bluuebunny/crossref_metadata_2025_split huggingface dataset:
Randomized Controlled Study to Evaluate Microbial Ecological Effects of CPP-ACP and Cranberry on Dental Plaque
Authors: Philip N. , Leishman S.J. , Bandara H.M.H.N. , Healey D.L. , Walsh L.J. 
Published: July 2019

Introduction: Ecological approaches to dental caries prevention play a key role in attaining long-term control over the disease and maintaining a symbiotic oral microbiome. Objectives: This study aimed to investigate the microbial ecological effects of 2 interventional dentifrices: a casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) dentifrice and the same dentifrice supplemented with a polyphenol-rich cranberry extract. Methods: The interventional toothpastes were compared with each other and with an active control fluoride dentifrice in a double-blinded randomized controlled trial. Real-time quantitative polymerase chain reaction (qPCR) analysis was used to determine changes in the bacterial loads of 14 key bacterial species (8 caries associated and 6 health associated) in the dental plaque of trial participants after they used the dentifrices for 5 to 6 wk. Results: From the baseline to the recall visit, significant differences were observed between the treatment groups in the bacterial loads of 2 caries-associated bacterial species ( Streptococcus mutans [ P < 0.001] and Veillonella parvula [ P < 0.001]) and 3 health-associated bacterial species ( Corynebacterium durum [P = 0.008], Neisseria flavescens [ P = 0.005], and Streptococcus sanguinis [ P < 0.001]). Compared to the fluoride control dentifrice, the CPP-ACP dentifrice demonstrated significant differences for S. mutans ( P = 0.032), C. durum ( P = 0.007), and S. sanguinis ( P < 0.001), while combination CPP-ACP–cranberry dentifrice showed significant differences for S. mutans ( P < 0.001), V. parvula ( P < 0.001), N. flavescens ( P = 0.003), and S. sanguinis ( P < 0.001). However, no significant differences were observed in the bacterial load comparisons between the CPP-ACP and combination dentifrices for any of the targeted bacterial species ( P > 0.05). Conclusions: Overall, the results indicate that dentifrices containing CPP-ACP and polyphenol-rich cranberry extracts can influence a species-level shift in the ecology of the oral microbiome, resulting in a microbial community less associated with dental caries (Australian New Zealand Clinical Trial Registry ANZCTR 12618000095268). Knowledge Transfer Statement: The results of this randomized controlled trial indicate that dentifrices containing casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) and polyphenol-rich cranberry extracts were able to beneficially modulate the microbial ecology of dental plaque in a group of high caries-risk patients. This could contribute toward lowering the risk of developing new caries lesions, an important goal sought by patients, clinicians, and policy makers.
Evidence for lifestyle interventions in asthma
Authors: Stoodley Isobel , Williams Lily , Thompson Cherry , Scott Hayley , Wood Lisa 
Published: July 2019

Asthma is a chronic inflammatory airways disease, estimated to affect 300 million people worldwide. Asthma management plans focus on optimisation of asthma pharmacotherapy. Lifestyle interventions also hold great promise for asthma sufferers as they are accessible, low cost and have minimal side-effects, thus making adherence more likely. This review explores lifestyle interventions that have been tested in asthma, including improving nutrition, increasing physical activity and introduction of relaxation therapies such as yoga and massage therapy. Available evidence suggests a protective effect of increasing fruit, vegetable and wholegrain intake and increasing physical activity levels in asthma. Weight loss is recommended for obese asthmatic patients, as just 5–10% weight loss has been found to improve quality of life and asthma control in most obese asthmatic patients. Other lifestyle interventions such as meditation, yoga and massage therapy show promise, with positive effects on asthma seen in some studies. However, the study protocols are highly variable and the results are inconsistent. Additional research is needed to further develop and refine recommendations regarding lifestyle modifications that can be implemented to improve asthma.Key pointsImproving diet quality, by increasing fruit, vegetable and wholegrain intake and reducing saturated fat intake, should be recommended in asthma, as there is evidence suggesting that this leads to improvements in airway inflammation, asthma control and exacerbation risk.Regular physical activity should be promoted for people with asthma, as it can improve quality of life and lung function, as well as general health.In obese asthmatic patients, weight loss should be recommended, as it leads to numerous health benefits, including improvements in asthma. Even small amounts of weight loss in adults (5–10% body weight) have been shown to improve asthma quality of life and asthma control in the majority of people with asthma.There is some evidence of benefit of meditation, yoga and breathing exercises for adults with asthma, while massage therapy shows promise in children with asthma. However, the evidence is inconsistent and more research is needed to make definitive recommendations.Educational aimsTo summarise current knowledge on lifestyle interventions in asthma.To improve awareness of how lifestyle modification can be used in asthma management.To identify areas for future research on lifestyle interventions in asthma.
The prevalence of poor sleep quality and its associated factors in patients with interstitial lung disease: a cross-sectional analysis
Authors: Cho Jin-Gun , Teoh Alan , Roberts Mary , Wheatley John 
Published: July 2019

