bluuebunny/crossref_metadata_2025_split huggingface dataset:
High in-hospital mortality due to COVID-19 in a community hospital in Spain: a prospective observational study
Authors: Trullàs Joan Carles , Ruiz Eva , Weisweiler Clara , Badosa Gemma , Serra Alba , Briceño Hugo , Soler Sílvia , Bisbe Josep 
Published: July 2020

Abstract
Background To describe the clinical characteristics and outcome of patients with COVID-19 in a community hospital in SpainMethods Prospective, single-centre case series of the first 100 consecutive hospitalized patients with COVID-19 at a community hospital in Spain, from March 16 to April 20, 2020. Demographics, comorbidities, clinical presentation, radiologic and laboratory findings, treatment and clinical outcome were collected.Results Of the 100 patients included in the study, the median age (IQR; range) was 75 years (20; 28–96) and 52% were men. The most common comorbidities were hypertension (63%), diabetes (22%) and cardiovascular diseases (28%). The most common symptoms were fever (80%), cough (69%), fatigue (59%) and dyspnea (52%) and 64% had respiratory insufficiency. Bilateral interstitial infiltrates (65/100, 65%) and bilateral vertical “B-kerley” lines (38/46, 82.6%) were the most common imaging manifestations in chest radiographs and lung ultrasound, respectively. All patients received supplementary oxygen, 69 (69%) received medical treatment (the most common regimen being hydroxychloroquine plus azithromycin in 66 patients) and 12% were treated with glucocorticoids. During hospitalization, 26 patients (26%) died, 10 (10%) were transferred to ICU and 64 (64%) were discharged at home. Mortality or ICU admission was more frequent in advanced age and with comorbidities.Conclusions This case series provides clinical characteristics and outcome of consecutively hospitalized patients with COVID-19 admitted to a community hospital in Spain. The majority were old patients, with comorbidities and in-hospital mortality was high (26%).
Pattern of Crimean-Congo hemorrhagic fever related high risk behaviors among Iranian butchers and its relation to perceived self-efficacy
Authors: Adham Davoud , Abazari Malek , Moradi-Asl Eslam , Abbasi-Ghahramanloo Abbas 
Published: July 2020

Abstract
Background
Crimean-Congo hemorrhagic fever (CCHF) is highly fatal to humans and an acute viral disease. The CCHF disease has been reported in occupations such as butchers, slaughterhouse butchers and workers. The aim of this study was to investigate the pattern of CCHF related high risk behaviors among butchers and determine the effects of perceived self-efficacy of the participants on their membership in latent classes.
Methods
The participants of this cross-sectional study were recruited from all the meat distribution centers in Ardabil Province in 2019–2020. The LCA approach was used to observe the CCHF related high risk behaviors patterns.
Results
The statistical significance level was assigned at P-value ˂ 0.05 in all the analyses. Three latent classes were identified; namely, 1) low risk (16.1%), 2) high risk (53.6%), and 3) very high risk (30.2%). After adjusting for other possible confounders higher score of perceived self-efficacy significantly decrease the odds of membership in high risk class (OR = 0.74) and very high risk class (OR = 0.62) compared to the low risk class. Also, age (OR = 1.07) and experience (OR = 0.91) associate with very high risk class.
Conclusions
This study revealed the co-occurrence of CCHF related high risk behaviors in the majority of workers in the livestock and meat industry. It is necessary to provide butchers and slaughterhouse workers with general education, force them to use protective equipment and investigate the rate of tick bites in risky occupations.
Revisiting the continuum of resistance theory in the digital age: A comparison of early and delayed respondents to the Norwegian Counties Public Health Survey
Authors: Clarsen Benjamin , Skogen Jens Christoffer , Nilsen Thomas Severinus , Aarø Leif Edvard 
Published: July 2020

