bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of acupuncture for the treatment of pain associated with naturally-occurring osteoarthritis in dogs: a prospective, randomized, placebo-controlled, blinded clinical trial
Authors: Baker-Meuten Alice , Wendland Theresa , Shamir Shelly K. , Hess Ann M. , Duerr Felix Michael 
Published: September 2020

AbstractBackgroundAcupuncture has been used as a treatment for pain associated with osteoarthritis (OA) for thousands of years; however, there is a lack of definitive evidence for this indication in humans or animals. The aim of this study was to prospectively evaluate the efficacy of acupuncture on lameness and clinical function in dogs affected by naturally-occurring OA using objective outcome measures. A total of 32 client-owned dogs completed this prospective, randomized, placebo-controlled, blinded clinical trial, using a cross-over design. Participants were assigned to receive placebo or acupuncture treatment once weekly for 4 weeks in random order with a two-week wash-out period in between treatment phases. Outcome measures included ground reaction forces (GRF), subjective orthopedic scoring (SOS), activity counts (AC), and owner-completed clinical metrology instruments (CMI; Canine Brief Pain Inventory [CBPI] and Client Specific Outcome Measures [CSOM]). For statistical comparison, baseline GRF, SOS, and CMI data were compared to data obtained 1 week after each treatment phase. Similarly, total weekly AC of the final week of each treatment phase were compared to the baseline week.ResultsEvidence of differences between baseline versus acupuncture and placebo treatments was not identified for the following outcome measures: GRF, AC, or SOS. However, evidence of differences was identified for some of the CMI scores, including the CSOM questionnaire which showed evidence of improvement when comparing baseline versus acupuncture (p = 0.0002) as well as between placebo versus acupuncture treatments (p = 0.035) but not between baseline versus placebo treatments (p = 0.221).ConclusionsThe applied acupuncture protocol did not show improvement in function when using objective outcome measures for OA in dogs; however, certain CMI measurements recorded some degree of treatment response.
Effects of physical and chemical factors on pseudorabies virus activity in vitro
Authors: Gong Lang , Deng Qiwei , Xu Runda , Ji Chihai , Wang Heng , Zhang Guihong 
Published: September 2020

AbstractBackgroundPseudorabies (PR) is latent and can persist in infected sows for a long time, and thus, convalescent sows can carry the virus throughout life, causing severe economic losses to farmers and posing a tremendous challenge to PR prevention and control. Here, to investigate the biological characteristics of pseudorabies virus (PRV), a variety of physical and chemical factors were analyzed under controlled conditions.ResultsThe results showed that a high ambient temperature and dry environment led to faster virus inactivation. PRV had a certain resistance to weakly acidic or alkaline environments and was rapidly inactivated in strongly acidic or alkaline environments. The effect of ultraviolet (UV) radiation on PRV activity primarily depended on the frequency, intensity, and irradiation time of the UV exposure. Exposure to sunlight inactivated PRV via multiple factors, including temperature, sunlight intensity, UV intensity, and environmental humidity, and any shielding from sunlight strongly lowered the killing effect. Conventional disinfectants had a good disinfection effect on PRV.ConclusionsThe biological characteristics of different PRV strains are variable. Generally, the activity of PRV is affected by multiple factors, which can show both synergy and antagonism. Real-world conditions should be taken into consideration to guide pork production.
Reaching health facilities in situations of emergency: qualitative study capturing experiences of pregnant women in Africa’s largest megacity
Authors: Banke-Thomas Aduragbemi , Balogun Mobolanle , Wright Ololade , Ajayi Babatunde , Abejirinde Ibukun-Oluwa Omolade , Olaniran Abimbola , Giwa-Ayedun Rokibat Olabisi , Odusanya Bilikisu , Afolabi Bosede Bukola 
Published: September 2020

Abstract
Background
The consequences of delays in travel of pregnant women to reach facilities in emergency situations are well documented in literature. However, their decision-making and actual experiences of travel to health facilities when requiring emergency obstetric care (EmOC) remains a ‘black box’ of many unknowns to the health system, more so in megacities of low- and middle-income countries which are fraught with wide inequalities.