BackgroundMany patients with interstitial lung disease (ILD) experience poor sleep quality, which may contribute to decreased quality of life. Sleep disordered breathing is commonly associated with ILD but there is less information on other factors that may contribute to poor sleep quality.MethodsWe conducted a cross-sectional analysis of 101 patients with a diagnosis of ILD at a pulmonary rehabilitation assessment clinic. We assessed the prevalence of poor sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and performed multivariable logistic regression analysis to determine factors independently associated with poor sleep quality.ResultsMedian forced expiratory volume in 1 s was 64% predicted (interquartile range (IQR) 50–77%) and vital capacity was 62% predicted (IQR 48–78%). 67 (66%) out of 101 patients reported poor sleep quality. The median PSQI was 8 units (IQR 4–11 units). There were no significant differences in physical or physiological parameters including age, sex distribution, body mass index or spirometry values between subjects with good sleep quality and those with poor sleep quality (all p>0.1). Multivariable logistic regression showed that depression (p=0.003) and Epworth Sleepiness Scale (p=0.03) were independently associated with poor sleep quality.ConclusionPoor sleep quality is common in patients with ILD and is independently associated with increasing symptoms of depression and sleepiness. Routine assessment of sleep quality should be undertaken and interventions targeting depression and coexisting sleep disorders may be required in symptomatic patients to determine if sleep quality and ultimately, health-related quality of life improves as a result.
Community analysis and co-occurrence patterns in airway microbial communities during health and disease
Authors: Einarsson Gisli G. , Zhao Jiangchao , LiPuma John J. , Downey Damian G. , Tunney Michael M. , Elborn J. Stuart 
Published: July 2019

Ecological relationships between bacteria are important when considering variation in bacterial communities in humans, with such variation playing an important role in both health and disease.Using high-throughput sequence data of the 16S rRNA marker-gene, we analysed the prevalence of taxa in the airways of a number of health- and disease-associated cohorts and determined the main drivers of community variance and bacterial co-occurrence.A number of facultative and obligately anaerobic bacterial taxa are commonly associated with the upper airways, forming the main “core” microbiota,e.g. Streptococcusspp.,Veillonellaspp.,Prevotellaspp.,Granulicatellaspp. andFusobacteriumspp. Opportunistic pathogenic bacteria associated with chronic airways disease, such asPseudomonasspp. (Pseudomonas aeruginosa), Burkholderiaspp. (Burkholderia cepaciacomplex) andHaemophilusspp. (Haemophilus influenzae) demonstrated poor correlation with other members of their respective communities (ρ<0.5; p>0.005), indicating probable independent acquisition and colonisation. Furthermore, our findings suggest that intra-genus variation between health and disease may affect community assemblies.Improved understanding of how bacteria assemble in time and space during health and disease will enable the future development of tailored treatment according to the patient's own signature microbiota, potentially providing benefit to patients suffering from airway diseases characterised by chronic infection.
Living With Neuroendocrine Tumors: Assessment of Quality of Life Through a Mobile Application
Authors: Adams Jared R. , Ray David , Willmon Renee , Pulgar Sonia , Dasari Arvind 
Published: July 2019