Abstract
BackgroundThe continuum of resistance model’s premise is that delayed respondents to a survey are more similar to non-respondents than early respondents are. For decades, survey researchers have applied this model in attempts to evaluate and adjust for non-response bias. Despite a recent resurgence in the model’s popularity, its value has not been assessed in a large online population health survey.MethodsRespondents to the Norwegian Counties Public Health Survey in Hordaland, Norway, were divided into three groups: those who responded within 7 days of the initial email/SMS invitation (wave 1, n = 6950); those who responded after 8 to 14 days and 1 reminder (wave 2, n =4950); and those who responded after 15 or more days and 2 reminders (wave 3, n = 4045). Logistic regression analyses were used to compare respondents’ age, sex and educational level between waves, as well as the prevalence of poor general health, life dissatisfaction, mental distress, chronic health problems, weekly alcohol consumption, monthly binge drinking, daily smoking, physical activity, low social support and receipt of a disability pension.ResultsThe overall response to the survey was 41.5%. Respondents in wave 1 were more likely to be older, female and more highly educated than those in waves 2 and 3. However, there were no substantial differences between waves for any health outcomes, with a maximal prevalence difference of 2.6% for weekly alcohol consumption (wave 1: 21.3%, wave 3: 18.7%).ConclusionsThere appeared to be a mild continuum of resistance for demographic variables. However, this was not reflected in health and related outcomes, which were uniformly similar across waves. The continuum of resistance model is unlikely to be useful to adjust for nonresponse bias in large online surveys of population health.
Construction and description of a constitutive plipastatin mono-producing Bacillus subtilis
Authors: Vahidinasab Maliheh , Lilge Lars , Reinfurt Aline , Pfannstiel Jens , Henkel Marius , Heravi Kambiz Morabbi , Hausmann Rudolf 
Published: July 2020

Abstract
Background Fengycin and plipastatin are potent Bacillus antimicrobial lipopeptide with the prospect to replace conventional antifungal chemicals for controlling plant pathogens. However, the application of these lipopeptides has so far been investigated in a few cases, principally because of their yield in low concentration and unknown regulation of biosynthesis pathways. B. subtilis synthesizes plipastatin by a non-ribosomal peptide synthetase encoded by the ppsABCDE operon. In this study, B. subtilis 3NA (a non-sporulation strain) was engineered to construct an efficient plipastatin mono-producer strain and to gain more insights about bottlenecks of plipastatin production.Results The first step toward the construction of a plipastatin mono-producer was repairing the defective sfp gene in strain 3NA to construct strain BMV9. Production of plipastatin was doubled after repairing the gene expression of the pleiotropic regulator degQ (strain BMV10) compared to BMV9. Moreover, substitution of the plipastatin promoter (Ppps) against the strong constitutive promoter Pveg led to approximately fivefold enhancement of plipastatin production in BMV11 compared to BMV9. Intriguingly, combination of both repaired degQ expression and promoter exchange (Ppps::Pveg) did not increase the plipastatin yield. Surprisingly, deletion of surfactin (srfAA-AD) operon by the retaining the functional comS gene, which is located within srfAB, resulted in the loss of plipastatin production in BMV9 and significantly decreased the plipastatin production of BMV11. We also observed that supplementation of ornithine as a precursor for plipastatin formation caused higher production of plipastatin in mono-producer strains, albeit with a modified pattern of plipastatin composition.Conclusions This study provides evidence that degQ stimulates the native plipastatin production. Surprisingly, it seems that surfactin synthetase or one of its subunits positively regulates plipastatin production by an unknown mechanism. Furthermore, as another conclusion of this study, results point towards ornithine provision being a bottleneck for plipastatin production. Therefore, targeting the ornithine metabolic flux might be a promising strategy to further investigate and enhance plipastatin production.
Analgesic Efficacy of Ultrasound-Guided Paravertebral Block in Patients Undergoing Percutaneous Nephrolithotomy: A Randomised, Controlled Clinical Study
Authors: Yaman Ferda , Tuglu Devrim 
Published: July 2020

