bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deprescribing in the Pharmacologic Management of Delirium: A Randomized Trial in the Intensive Care Unit
Authors: Campbell Noll L. , Perkins Anthony J. , Khan Babar A. , Gao Sujuan , Farber Mark O. , Khan Sikandar , Wang Sophia , Boustani Malaz A. 
Published: January 2019

ObjectiveBenzodiazepines and anticholinergics are risk factors for delirium in the intensive care unit (ICU). We tested the impact of a deprescribing intervention on short‐term delirium outcomes.DesignMultisite randomized clinical trial.SettingICUs of three large hospitals.ParticipantsTwo hundred adults aged 18 years or older and admitted to an ICU with delirium, according to the Richmond Agitation‐Sedation Scale and the Confusion Assessment Method for the ICU (CAM‐ICU). Participants had a contraindication to haloperidol (seizure disorder or prolonged QT interval) or preference against haloperidol as a treatment for delirium, and were excluded for serious mental illness, stroke, pregnancy, or alcohol withdrawal. Participants were randomized to a deprescribing intervention or usual care. The intervention included electronic alerts combined with pharmacist support to deprescribe anticholinergics and benzodiazepines.MeasurementsPrimary outcomes were delirium duration measured by the CAM‐ICU and severity measured by the Delirium Rating Scale Revised‐98 (DRS‐R‐98) and the CAM‐ICU‐7; secondary outcomes included adverse events and mortality.ResultsParticipants had a mean age of 61.8 (SD = 14.3) years, 59% were female, and 52% were African American, with no significant differences in baseline characteristics between groups. No differences between groups were identified in the number exposed to anticholinergics (P = .219) or benzodiazepines (P = .566), the median total anticholinergic score (P = .282), or the median total benzodiazepine dose in lorazepam equivalents (P = .501). Neither median delirium/coma‐free days (P = .361) nor median change in delirium severity scores (P = .582 for DRS‐R‐98; P = .333 for CAM‐ICU‐7) were different between groups. No differences in adverse events or mortality were identified.ConclusionsWhen added to state‐of‐the‐art clinical services, this deprescribing intervention had no impact on medication use in ICU participants. Given the age of the population, results of clinical outcomes may not be easily extrapolated to older adults. Nonetheless, improved approaches for deprescribing or preventing anticholinergics and benzodiazepines should be developed to determine the impact on delirium outcomes. J Am Geriatr Soc 67:695–702, 2019.
Effect of local probiotic (Lactobacillus reuteri) vs systemic antibiotic therapy as an adjunct to non‐surgical periodontal treatment in chronic periodontitis
Authors: Ikram Sana , Hassan Nuzhat , Baig Saeeda , Borges Kevin Joseph Jerome , Raffat Muhammad Arsalan , Akram Zohaib 
Published: January 2019

AbstractAimThe aim of the present study was to assess and compare the clinical efficacy of local probiotic Lactobacillus reuteri (L. reuteri) and systemic antibiotics as adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis (CP).MethodsThirty systemically‐healthy participants (15 probiotic and 15 antibiotic), clinically diagnosed with CP, were enrolled. All patients underwent SRP. Adjunctive probiotics were administered twice daily for 3 months, whereas a combination of amoxicillin and metronidazole were given three times daily for 7 days.ResultsIntragroup analysis showed statistically‐significant improvement in all clinical parameters: plaque index, bleeding on probing, periodontal pocket depth, and clinical attachment level gain at each follow‐up visit. However, intergroup comparison of clinical periodontal parameters did not show statistical significance.ConclusionThe adjunctive use of L. reuteri and systemic antibiotics along with SRP showed similar improvement in all clinical periodontal parameters. This indicates that both adjunctive therapeutic agents showed similar efficacy in resolving inflammation and improving periodontal outcomes.
Oral and uro‐vaginal intra‐amniotic infection in women with preterm delivery: A case‐control study
Authors: Montenegro Daniel A. , Borda Luis F. , Neuta Yineth , Gómez Luz A. , Castillo Diana M. , Loyo Daniela , Lafaurie Gloria I. 
Published: January 2019