PURPOSE To understand the quality of life (QoL) for patients with neuroendocrine tumors (NETs) through comparison of QoL questionnaires and symptom tracking as well as journaling via the Carcinoid NETs Health Storylines mobile application (app). PATIENTS AND METHODS This was a 12-week prospective, observational study of US patients with NET who were taking long-acting somatostatin analogs. National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) and European Organisation for Research and Treatment of Cancer (EORTC) questionnaires were administered three times. Patients also monitored symptoms, mood, bowel movements, food, activity, and sleep, and they journaled in their app, which was coded by theme and sentiment for qualitative analysis. RESULTS Of the 120 patients with NET, 78% were women (mean age, 57 years); 76% had gastroenteropancreatic NETs, and 88% had metastases. Lanreotide depot and octreotide long-acting release (LAR) were used by 41% and 59%, respectively. The most common symptoms at baseline were fatigue (76.7%), diarrhea (62.5%), abdominal discomfort (64.1%), and trouble sleeping (57.5%). The majority completed five of six survey assessments (median, 5; mean, 5.1) and tracked four symptoms in the app (median, 4; mean, 5.5); the average frequency was 41.6 days for each symptom (median, 43; mean, 41.6; range, 1 to 84 days [12 weeks]). Without treatment change, most EORTC-assessed physical symptoms decreased from baseline to midpoint (eg, 59.3% at baseline v 33% at midpoint reported “quite a bit” or “very much” diarrhea; P = .002). App-based symptom tracking revealed large day-to-day variation, but weekly averages correlated well with survey scores. Journal entries showed that more patients made predominantly negative unsolicited entries about their injection experience with octreotide LAR compared with lanreotide (13 of 17 v two of 13; P < .001). CONCLUSION Patients with NET experience a large symptom burden that varies daily. A decrease in physical symptoms on QoL surveys suggests an effect from daily app-based monitoring or journaling, which may reduce recall bias and benefit the patient’s experience of symptoms.
Neoadjuvant Three-Dimensional Conformal Radiotherapy for Resectable Hepatocellular Carcinoma With Portal Vein Tumor Thrombus: A Randomized, Open-Label, Multicenter Controlled Study
Authors: Wei Xubiao , Jiang Yabo , Zhang Xiuping , Feng Shuang , Zhou Bin , Ye Xiaofei , Xing Hui , Xu Ying , Shi Jie , Guo Weixing , Zhou Dong , Zhang Hui , Sun Huichuan , Huang Cheng , Lu Congde , Zheng Yaxin , Meng Yan , Huang Bin , Cong Wenming , Lau Wan Yee , Cheng Shuqun 
Published: July 2019

PURPOSE To compare the survival outcomes of neoadjuvant three-dimensional conformal radiotherapy (RT) followed by hepatectomy with hepatectomy alone in patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT). PATIENTS AND METHODS A randomized, multicenter controlled study was conducted from January 2016 to December 2017 in patients with resectable HCC and PVTT. Patients were randomly assigned to receive neoadjuvant RT followed by hepatectomy (n = 82) or hepatectomy alone (n = 82). The modified Response Evaluation Criteria in Solid Tumors (mRECIST) guidelines were used to evaluate the therapeutic effects of RT. The primary end point was overall survival. The expression of interleukin-6 (IL-6) in patients’ serum before RT and in surgical specimens was correlated with response to RT. RESULTS In the neoadjuvant RT group, 17 patients (20.7%) had partial remission. The overall survival rates for the neoadjuvant RT group at 6, 12, 18, and 24 months were 89.0%, 75.2%, 43.9%, and 27.4%, respectively, compared with 81.7%, 43.1%, 16.7%, and 9.4% in the surgery-alone group ( P < .001). The corresponding disease-free survival rates were 56.9%, 33.0%, 20.3%, and 13.3% versus 42.1%, 14.9%, 5.0%, and 3.3% ( P < .001). On multivariable Cox regression analyses, neoadjuvant RT significantly reduced HCC-related mortality and HCC recurrence rates compared with surgery alone (hazard ratios, 0.35 [95% CI, 0.23 to 0.54; P < .001] and 0.45 [95% CI, 0.31 to 0.64; P < .001]). Increased expressions of IL-6 in pre-RT serum and tumor tissues were significantly associated with resistance to RT. CONCLUSION For patients with resectable HCC and PVTT, neoadjuvant RT provided significantly better postoperative survival outcomes than surgery alone. IL-6 may predict response to RT in these patients.
Epidural Analgesia During Childbirth and Postpartum Depressive Symptoms: A Population-Based Longitudinal Cohort Study
Authors: Eckerdal Patricia , Kollia Natasa , Karlsson Linnea , Skoog-Svanberg Agneta , Wikström Anna-Karin , Högberg Ulf , Skalkidou Alkistis 
Published: July 2019

BACKGROUND:
Severe pain has been linked to depression, which raises the question of whether epidural analgesia (EDA) during childbirth is associated with a reduced risk of postpartum depression (PPD). This association has been explored previously, but the studies were restricted by small sample sizes and the inability to control for relevant confounders. This study aimed to investigate the association between the administration of EDA and the development of PPD after adjusting for sociodemographic, psychosocial, and obstetric variables.