Abstract
Background Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety of operations on the thorax, abdomen or pelvis. PVB is straightforward, efficacious in operations performed. This study was undertaken to evaluate how efficacious ultrasound-guided thoracic paravertebral block is when used in patients undergoing percutaneous nephrolithotomy (PCN).Methods A total of forty-four patients, falling in categories I to III of the American Society of Anesthesiologists, and aged between 18 and 65 years, who were scheduled for PCN, were randomly distributed into two groups. The anaesthetic intervention group (PVB) contained 22 individuals, who were injected at level T8-T9 with 20 mL 0.25% bupivacaine as a single administration. In the control group C, also containing 22 individuals, the intervention was not carried out. The groups were compared after PCN in terms of opioid use, pain score, opioid adverse effects profile and the need for supplemental analgesia.Results Visual analogue scale pain scores whilst at rest or moving were lower at the level of statistical significance in the PVB group compared to controls at 2 and 4 hours post-surgery. At 6 and 8 hours post-surgery, the control group had a lower VAS score when moving, and this result reached statistical significance (p < 0.05). The controls used more opioid relief than the PVB group and had lower scores for satisfaction (p < 0.05).Conclusion Ultrasound-guided PVB using bupivacaine and an in-plane technique provides effective analgesia in PNL. It is associated with high scores on patient satisfaction and minimal complications.Trial registration: ClinicalTrials.gov, NCT04406012. Registered retrospectively, on 27 May 2020.
Dexmedetomidine intravesical instillation reduces postoperative catheter-related bladder discomfort in male patients under general anesthesia: a randomized controlled study
Authors: Chen Hong , Wang Bin , Li Qin , Zhou Juan , Li Rui , Zhang Ye 
Published: July 2020

Abstract
Background The catheter-related bladder discomfort (CRBD) of male patients is a common clinical problem, albeit lacking effective solutions. The present study aimed to investigate whether dexmedetomidine intravesical instillation alleviates the postoperative urinary discomfort in male patients with catheter under general anesthesia.Methods This single-blinded, prospective, randomized study included a total of 167 male patients American Society of Anesthesiologists (ASA) physical status I-II scheduled for surgery under general anesthesia were allocated to two groups: 84 in the dexmedetomidine (Dex) group and 83 in the control group. Dex group patients received intravesical instillation of the drug 0.5 µg/kg and normal saline 20 mL, while the control group received intravesical instillation of 20 mL normal saline. The catheter was clamped for 30 min after intravesical instillation for all patients. Bladder stimulation scales and urethra pain numerical rating scale (NRS) scores were measured at admittance to post-anesthesia care unit (PACU) (T0), intravesical instillation (T1), 30 min (T2), 60 min (T3), 2 h (T4) after intravesical instillation, discharged from PACU (T5), and 6 h (T6) and 24 h (T7) after the operation. Patient satisfaction at discharge from PACU and 24 h post-operation were compared between the two groups.Results Bladder stimulation scales and urethra pain NRS scores after 30 min of dexmedetomidine intravesical instillation to 24 h post-operation were significantly lower than the control group (p < 0.001), and patient satisfaction was higher at discharge from PACU and 24 h post-operation (p < 0.001). No differences were detected in Steward score out of PACU (p = 0.213) and from the time of the end of operation to fully awake (p = 0.417).Conclusion Dex intravesical instillation reduces postoperative urinary discomfort and urethra pain and improves satisfaction in male patients under general anesthesia.Clinical Trial Registration: Chinese Clinical Trial Registry (No. ChiCTR1800016429), date of registration 1st June 2018
Association Between Non-traumatic Vertebral Fractures and Adjacent Discs Degeneration: A Cross-sectional Study and Literature Review
Authors: Takegami Norihiko , Akeda Koji , Murata Koichiro , Yamada Junichi , Sudo Akihiro 
Published: July 2020