AbstractAimThe aim of the present study was to establish the association between the presence of oral and uro‐vaginal microorganisms in the placental membrane and preterm delivery (PTD), the premature rupture of membranes (PRM), and the clinical signs of intra‐amniotic infection.MethodsEighty‐four women with PTD and 127 women with delivery at term were assessed for the PRM, clinical signs of intra‐amniotic infection, and the presence of periodontitis. Twenty‐seven microorganisms were identified in the placental tissue using nested polymerase chain reaction (PCR). Porphyromonas gingivalis (P. gingivalis) was quantified by droplet digital PCR.ResultsThe prevalence of microorganisms was 9.47% (20/211). P. gingivalis was the most prevalent (12/211, 5.68%). Mycoplasma hominis, Ureaplasma urealyticum, Staphylococcus spp, and Fusobacterium nucleatum were isolated at a very low frequency in the placenta. Candida albicans was associated with PTD (P = 0.027). Periodontitis was associated with clinical signs of infection (odds ratio [OR] = 3.8, 95% confidence interval [CI]: 1.28‐13.5) and with PTD (OR = 1.99; 95% CI: 1.07‐3.72).ConclusionThe presence of P. gingivalis in the placenta was not associated with perinatal complications. Detecting microorganisms in the placenta by nested PCR is not relevant, as it has a poor association with clinical variables that establish the diagnosis of chorioamnionitis. However, periodontitis was associated with the clinical signs of intra‐amniotic infection and PTD.
Protein S‐Nitrosylation in plants: Current progresses and challenges
Authors: Feng Jian , Chen Lichao , Zuo Jianru 
Published: January 2019

AbstractNitric oxide (NO) is an important signaling molecule regulating diverse biological processes in all living organisms. A major physiological function of NO is executed via protein S‐nitrosylation, a redox‐based posttranslational modification by covalently adding a NO molecule to a reactive cysteine thiol of a target protein. S‐nitrosylation is an evolutionarily conserved mechanism modulating multiple aspects of cellular signaling. During the past decade, significant progress has been made in functional characterization of S‐nitrosylated proteins in plants. Emerging evidence indicates that protein S‐nitrosylation is ubiquitously involved in the regulation of plant development and stress responses. Here we review current understanding on the regulatory mechanisms of protein S‐nitrosylation in various biological processes in plants and highlight key challenges in this field.
The Effectiveness of Consumption Taxes and Transfers as Insurance Against Idiosyncratic Risk
Authors: NAKAJIMA TOMOYUKI , TAKAHASHI SHUHEI 
Published: January 2019

AbstractWe quantitatively evaluate the effectiveness of a consumption tax and lump‐sum transfer program as insurance against idiosyncratic earnings risk. We use a heterogeneous agent, incomplete markets model in which households adjust savings and employment in each period in the presence of idiosyncratic productivity risk and a borrowing constraint. The model is calibrated to the U.S. economy. We find a weak insurance effect of the consumption tax and transfer program. Expanding the tax and transfer program from the current U.S. level increases the capital‐output ratio and reduces the interest rate. Consumption inequality also decreases only slightly.
Neuronal KIF5b deletion induces striatum‐dependent locomotor impairments and defects in membrane presentation of dopamine D2 receptors
Authors: Cromberg Lucas E. , Saez Trinidad M. M. , Otero María G. , Tomasella Eugenia , Alloatti Matías , Damianich Ana , Pozo Devoto Victorio , Ferrario Juan , Gelman Diego , Rubinstein Marcelo , Falzone Tomás L. 
Published: January 2019

AbstractThe process of locomotion is controlled by fine‐tuned dopaminergic neurons in the Substantia Nigra pars‐compacta (SNpc) that projects their axons to the dorsal striatum regulating cortical innervations of medium spiny neurons. Dysfunction in dopaminergic neurotransmission within the striatum leads to movement impairments, gaiting defects, and hypo‐locomotion. Due to their high polarity and extreme axonal arborization, neurons depend on molecular motor proteins and microtubule‐based transport for their normal function. Transport defects have been associated with neurodegeneration since axonopathies, axonal clogging, microtubule destabilization, and lower motor proteins levels were described in the brain of patients with Parkinson's Disease and other neurodegenerative disorders. However, the contribution of specific motor proteins to the regulation of the nigrostriatal network remains unclear. Here, we generated different conditional knockout mice for the kinesin heavy chain 5B subunit (Kif5b) of Kinesin‐1 to unravel its contribution to locomotion. Interestingly, mice with neuronal Kif5b deletion showed hypo‐locomotion, movement initiation deficits, and coordination impairments. High pressure liquid chromatography determined that dopamine (DA) metabolism is impaired in neuronal Kif5b‐KO, while no dopaminergic cell loss was observed. However, the deletion of Kif5b only in dopaminergic neurons is not sufficient to induce locomotor defects. Noteworthy, pharmacological stimulation of DA release together with agonist or antagonist of DA receptors revealed selective D2‐dependent movement initiation defects in neuronal Kif5b‐KO. Finally, subcellular fractionation from striatum showed that Kif5b deletion reduced the amount of dopamine D2 receptor in synaptic plasma membranes. Together, these results revealed an important role for Kif5b in the modulation of the striatal network that is relevant to the overall locomotor response.Open science badgesThis article has received a badge for *Open Materials* because it provided all relevant information to reproduce the study in the manuscript. The complete Open Science Disclosure form for this article can be found at the end of the article. More information about the Open Practices badges can be found at https://cos.io/our-services/open-science-badges/.
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Role of intravenous tranexamic acid in reducing blood loss during caesarean section: Study at tribal‐dominated area hospital in Chhattisgarh, India
Authors: Sahu Jaiprakash , Mishra Nalini 
Published: January 2019