Methods
This in-depth study on travel of pregnant women in Africa’s largest megacity, Lagos, is based on interviews conducted between September 2019 and January 2020 with 47 women and 11 of their relatives who presented at comprehensive EmOC facilities in situations of emergency, requiring some EmOC services. Following familiarisation, coding, and searching for patterns, the data was analysed for emerging themes.

Results
Despite recognising danger signs, pregnant women are often faced with conundrums on “when”, “where” and “how” to reach EmOC facilities. While the decision-making process is a shared activity amongst all women, the available choices vary depending on socio-economic status. Women preferred to travel to facilities deemed to have “nicer” health workers, even if these were farther from home. Reported travel time was between 5 and 240 min in daytime and 5–40 min at night. Many women reported facing remarkably similar travel experiences, with varied challenges faced in the daytime (traffic congestion) compared to night-time (security concerns and scarcity of public transportation). This was irrespective of their age, socio-economic background, or obstetric history. However, the extent to which this experience impacted on their ability to reach facilities depended on their agency and support systems. Travel experience was better if they had a personal vehicle for travel at night, support of relatives or direct/indirect connections with senior health workers at comprehensive EmOC facilities. Referral barriers between facilities further prolonged delays and increased cost of travel for many women.

Conclusion
If the goal, to leave no one behind, remains a priority, in addition to other health systems strengthening interventions, referral systems need to be improved. Advocacy on policies to encourage women to utilise nearby functional facilities when in situations of emergency and private sector partnerships should be explored.
Mental health impacts among health workers during COVID-19 in a low resource setting: a cross-sectional survey from Nepal
Authors: Khanal Pratik , Devkota Navin , Dahal Minakshi , Paudel Kiran , Joshi Devavrat 
Published: September 2020

Abstract
Background
Health care workers exposed to COVID-19 might be at increased risk of developing mental health problems. The study aimed to identify factors associated with anxiety, depression and insomnia among health workers involved in COVID-19 response in Nepal.

Methods
This was a cross-sectional web-based survey conducted between April 26 and May 12, 2020. A total of 475 health workers participated in the study. Anxiety and depression were measured using a 14-item Hospital Anxiety and Depression Scale (HADS: 0–21) and insomnia was measured by using a 7-item Insomnia Severity Index (ISI: 0–28). Multivariable logistic regression analysis was done to determine the risk factors of mental health outcomes.

Results
Overall, 41.9% of health workers had symptoms of anxiety, 37.5% had depression symptoms and 33.9% had symptoms of insomnia. Stigma faced by health workers was significantly associated with higher odds of experiencing symptoms of anxiety (AOR: 2.47; 95% CI: 1.62–3.76), depression (AOR: 2.05; 95% CI: 1.34–3.11) and insomnia (AOR: 2.37; 95% CI: 1.46–3.84). History of medication for mental health problems was significantly associated with a higher likelihood of experiencing symptoms of anxiety (AOR: 3.40; 95% CI:1.31–8.81), depression (AOR: 3.83; 95% CI: 1.45–10.14) and insomnia (AOR: 3.82; 95% CI: 1.52–9.62) while inadequate precautionary measures in the workplace was significantly associated with higher odds of exhibiting symptoms of anxiety (AOR: 1.89; 95% CI: 1.12–3.19) and depression (AOR: 1.97; 95% CI: 1.16–3.37). Nurses (AOR: 2.33; 95% CI: 1.21–4.47) were significantly more likely to experience anxiety symptoms than other health workers.

Conclusion
The study findings revealed a considerate proportion of anxiety, depression and insomnia symptoms among health workers during the early phase of the pandemic in Nepal. Health workers facing stigma, those with history of medication for mental health problems, and those reporting inadequate precautionary measures in their workplace were more at risk of developing mental health outcomes. A focus on improving mental wellbeing of health workers should be immediately initiated with attention to reduction of stigma, ensuring an adequate support system such as personal protective equipments, and family support for those with history of mental health problems.
Hepatic epithelioid hemangioendothelioma: case series of a rare vascular tumor mimicking metastases
Authors: Din Nasir Ud , Rahim Shabina , Asghari Tamana , Abdul-Ghafar Jamshid , Ahmad Zubair 
Published: September 2020

Abstract
Background
Hepatic epithelioid hemangioendothelioma is an extremely rare malignant vascular tumor which is often multifocal and, in many cases, discovered incidentally. Here, we describe the clinicopathological features of hepatic epithelioid hemangioendothelioma cases seen in our practice and present a detailed review of the published literature.