Abstract
Background
Previous clinical studies reported that thoracolumbar vertebral fractures (VFs) associated with high energy spine trauma cause adjacent intervertebral disc (IVD) degeneration; however, there has been no study that evaluates the effect of non-traumatic VFs on the progression of adjacent disc degeneration. The purpose of this study was to examine the association between non-traumatic VFs and degenerative changes of adjacent IVDs.
Methods
98 consecutive patients undergoing spinal surgery were included in this study. VFs were semi-quantitatively evaluated by lateral lumbar radiography. The degree of IVD degeneration was evaluated by MRI and classified into two groups (early and advanced). Intradiscal vacuum phenomena (VPs) were evaluated by computed tomography. Adjacent IVDs were categorized according to the locations of VFs (superior, inferior, and bilateral). Associations between the presence of VFs and the extent of IVD degeneration or the presence of VPs were statistically analyzed.
Results
IVDs adjacent to VFs were identified in 115 IVDs (31.1% of total; superior: 11.4%, bilateral: 8.6%, inferior: 11.1%). The presence of VFs was significantly associated with MRI grades of adjacent IVD degeneration (P < 0.01) and the prevalence of VPs within adjacent IVDs (P < 0.01). From logistic regression analysis, age, disc level, and VFs were independent related factors for disc degeneration (P < 0.05).
Conclusion
This study showed that VFs were an independent related factor for adjacent disc degeneration and occurrence of intradiscal VPs. VFs may affect the micro-environment of adjacent IVDs, leading to disc degeneration and disc rupture.
Comparison of chest drainage tube types (24Fr silastic vs. thoracic catheter) after lung resection
Authors: Hato Tai , Yamaguchi Masatoshi , Kashimada Hiroaki , Sugiyama Ato , Inoue Yoshiaki , Aoki Kohei , Fukuda Hiroaki , Gika Masathoshi , Nakayama Mitsuo 
Published: July 2020

Abstract
Background: Silastic drains (SDs) are widely used for postoperative chest drainage. We performed a direct comparison of SDs and conventional single-lumen thoracic catheters (TCs) with similar sizes.Methods: We performed a historically controlled retrospective study. SDs (24 Fr in size) were used for postoperative drainage from September 2017 to May 2018, and TCs (24 or 28Fr) were used from June 2018 to March 2019. Drainage tubes were maintained with a water seal alone. A comparison was performed of the volume and the speed of fluid until 48 hrs after surgery, the undrained area on chest X-ray, expansion of subcutaneous emphysema, and the duration of drainage.Results: One hundred fifty-eight patients with SDs and one hundred fifty-five patients with TCs were included. The patient characteristics were equivalent between the groups. The median length of drainage was two days for both groups. The fluid drainage speed was similar between the groups. While the incidence of expansion of subcutaneous emphysema was equivalent for both groups, reinsertion of drainage tubes was more frequent in the SD group due to insufficient air drainage.Conclusions: SDs and TCs have almost equivalent drainage performances. For patients with a risk of massive air leakage, SDs should be avoided.
Comparison of the clinical manifestations and cement distribution after percutaneous vertebroplasty between thoracolumbar Kümmell’s disease and OVCFs
Authors: Wang Cheng-Liang , Chen Ji-Bin , Li Te 
Published: July 2020

Abstract
Background：Kümmell's disease is a chronic, non-healing osteoporotic vertebral compression fractures (OVCFs), which is associated with ischemic necrosis and vertebral pseudarthrosis. The purpose of this study was to compare the therapeutic effect and distribution characteristics of bone cement in the percutaneous vertebroplasty (PVP) treatment between thoracolumbar Kümmell's diseases and OVCFs.Methods: A total of 70 patients with Kümmell ’s disease (K group) or OVCFs (O group) who underwent PVP surgery from February 2016 to February 2018 were included in this study. The follow-up time was 24-48 months. The course of disease was significantly longer in the K group than in the O group (P=0.000). Most cases in the K group had no history of trauma, while most cases in the O group had a history of falls (P=0.001). The vertebral compression rate and degree of osteoporosis were more serious in the K group than in the O group (P<0.05, respectively). Distribution pattern, volume and leakage rate of bone cement, operation time, VAS score, ODI, correction rates of vertebral compression and kyphosis, re-fracture rate of adjacent vertebrae between the two groups were compared to assess clinical effect.Results: The amount of bone cement injected was significantly higher in the K group than in the O group (P=0.025). The cement distribution pattern of local solid lump was dominant in the K group (65.71%), while intercalation with trabeculae was dominant in the O group (74.29%) (P<0.001). VAS and ODI were significantly lower both in the two groups at the 1st day, 1st year and 2nd years after surgery than before surgery (all P<0.05), but significantly lower in the K group than in the O group at each time point after surgery (all P<0.05). The correction rates of kyphosis and vertebral compression in both groups were significantly improved (P<0.05, respectively) and gradually lost with time (P<0.05, respectively). The correction rates of kyphosis and vertebral compression were significantly higher in the K group than in the O group at each time point after surgery (all P<0.05).Conclusion: Kümmell's disease has a higher degree of disease progression and osteoporosis than OVCFs. PVP can better restore partial vertebral height and correct kyphosis in the treatment of Kümmell's disease, while can better alleviate pain and improve ODI in the treatment of OVCFs.
When to Resume Bariatric Surgery after COVID-19 Pandemic? – Results of Patients’ and Surgeons’ Survey.
Authors: Dudek Aicja , Dudek Alicja , Wysocki Michał , Walędziak Maciej , Szeliga Jacek , Proczko-Stepaniak Monika , Pedziwiatr Michał , Major Piotr 
Published: July 2020

