success of endoscopic hepaticogastrostomy was achieved in 46/53 (86.79%) patients. Bismuth type II–IV cholangiocarcinoma, hepatic metastases, ascites, suppurative cholangitis, and high blood bilirubin levels exceeding 30 mg/dL were independent factors for increased complications and inefficacy of endoscopic hepaticogastrostomy. Conclusions: In the event of transpapillary biliary drainage proving ineffective, extra-anatomical anastomoses of bile ducts to the gastrointestinal tract provide an effective method for the treatment of patients with malignant biliary obstruction.
Hiccups Induced by Aripiprazole Combined With Sertraline in An Adolescent With Olfactory Reference Disorder: A Case Report
Authors: Li Zhe , Li Yang , Xiong Zhenzhen , Li Zhixiong , Yuan Yiwen , Deng Junfeng , Li Xiao 
Published: January 2021

Abstract
Background Hiccup can cause significant distress to patients and affect medication compliance. Individuals with olfactory reference disorder (ORD) who might develop persistent hiccups when treated with a combination of antidepressant and antipsychotic, leading to significant distress and impairment. Case presentation We report a rare case of an adolescent with ORD who was treated with aripiprazole combined with sertraline and who began to hiccup persistently after 6 days on this treatment. He stopped hiccupping after the aripiprazole had been suspended for 12 h. After discharge, the patient continued on sertraline alone and reported no hiccupping at one-month follow-up. Conclusions Clinicians should consider that the combination of aripiprazole and sertraline can induce hiccups during the acute administration period in adolescents with ORD.
Glucocorticoids Improves Pregnancy Rate and Outcome in Woman With Unexplained Positive Autoantibody: a Systematic Review and Meta-analysis
Authors: Li Ting , Yuan Yilin , Liu Huixin , Lu Qun , Mu Rong 
Published: January 2021

Abstract
Background: The effect of glucocorticoids (GCs) therapy for women with unexplained positive autoantibody is under debate. This systematic review and meta-analysis was performed to evaluate whether GCs administration can improve the pregnancy outcome of this population.Methods: A meta-analysis based on a systematic review of PubMed, Embase, EBSCO, and the Cochrane Central Register of Controlled Trials, until January 2021, was used to evaluate pregnancy outcome of GCs treatment for women with unexplained recurrent fetal loss or infertility whose autoantibody positive, but does not meet any classification criteria for autoimmune diseases.Results: We found GCs treatment improved clinical pregnancy rate (RR 2.19, 95% CI 1.64 to 2.92) and live birth rate (RR 1.92, 95% CI 1.17 to 3.16), especially when started GCs administration before pregnancy (clinical pregnancy rate: RR 2.30, 95% CI 1.58 to 3.34; live birth rate: RR 2.30, 95% CI 1.58 to 3.34). However, no effect of GCs on miscarriage rate was found (RR 0.75, 95% CI 0.55 to 1.02) regardless of time of drug administration.Conclusions: Our systematic review and meta-analysis surports the rational use of GCs in women with unexplained positive autoantibody.