Methods
All cases of hepatic epithelioid hemangioendothelioma diagnosed in Department of Pathology and Laboratory Medicine, Aga Khan University Hospital between January 1, 2006 and December 31, 2019 were included in the study. Slides were reviewed and follow up was obtained.

Results
Seven cases were reported during the study period. There were 4 females and 3 males. Age range was 20 to 77 years, mean age was 45 years. Three patients presented with right upper abdominal pain; 1 patient presented with jaundice while 3 patients were asymptomatic. In all 7 cases, lesions were identified on imaging studies. In 5 cases, liver lesions were multifocal. Clinical differential diagnosis in all cases was metastatic carcinoma and multifocal hepatocellular carcinoma. Liver function tests were normal in 5 cases. In 1 patient, tumor had already metastasized to the right lung. On histological examination of liver core biopsies performed in all 7 cases, classic histological features of epithelioid hemangioendothelioma were seen. Tumor cells expressed positivity for vascular markers (CD 34, CD31 and ERG) and were negative for cytokeratins, Hep par 1 and Glypican 3. Surgical resection was not performed in any of the 7 cases and all patients were treated by chemotherapy. Follow up was available in 5 cases. Of these, 3 patients died of disease and another patient was alive with metastases in both lungs, omentum and colon.

Conclusion
Clinicopathological features of the 7 cases in our series and detailed review of published literature is presented. Prognosis was bad in our cases most likely due to fact that surgical resection could not be performed in any of the cases owing to lack of surgical expertise for liver tumor surgery in most parts of the country.
Impact of fibrinogen level on the prognosis of patients with traumatic brain injury: a single-center analysis of 2570 patients
Authors: Lv Ke , Yuan Qiang , Fu Pengfei , Wu Gang , Wu Xing , Du Zhuoying , Yu Jian , Li Zhiqi , Hu Jin 
Published: September 2020

Abstract
Background
Fibrinogen may play an important role in the survival of trauma patients; however, its role in traumatic brain injury (TBI) and its correlation with disease prognosis remain poorly understood. The aims of this study were to determine the incidence of TBI-associated hypofibrinogenemia in patients with TBI and to evaluate the prognostic value of fibrinogen level with respect to mortality and clinical outcomes.

Methods
A total of 2570 consecutive TBI patients were retrospectively studied. Prognostic evaluations were determined using the Glasgow Outcome Score (GOS) assessment 3 months after injury. The shape of the relationship between fibrinogen level and mortality or outcome was examined using cubic spline functions. Logistic regression analyses were conducted to identify the association between fibrinogen level and 3-month functional outcomes.

Results
Fibrinogen concentrations < 2 g/L were observed in 992 (38.6%) patients at the time of admission. Multivariate analyses showed that for patients with fibrinogen levels < 2.0 g/L, those levels were an independent prognostic factor for 3-month mortality (odds ratio [OR], 0.91; 95% confidence interval [CI], 0.89–0.93; P < .001). By contrast, for patients with fibrinogen levels < 2.5 g/L, the levels were an independent prognostic factor for favorable outcomes at 3 months (OR, 1.654; 95% CI, 1.186–2.306; P = .003). Similar results were also seen for patients with fibrinogen levels > 3.0 g/L, with the levels being an independent prognostic factor for favorable outcomes at 3 months (OR, 0.771; 95% CI, 0.607–0.979; P = .033).

Conclusions
Fibrinogen is an independent prognostic factor for clinical outcomes in TBI patients. Maintaining the level of fibrinogen between 2.5 and 3 g/L may improve clinical outcomes in patients with TBI.
Novel technique of repairing right partial anomalous pulmonary venous connection with intact atrial septum using in situ interatrial septum as a flap in a 68-year-old-woman: a case report
Authors: Morishita Atsushi , Hagino Ikuo , Tomioka Hideyuki , Katahira Seiichiro , Hoshino Takeshi , Hanzawa Kazuhiko 
Published: September 2020

Abstract
Background
Partial anomalous pulmonary venous connection draining into the right atrium with an intact atrial septum is a very rare clinical entity in the adult population. Partial anomalous pulmonary venous connection must be suspected as a differential diagnosis when the cause of right heart enlargement and pulmonary artery hypertension is unknown.