METHODS:
Data were retrieved from the Biology, Affect, Stress, Imaging and Cognition (BASIC) project (2009–2017), a population-based longitudinal cohort study of pregnant women conducted at Uppsala University Hospital, Sweden. The outcome was PPD at 6 weeks postpartum, defined as a score of ≥12 points on the Edinburgh Postnatal Depression Scale (EPDS). Information was collected through medical records and self-reported web-based questionnaires during pregnancy and 6 weeks after childbirth. Only primiparous women with spontaneous start of childbirth were included (n = 1503). The association between EDA and PPD was examined in multivariable logistic regression models, adjusting for sociodemographic, psychosocial, and obstetric variables. Results are presented as odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS:
Of the 1503 women included in the analysis, 800 (53%) reported use of EDA during childbirth. PPD at 6 weeks postpartum was present in 193 (13%) women. EDA was not associated with higher odds of PPD at 6 weeks postpartum after adjusting for suspected confounders (age, fear of childbirth, antenatal depressive symptoms; adjusted OR [aOR] = 1.22; 95% CI, 0.87–1.72).

CONCLUSIONS:
EDA was not associated with the risk of PPD at 6 weeks postpartum after adjusting for sociodemographic, psychosocial, and obstetric variables. However, these findings do not preclude a potential association between PPD and childbirth pain or other aspects of EDA that were not assessed in this study.
Lipid Emulsion Containing High Amounts of n3 Fatty Acids (Omegaven) as Opposed to n6 Fatty Acids (Intralipid) Preserves Insulin Signaling and Glucose Uptake in Perfused Rat Hearts
Authors: Lou Phing-How , Lucchinetti Eliana , Hersberger Martin , Clanachan Alexander S. , Zaugg Michael 
Published: July 2019

BACKGROUND:
It is currently unknown whether acute exposure to n3 fatty acid–containing fish oil–based lipid emulsion Omegaven as opposed to the n6 fatty acid–containing soybean oil–based lipid emulsion Intralipid is more favorable in terms of insulin signaling and glucose uptake in the intact beating heart.

METHODS:
Sprague–Dawley rat hearts were perfused in the working mode for 90 minutes in the presence of 11 mM glucose and 1.2 mM palmitate bound to albumin, the first 30 minutes without insulin followed by 60 minutes with insulin (50 mU/L). Hearts were randomly allocated to 100 µM Intralipid, 100 µM Omegaven, or no emulsion (insulin treatment alone) for 60 minutes. Glycolysis and glycogen synthesis were measured with the radioactive tracer [5-3H]glucose, and glucose uptake was calculated. Phosphorylation of protein phosphatase 2A (PP2A), protein kinase Akt, and phosphofructokinase (PFK)-2 was measured by immunoblotting. Glycolytic metabolites were determined by enzymatic assays. Mass spectrometry was used to establish acylcarnitine profiles. Nuclear factor κB (NFκB) nuclear translocation served as reactive oxygen species (ROS) biosensor.

RESULTS:
Insulin-mediated glucose uptake was decreased by Intralipid (4.9 ± 0.4 vs 3.7 ± 0.3 μmol/gram dry heart weight [gdw]·min; P = .047) due to both reduced glycolysis and glycogen synthesis. In contrast, Omegaven treatment did not affect insulin-mediated glycolysis or glycogen synthesis and thus preserved glucose uptake (5.1 ± 0.3 vs 4.9 ± 0.4 μmol/gdw·min; P = .94). While Intralipid did not affect PP2A phosphorylation status, Omegaven resulted in significantly enhanced tyrosine phosphorylation and inhibition of PP2A. This was accompanied by increased selective threonine phosphorylation of Akt and the downstream target PFK-2 at S483. PFK-1 activity was increased when compared with Intralipid as measured by the ratio of fructose 1,6-bisphosphate to fructose 6-phosphate (Omegaven 0.60 ± 0.11 versus Intralipid 0.47 ± 0.09; P = .023), consistent with increased formation of fructose 2,6-bisphosphate by PFK2, its main allosteric activator. Omegaven lead to accumulation of acylcarnitines and fostered a prooxidant response as evidenced by NFκB nuclear translocation and activation.