Abstract
BackgroundCOVID-19 is affecting most countries around the world, including Poland. In response, all elective surgeries have been postponed. We asked patients and surgeons when they want bariatric surgery to resume after pandemic. The main aim of the study was to determine patients’ and surgeons’ expectations about when to resume bariatric surgery regarding COVID-19 pandemic state.MethodsThe study was conducted in two groups: Group 1 – bariatric patients; Group 2 – bariatric surgeons. Two online surveys were distributed.Results A total of 895 patients, 299 before, 596 after surgery and 32 surgeons took part in survey. All patients and surgeons declared willingness to resume bariatric surgeries after pandemic and responded that they should be resumed immediately the World Health Organization announces end of pandemic (42%). The majority of patients before surgery answered that bariatric procedures should be resumed immediately the number of daily incidents begins to decrease (53%). In the patient group, current body mass index (p<0.001) and contact with COVID+/quarantined persons (p<0.001) had impact on the response to resumption of bariatric procedures.ConclusionsPatients opted to wait for bariatric surgery until the oncological queue has become shorter. Surgeons presented a readiness to resume both procedures in parallel.
Comparing Charlson and Elixhauser comorbidity indices with different weightings to predict in-hospital mortality: an analysis of national inpatient data
Authors: Sharma Narayan , Schwendimann René , Endrich Olga , Ausserhofer Dietmar , Simon Michael 
Published: July 2020

Abstract
Background When chronic conditions are associated with outcomes such as mortality, comorbidity measures are essential both to describe patient health status and to adjust for potential confounding. The Charlson and Elixhauser comorbidity indices are well-established for risk adjustment and mortality prediction. Still, as optimal comorbidity weightings remain undetermined. The present study aimed to derive a set of new population-based Elixhauser comorbidity weightings, then to validate and compare their mortality predictivity against those of the Charlson and Elixhauser-based van Walraven weightings estimates in a population-based cohort.Methods Retrospective analysis was conducted with routine Swiss general hospital (102 hospitals) data (2012–2017) for 6.09 million inpatient cases. To derive the population-based weightings for the Elixhauser comorbidity index, we randomly halved the inpatient data and validated the results for Part 1 alongside the established weighting systems used for Part 2. Charlson and van Walraven weightings were applied to Charlson and Elixhauser comorbidity indices. Generalized additive models were weighted and adjusted for age, gender and hospital types.Results Overall, the population-based weights’ c-statistic (0.867, 95% CI: 0.865–0.868) was consistently higher than Elixhauser-van Walraven’s (0.863, 95% CI: 0.862–0.864) and Charlson’s (0.850, 95% CI: 0.849–0.851) in the derivation and validation groups and net reclassification improvement of new weights offers improved predictive performance of 0.4% on the Elixhauser-van Walraven and 6.1% on the Charlson weightings.Conclusions All weightings were validated with the national dataset and the new population-based weightings model improved the prediction of in-hospital mortality. The newly derive weights support patient population-based analysis of health outcomes.