AbstractAimTo evaluate the effect of low dose (1 g) of intravenous tranexamic acid (TXA) before caesarean delivery upon the mean blood loss during and after surgery as well side effects of the drug and to compare these effects with those who did not receive this medication in a referral hospital situated at the tribal terrain of Chhattisgarh.MethodsTotal 100 women fulfilling inclusion criteria and shifted for caesarean section were studied. Fifty women comprising the study group were given one gram TXA (10 mL) intravenously over 10–20 min before skin incision whereas the other 50 women did not receive the drug (control group). Active Management of the Third Stage of Labor was done in all using 10 units of oxytocin intramuscularly within one minute of delivery of baby. The blood loss was quantified by the combination of gravimetric and direct measurement.ResultsThe mean blood loss (intra as well as postoperative) was 436.5 ± 118.07 mL in the study group in comparison to 616.5 ± 153.34 mL in the control group (P ≤ 0.05), only two (4%) women had a blood loss >500 mL during surgery versus nine (18%) (P ≤ 0.05), none versus three (6%) had PPH and postoperative mean change in the hemoglobin was 0.494 ± 0.12 g % versus 0.594 ± 0.16 g % (P ≤ 0.05) in the study and control groups, respectively. No adverse effects were reported in women or neonates.ConclusionTXA is a cheap, easily available antifibrinolytic drug that significantly reduces the intra and postoperative blood loss in caesarean section and is very useful for low resource settings.
Comparing the effectiveness of Salvia officinalis, clotrimazole and their combination on vulvovaginal candidiasis: A randomized, controlled clinical trial
Authors: Ahangari Fatemeh , Farshbaf‐Khalili Azizeh , Javadzadeh Yousef , Adibpour Mohammad , Sadeghzadeh Oskouei Behnaz 
Published: January 2019

AbstractAimTo determine the effect of vaginal tablet of Salvia officinalis, alone and in combination with Clotrimazole, on the recovery of Vulvovaginal candidiasis.MethodsIn this triple‐blind randomized controlled trial, 111 participants were randomly assigned into three groups of 37 patients using block randomization with block sizes of 6 and 9, and allocation ratio of 1:1:1: 100 mg vaginal tablet of Clotrimazole and Placebo (CP), 400 mg vaginal tablet of S. officinalis and Placebo (SP), and vaginal tablet of S. officinalis and Clotrimazole (SC), once daily for 7 days. On the seventh day after the treatment was ended up, Vulvovaginal candidiasis were examined by vaginal symptoms and wet test, and if positive, they were examined by culture in chrome agar Candida medium.ResultsSocio‐demographic characteristics was similar (P > 0.05). Thirty‐six, 36 and 35 patients, respectively in CP, SC and SP groups recruited in the study. The frequency of a positive wet test confirmed by Sabrodextrose agar medium 7 days after treatment was significantly lower in SC group than the reference group of CP (adjusted odds ratio = 0.09, 95% confidence interval: 0.93–0.932, P = 0.043). There was no significant difference between SP and CP group (P = 0.071, 95% confidence interval: 0.032–1.151, adjusted odds ratio = 0.192). Also, there was no significant difference between the three groups in terms of vaginal symptoms at the baseline (P > 0.05), however the statistical differences were indicated after the intervention in cheesy discharge, pruritus and Vulvovaginal edema (P < 0.05.(.Conclusion
S. officinalis in the form of vaginal tablet, alone and when combined with Clotrimazole, can treat the Vulvovaginal Candidiasis.
Early feasibility surveillance of gynecologic robotic‐assisted surgeries in Japan
Authors: Baba Tsukasa , Mandai Masaki , Nishi Hirotaka , Nishii Osamu , Kitawaki Jo , Sawada Morio , Isaka Keiichi , Fujii Tomoyuki 
Published: January 2019