CONCLUSIONS:
Omegaven as opposed to Intralipid preserves glucose uptake via the PP2A–Akt–PFK pathway in intact beating hearts. n3 fatty acids decelerate β-oxidation causing accumulation of acylcarnitine species and a prooxidant response, which likely inhibits redox-sensitive PP2A and thus preserves insulin signaling and glucose uptake.
Toxicity of the hydroalcoholic extracts of fruit leaves from the Peruvian Amazon in Artemia salina
Authors: Sandoval Vergara Ana , Ismiño Riquelme Armando 
Published: July 2019

Background: Medicinal plants have been used since ancient times, receiving interest in their healing potential because of their active components. The Amazon rainforest in the east of Peru has great diversity of flora, especially monocotyledons (Cocos nucifera, Mauritia flexuosa and Coffea spp.) and dicotyledons (Theobroma cacao L. and Musa spp. The toxicity of the hydroalcoholic extract of plant leaves from the Peruvian Amazon in Artemia salina was evaluated in this study. Methods: The leaves of the plants Cocos nucifera, Mauritia flexuosa, Theobroma cacao L., Coffea sp, and Musa sp were collected in the district of Cacatachi, San Martín. Phytochemical analysis of the leaves was carried out to identify their active components. The eggs of Artemia salina were provided by the Department of Animal Physiology of Universidad Nacional de Trujillo. The hydro-alcoholic extraction was carried out via the maceration method using 300 g of leaves and 500 mL of 96% ethanol for 15 days in agitation. The solutions were taken to a vertical rotavapor to obtain dry extracts and concentrations of 10, 100 and 1000 μL/ml were prepared. To test toxicity, 10 larvae were given the extract for each plant species and concentration in triplicate. The CL50 toxicity of Artemia salina samples was classified as: ˃ 1000 μL/ml (non-toxic), 500˂CL50 ≤ 1000 (low toxicity), 100˂CL50 ≤ 500 (moderate toxicity), CL50˂100 (high toxicity). Results: It was observed that Mauritia flexuosa and Musa sp. at concentrations of 10, 100 and 1000 μL/ml have high, medium and low toxicity, respectively. However, only low toxicity was observed in Cocos nucifera, Theobroma cacao L. and Coffea sp. Conclusions: It can be concluded that the obtained results are in accordance with other studies that examined different extracts, indicating that if a sample is non-toxic to Artemia salina, then its effects will also be similar in humans.
Ouster Clause: Legislative Blaze and Judicial Phoenix
Authors: S A Sandhya Ram 
Published: July 2019

If constitutionalism denotes obedience to the
Constitution, the scheme for enforcement of obedience
and invalidation of disobedience should be found in the
Constitution itself. It is important that this scheme be
clear and the task of enforcement be vested in a
constitutional body. In such a situation, the question of
custodianship i.e., who will ensure the rule of
constitutionalism assumes prime importance, as any
ambiguity regarding the same will result in conflicts
uncalled for between legislature and judiciary. This
conflict intensifies when judiciary determines the
constitutionality of the legislations and the legislature
defends by placing it in the „ouster clauses‟ within the
Constitution to exclude the judicial determination.
Judiciary counters by nullifying the legislative attempts
through innovative interpretation. An attempt is made to
study Article 31 B, the most prominent ouster clause in
the Constitution of India barring judicial review of
legislations and how the Indian judiciary retaliated to
such legislative attempts and effectively curbed them. The
study outlines the historical reasons which necessitated
the insertion of Article 31 B in the Constitution and
analyses the myriad implications of such an ouster clause
within the Constitution. The constitutional basis of
judicial review is studied to audit the justifiability of the
open ended Ninth Schedule along with Article 31 B. A
comparison between Article 31 B and the other ouster clauses namely Articles 31 A and 31 C is also made,
bringing out the effect and scope of Article 31 B. The
study covers a critical survey of judicial pronouncements
from 1951 to 2007.
Recognition of the Rights of the Victims of Climate Change under Public International Law: A Study
Authors: Sengupta Piyali 
Published: July 2019

In recent years, climate change is emerging as a major
environmental disaster. The impact of such disasters has
been the rise in global temperature and flooding of coastal
zone communities, frequent droughts and disruptions in
rainfall pattern. This has resulted in the increase in the
number of environmental refugees. Climate change
disasters constitute a major reason for displacement of
population than war and persecution. Climate induced
migration is a highly complex issue. The status of climate
refugees is not recognized in the international framework.
The non recognition of these victims in international and
national legislations has not only deprived them of their
basic human rights but has also raised crucial questions
relating to their existence and identity. This paper tries to
bring out the lacunae in the present policy and legal
framework relating to environmental refugees with
reference to the non-refoulement principle. Further, the
paper emphasizes on the need to include climate refugees
under the term „refugee‟ as laid down in the United
Nations Convention relating to the Status of Refugees,
1951and provides suggestions for improving the
condition and protection of this hitherto neglected
population.