Case presentation
This study describes the surgical case of an isolated right partial anomalous pulmonary venous connection to the right atrium in a 68-year-old woman, who underwent tricuspid ring annuloplasty and right-sided maze procedure simultaneously. She had complaints of gradually progressing dyspnea on exertion. However, a diagnosis could not be established despite consultations at multiple hospitals for over a year. Right heart catheterization revealed severe pulmonary artery hypertension with a mean pulmonary artery pressure of 46 mmHg, step-up phenomenon of oxygen saturation at the mid-level of the right atrium with a pulmonary-to-systemic blood flow ratio of 2.4, and a pulmonary vascular resistance of 3.1 Wood Units. As medical treatment with pulmonary artery vasodilator therapy did not improve her symptoms, she underwent surgical repair. An atrial septal defect was created surgically with a curvilinear tongue-shaped cut. The right anomalous pulmonary veins were rerouted through the surgically created atrial septal defect into the left atrium with a baffle comprised of the interatrial septum flap, kept in continuity with the anterior margin and sutured while mobilizing the enlarged right atrium. The patient had an uneventful postoperative course and remains asymptomatic.

Conclusions
The described surgical technique could be considered an effective alternative for patients undergoing surgical repair for a partial anomalous pulmonary venous connection isolated to the right atrium. The indication for surgery must be judged on a case-by-case basis in these patients with prevalent systemic-to-pulmonary shunting.
A transient increase in MHC-IIlow monocytes after experimental infection with Avibacterium paragallinarum (serovar B-1) in SPF chickens
Authors: Alvarez Karla Lucía F. , Poma-Acevedo Astrid , Fernández-Díaz Manolo 
Published: September 2020

AbstractInfectious coryza (IC), an upper respiratory tract disease affecting chickens, is caused by Avibacterium paragallinarum. The clinical manifestations of IC include nasal discharge, facial swelling, and lacrimation. This acute disease results in high morbidity and low mortality, while the course of the disease is prolonged and mortality rates are increased in cases with secondary infections. Studies regarding the immune response in infected chickens are scarce, and the local immune response is the focal point of investigation. However, a large body of work has demonstrated that severe infections can impact the systemic immune response. The objective of this study was to evaluate the systemic effects of Avibacterium paragallinarum (serovar B-1) infection on immune cells in specific pathogen-free (SPF) chickens. The current study revealed the presence of a transient circulating monocyte population endowed with high phagocytic ability and clear downregulation of major histocompatibility complex class II (MHC-II) surface expression. In human and mouse studies, this monocyte population (identified as tolerant monocytes) has been correlated with a dysfunctional immune response, increasing the risk of secondary infections and mortality. Consistent with this dysfunctional immune response, we demonstrate that B cells from infected chickens produced fewer antibodies than those from control chickens. Moreover, T cells isolated from the peripheral blood of infected chickens had a lower ability to proliferate in response to concanavalin A than those isolated from control chickens. These findings could be related to the severe clinical signs observed in complicated IC caused by the presence of secondary infections.
Degenerate Bell polynomials associated with umbral calculus
Authors: Kim Taekyun , Kim Dae San , Kim Han-Young , Lee Hyunseok , Jang Lee-Chae 
Published: September 2020

AbstractCarlitz initiated a study of degenerate Bernoulli and Euler numbers and polynomials which is the pioneering work on degenerate versions of special numbers and polynomials. In recent years, studying degenerate versions regained lively interest of some mathematicians. The purpose of this paper is to study degenerate Bell polynomials by using umbral calculus and generating functions. We derive several properties of the degenerate Bell polynomials including recurrence relations, Dobinski-type formula, and derivatives. In addition, we represent various known families of polynomials such as Euler polynomials, modified degenerate poly-Bernoulli polynomials, degenerate Bernoulli polynomials of the second kind, and falling factorials in terms of degenerate Bell polynomials and vice versa.
Antimicrobial resistance in Clostridioides (Clostridium) difficile derived from humans: a systematic review and meta-analysis
Authors: Sholeh Mohammad , Krutova Marcela , Forouzesh Mehdi , Mironov Sergey , Sadeghifard Nourkhoda , Molaeipour Leila , Maleki Abbas , Kouhsari Ebrahim 
Published: September 2020