AbstractAimTo evaluate the clinical relevance of robotic‐assisted surgeries (RAS) for gynecologic malignancies in a Japanese multi‐institutional cohort.MethodsA retrospective review of perioperative outcomes of 357 gynecologic RAS procedures was conducted in 24 hospitals accredited to perform RAS by the Japanese Society of Obstetrics and Gynecology (JSOG) over a 4‐year period, January 2014 to December 2017.ResultsMore than 25 (high), 10–24 (middle) and less than 10 cases (low) were enrolled from 3, 8 and 13 hospitals, respectively. A total of 247 patients underwent RAS for malignant indications. Radical hysterectomy (RH) was conducted for 200 patients, while para‐aortic node excision (PAN) for 47 patients. RAS with RH or PAN was more feasible in high‐volume centers with significantly shorter operation time and lesser blood loss than that in middle‐volume centers. The total rate of perioperative injury and complications in RAS with PAN reached 33.3% in high‐volume centers, which was almost equal to those in middle‐volume centers (35.5%) but much higher than RAS without PAN (8.5%).ConclusionPerioperative surveillance demonstrated high feasibility of gynecologic RAS procedures conducted in JSOG accredited hospitals for these 4 years. It is mandatory for RAS conducting hospitals to have careful attitudes to realize their learning curves in conducting advanced procedures.
Self and identity in social anxiety disorder
Authors: Gilboa‐Schechtman Eva , Keshet Hadar , Peschard Virginie , Azoulay Roy 
Published: January 2019

AbstractModels of social anxiety (SA) place the self as an organizing and causal center involved in the maintenance of this condition. An integrative conceptual framework for the understanding of the self is used to review the literature on the self in SA. Two main distinctions are emphasized: the self‐as‐a‐subject (I‐self) versus self‐as‐an‐object (Me‐self), and the evolutionary‐based distinction of social rank versus affiliation. We argue that (a) although much progress has been made in understanding the association between SA and Me‐self, the association between SA and I‐self remains largely unexplored (with the important exception of anxiety‐related processes in social situations); and (b) experiences and representations of the self in SA center on social rank. We suggest that in SA, social rank themes constitute the linchpins of identity, defined as the content and structure of the Me‐self. We speculate that processes related to low social rank contribute to the focus on representational (Me), rather than experiential (I), self‐aspects. Finally, we delineate the ways in which such an understanding may direct and refine the construction of novel, individually tailored, therapeutic approaches.
Baicalin reduces ciclosporin bioavailability by inducing intestinal p-glycoprotein in rats
Authors: Tian Xin , Chang Yuanyuan , Wei Jingyao , Liu Ruijuan , Wang Li , Zhang Ji , Zhang Xiaojian 
Published: January 2019

Abstract

Objectives
To investigate the effects of multiple doses of baicalin (BG) on the pharmacokinetics of ciclosporin (CsA) in rats and the potential mechanisms.

Methods
Pharmacokinetic parameters of CsA were determined in male rats after administration of CsA (3 mg/kg, i.g. or i.v.) to rats in the presence and absence of BG (80 mg/kg, i.g. or i.v.) for 7 days. The livers and intestines of rats were isolated and the CYP3A and p-glycoprotein (P-gp) expression were analysed. The effect of BG on the intestinal absorptive behaviour of CsA was also investigated using in-vitro everted rat gut sac model.

Key findings
Baicalin (80 mg/kg, i.v., 7 days) had no effect on the intravenously administered CsA. However, BG (80 mg/kg, i.g., 7 days) significantly decreased the Cmax, AUC0–t and AUC0–∞ of orally administered CsA by 38, 26 and 25%, respectively (P &lt; 0.01 or P &lt; 0.05). Further study revealed that the expression of P-gp in intestine increased in oral multiple doses of BG-treated rats. The in-vitro everted rat gut sac model demonstrated BG (10 μm) significantly decreased the absorption of CsA (10 μm) in intestine (P &lt; 0.05).

Conclusions
Multiple doses of BG decreased the oral bioavailability of CsA in rats significantly, which may be mainly attributable to inhibition of absorption of CsA in intestine and induction of P-gp. The interaction between BG and CsA may occur when BG and CsA were co-administered for long-term use. The dosage adjustment and blood concentration monitoring of CsA may be required in clinic.
Monitoring the hepatitis C epidemic in England and evaluating intervention scale‐up using routinely collected data
Authors: Harris Ross J. , Harris Helen E. , Mandal Sema , Ramsay Mary , Vickerman Peter , Hickman Matthew , De Angelis Daniela 
Published: January 2019

SummaryIn England, 160 000 individuals were estimated to be chronically infected with hepatitis C virus (HCV) in 2005 and the burden of severe HCV‐related liver disease has increased steadily for the past 15 years. Direct‐acting antiviral treatments can clear infection in most patients, motivating HCV elimination targets. However, the current burden of HCV is unknown and new methods are required to monitor progress. We employed a Bayesian back‐calculation approach, combining data on severe HCV‐related liver disease and disease progression, to reconstruct historical HCV incidence and estimate current prevalence in England. We explicitly modelled infections occurring in people who inject drugs, the key risk group, allowing information on the size of this population and surveillance data on HCV prevalence to inform recent incidence. We estimated that there were 143 000 chronic infections in 2015 (95% credible interval 123 000‐161 000), with 34% and 54% in those with recent and past injecting drug use, respectively. Following the planned scale‐up of new treatments, chronic infections were predicted to fall to 113 400 (94 900‐132 400) by the end of 2018 and to 89 500 (71 300‐108 600) by the end of 2020. Numbers developing severe HCV‐related liver disease were predicted to fall by at least 24% from 2015 to 2020. Thus, we describe a coherent framework to monitor progress using routinely collected data, which can be extended to incorporate additional data sources. Planned treatment scale‐up is likely to achieve 2020 WHO targets for HCV morbidity, but substantial efforts will be required to ensure that HCV testing and patient engagement are sufficiently high.
Sofosbuvir/Velpatasvir/Voxilaprevir for patients with HCV who previously received a Sofosbuvir/Velpatasvir‐containing regimen: Results from a retreatment study
Authors: Ruane Peter , Strasser Simone I. , Gane Edward J. , Hyland Robert H. , Shao Jiang , Dvory‐Sobol Hadas , Tran Tram , Stamm Luisa M. , Brainard Diana M. , Nyberg Lisa , Shafran Stephen 
Published: January 2019

SummaryThis study evaluated 12‐week retreatment with sofosbuvir/velpatasvir/voxilaprevir in patients with chronic hepatitis C virus (HCV) infection who did not achieve sustained virologic response after previous treatment with a sofosbuvir‐ and velpatasvir‐containing regimen. All 31 patients maintained a sustained virologic response 12 weeks after the last sofosbuvir/velpatasvir/voxilaprevir dose.
Treatment with metformin is associated with a prolonged survival in patients with hepatocellular carcinoma
Authors: Schulte Lena , Scheiner Bernhard , Voigtländer Torsten , Koch Sandra , Schweitzer Nora , Marhenke Silke , Ivanyi Philipp , Manns Michael P. , Rodt Thomas , Hinrichs Jan B. , Weinmann Arndt , Pinter Matthias , Vogel Arndt , Kirstein Martha M. 
Published: January 2019

AbstractBackgroundHepatocellular carcinoma (HCC) is one of the most lethal cancers. Nutrition‐ and life style‐associated risk factors are increasingly prevalent. Metformin, the mainstay of type 2 diabetes mellitus (T2DM)‐treatment, reduces the risk of hepatocarcinogenesis. However, its influence on the prognosis of patients with HCC has not been investigated on a large scale, yet.MethodsFive thousand and ninety‐three patients treated for HCC between 2000 and 2016 at three referral centres were included in this retrospective multicentre study. The aim of this study was to assess whether treatment with metformin for T2DM is associated with a prolonged overall survival (OS) in patients diagnosed with HCC.ResultsAmong 5093 patients with HCC, 1917 patients (37.6%) were diagnosed with T2DM, of which 338 (17.6%) received treatment with metformin. Compared to diabetic patients not treated with metformin, patients on metformin had a significantly better hepatic function (Child‐Pugh‐Score A: 69.2% vs 47.4%, P < 0.001) and underwent significantly more often tumour resection (22.1% vs 16.5%, P = 0.024). Patients on metformin had a significantly longer median OS (mOS) compared to diabetic patients not treated with metformin (22 vs 15 months, P = 0.019). The prolongation of survival was most significant in patients treated with surgery. Using a propensity score match (PSM), patients were adjusted for hepatic function and initial therapy. In the matched cohorts, mOS remained significantly longer in metformin‐treated patients (22 vs 16 months, P = 0.021). Co‐treatment of metformin and sorafenib was associated with a survival disadvantage.ConclusionTreatment with metformin was associated with an improved survival in patients with T2DM and HCC. This effect was most pronounced in patients at potentially curative tumour stages.