AbstractBackgroundClostridioides(Clostridium)difficileis an important pathogen of healthcare- associated diarrhea, however, an increase in the occurrence ofC. difficileinfection (CDI) outside hospital settings has been reported. The accumulation of antimicrobial resistance inC. difficilecan increase the risk of CDI development and/or its spread. The limited number of antimicrobials for the treatment of CDI is matter of some concern.ObjectivesIn order to summarize the data on antimicrobial resistance toC. difficilederived from humans, a systematic review and meta-analysis were performed.MethodsWe searched five bibliographic databases: (MEDLINE [PubMed], Scopus, Embase, Cochrane Library and Web of Science) for studies that focused on antimicrobial susceptibility testing inC. difficileand were published between 1992 and 2019. The weighted pooled resistance (WPR) for each antimicrobial agent was calculated using a random- effects model.ResultsA total of 111 studies were included. The WPR for metronidazole and vancomycin was 1.0% (95% CI 0–3%) and 1% (95% CI 0–2%) for the breakpoint > 2 mg/L and 0% (95% CI 0%) for breakpoint ≥32 μg/ml. Rifampin and tigecycline had a WPRs of 37.0% (95% CI 18–58%) and 1% (95% CI 0–3%), respectively. The WPRs for the other antimicrobials were as follows: ciprofloxacin 95% (95% CI 85–100%), moxifloxacin 32% (95% CI 25–40%), clindamycin 59% (95% CI 53–65%), amoxicillin/clavulanate 0% (0–0%), piperacillin/tazobactam 0% (0–0%) and ceftriaxone 47% (95% CI 29–65%). Tetracycline had a WPR 20% (95% CI 14–27%) and meropenem showed 0% (95% CI 0–1%); resistance to fidaxomicin was reported in one isolate (0.08%).ConclusionResistance to metronidazole, vancomycin, fidaxomicin, meropenem and piperacillin/tazobactam is reported rarely. From the alternative CDI drug treatments, tigecycline had a lower resistance rate than rifampin. The high-risk antimicrobials for CDI development showed a high level of resistance, the highest was seen in the second generation of fluoroquinolones and clindamycin; amoxicillin/clavulanate showed almost no resistance. Tetracycline resistance was present in one fifth of human clinicalC. difficileisolates.
Exploration of CYP21A2 and CYP17A1 polymorphisms and preeclampsia risk among Chinese Han population: a large-scale case-control study based on 5021 subjects
Authors: Hou Bo , Jia Xuewen , Deng Ziwen , Liu Xin , Liu Huitang , Yu Haichu , Liu Shiguo 
Published: September 2020

Abstract
Background
Several genome-wide association studies have identified single-nucleotide polymorphisms (SNPs), such as rs4409766, rs1004467, and rs3824755 in CYP17A1 and rs2021783 in CYP21A2, as new hypertension susceptibility genetic variants in the Chinese population. This study aimed to look into the relationship between preeclampsia (PE) and these SNPs in Chinese Han women.

Methods
Overall, 5021 unrelated pregnant women were recruited, including 2002 patients with PE and 3019 normal healthy controls. The real-time PCR (TaqMan) method was applied to genotype these four polymorphisms.

Results
A statistically obvious difference in the allelic frequencies was observed in CYP21A2 rs2021783 between cases and controls (χ2 = 7.201, Pc = 0.028 by allele), and the T allele was associated with the occurrence and development of PE (OR = 1.151, 95% CI 1.039–1.275). We also found a significant association between rs2021783 and the development of early-onset PE (Pc = 0.008 by genotype, Pc = 0.004 by allele). For rs1004467 and rs3824755, the distribution of allelic frequencies differed markedly between mild PE and control groups (χ2 = 6.843, Pc = 0.036; χ2 = 6.869, Pc = 0.036), and patients with the TT genotype of rs1004467 were less easy to develop mild PE than were those carrying the CT or CC genotype (χ2 = 7.002, Pc = 0.032, OR = 1.306, 95% CI 1.071–1.593). The GG genotype of rs3824755 appeared to a protective effect on the occurrence of mild PE (OR = 0.766, 95% CI 0.629–0.934).

Conclusions
CYP21A2 rs2021783 appears to be closely related to PE susceptibility, and CYP17A1 rs1004467 and rs3824755 seem to be closely associated with mild PE in Han women.