bluuebunny/crossref_metadata_2025_split huggingface dataset:
A preliminary assessment of vital-signs-integrated patient-assisted intravenous opioid analgesia (VPIA) for postsurgical pain
Authors: SNG Ban Leong , Tan Daryl Jian'an , TAN Chin Wen , HAN Nian-Lin Reena , SULTANA Rehena , SIA Alex Tiong Heng 
Published: June 2020

Abstract
Background: We developed a Vital-signs-integrated Patient-assisted Intravenous opioid Analgesia (VPIA) analgesic infusion pump, a closed-loop vital signs monitoring and drug delivery system which embodied in a novel algorithm that took into account patients’ vital signs (oxygen saturation, heart rate). The system aimed to allow responsive titration of personalized pain relief to optimize pain relief and reduce the risk of respiratory depression. Moreover, the system would be important to enable continuous monitoring of patients during delivery of opioid analgesia.Methods: Nineteen patients who underwent elective gynecological surgery with postoperative patient controlled analgesia (PCA) with morphine were recruited. The subjects were followed up from their admission to the recovery room/ ward for at least 24 hours until assessment of patient satisfaction on the VPIA analgesic infusion pump.Results: The primary outcome measure of incidence of oxygen desaturation showed all patients had at least one episode of oxygen desaturation (<95%) during the study period. Only 6 (31.6%) patients had oxygen desaturation that persisted for more than 5 minutes. The median percentage time spent during treatment that oxygen saturation fell below 95% was 1.9%. Fourteen (73.7%) out of 19 patients encountered safety pause, due to transient oxygen desaturation or bradycardia. The patients’ median [IQR] pain scores at rest and at movement after post-op 24 hours were 0.0 [2.0] and 3.0 [2.0], respectively. The average morphine consumption in the first 24 hours was 12.5 ± 7.1mg. All patients were satisfied with their experience with the VPIA analgesic infusion pump. Conclusions: The use of VPIA analgesic infusion pump, when integrated with continuous vital sign monitor and variable lockout algorithm, was able to provide pain relief with good patient satisfaction.Keywords: infusion pump, postoperative pain, vital sign monitoring, oxygen desaturation.Trial registration: This study was registered on clinicaltrials.gov registry (NCT02804022) on 28 Feb 2016.
Six-minute walking distance in healthy Chinese people older than 60 years
Authors: Zou He , Zhang Jia , Zou Yingying , Chen Xiaoshu , Wang Yi , Shiwei Huang , Ye Fanhao , Yu Haizhu 
Published: June 2020

Abstract
Introduction: The six-minute walking test (6MWT) is a tool that plays a key role in evaluating the functional exercise capacity, prognosis and evaluation of treatment response of patients with various cardiopulmonary diseases. However, standard reference equations are currently unavailable for the six-minute walking distance (6MWD) for people aged 60-85 years in China. The purpose of this study was to 1) measure the 6MWD of healthy Chinese people aged 60-85 years, 2) establish reference equations for predicting the 6MWD, and 3) compare our reference equations with equations reported in previously published studies.Method: We obtained informed consent from each participant prior to the test, and the research design was approved by the Ethics Committee of Wenzhou People’s Hospital. The demographic and anthropometric data and the 6MWD of healthy Chinese subjects aged 60-85 years old were measured using a standardized protocol. Every subject completed two 6MWTs, and the longest 6MWD further analyzed.Results: Two hundred sixty-six subjects (128 males and 138 females) completed the 6MWT, and the mean walking distance was 518±72 m. Males achieved a longer walking distance than females (518±72 m vs. 487±70m; p<0.0001), and active subjects achieved a longer walking distance than nonactive subjects (512±76 m vs. 485±63 m; p<0.0001). According to the univariate analysis, the 6MWD was significantly associated with age, height, body mass index (BMI), heart rate and blood pressure after exercise and changes in heart rate before and after exercise. The stepwise multivariate regression analysis identified age, height and BMI as independent predictors of the 6MWD. The reference equations for Caucasians and South Americans tended to overestimate the 6MWD of our subjects, while the equations for Asian and African populations tended to underestimate the 6MWD.Conclusions: This study is the first to describe the 6MWD of healthy Chinese people aged 60-85 years, and reference prediction equations were proposed. These findings will help to improve the evaluation of Chinese patients with diseases that affect exercise capacity.
PS4DR: A multimodal workflow for identification and prioritization of drugs based on pathway signatures
Authors: Emon Mhammad Asif , Domingo-Fernández Daniel , Hoyt Charles Tapley , Hofmann-Apitius Martin 
Published: June 2020

Abstract
Background: During the last decade, there has been a surge towards computational drug repositioning owing to constantly increasing -omics data in the biomedical research field. While numerous existing methods focus on the integration of heterogeneous data to propose candidate drugs, it is still challenging to substantiate their results with mechanistic insights of these candidate drugs. Therefore, there is a need for more innovative and efficient methods which can enable better integration of data and knowledge for drug repositioning. Results: Here, we present a customizable workflow ( PS4DR) which not only integrates high-throughput data such as genome-wide association study (GWAS) data and gene expression signatures from disease and drug perturbations but also takes pathway knowledge into consideration to predict drug candidates for repositioning. We have collected and integrated publicly available GWAS data and gene expression signatures for several diseases and hundreds of FDA-approved drugs or those under clinical trial in this study. Additionally, different pathway databases were used for mechanistic knowledge integration in the workflow. Using this systematic consolidation of data and knowledge, the workflow computes pathway signatures that assist in the prediction of new indications for approved and investigational drugs. Conclusion: We showcase PS4DR with applications demonstrating how this tool can be used for repositioning and identifying new drugs as well as proposing drugs that can simulate disease dysregulations. We were able to validate our workflow by demonstrating its capability to predict FDA-approved drugs for their known indications for several diseases. Further, PS4DR returned many potential drug candidates for repositioning that were backed up by epidemiological evidence extracted from scientific literature. Source code is freely available at https://github.com/ps4dr/ps4dr .
Epidemiology, vaccine effectiveness, and risk factors for mortality for pneumococcal disease among hospitalised adults in Singapore: a case-control study
Authors: Chan Tyson , Tay Min Zhi , Kyaw Win Mar , Chow Angela , Ho Hanley J 
Published: June 2020

Abstract
Background: Streptococcus pneumoniae infections can lead to severe morbidity and mortality, especially in patients with invasive pneumococcal disease (IPD). This study evaluated factors associated with pneumococcal disease, pneumococcal vaccine effectiveness, and risk factors for all-cause mortality in hospitalised adults with pneumococcal disease in Singapore. Methods: Retrospective case-control study of patients tested for pneumococcal disease with streptococcal urinary antigen testing and at least one sterile site culture, during their admission to a tertiary hospital in Singapore from 2015-2017. Patients were defined as cases of IPD or non-IPD, or as controls, based on laboratory results and clinical diagnoses. Multivariable models were constructed to determine factors associated with IPD/non-IPD, and risk factors for mortality from pneumococcal disease. Vaccine effectiveness against IPD/non-IPD was estimated using a variation of the test-negative design. Results: We identified 496 pneumococcal disease cases, of whom 92 (18.5%) had IPD. The mean age of cases was 69.1±15.4yrs, and 65.5% were male. Compared with controls (N=9,181), IPD patients were younger (mean age 61.5±16.3yrs, vs 72.2±16.1yrs in controls; p<0.001) and with less co-morbidities [median Charlson’s score 1 (IQR 0-4), vs 3 (1-5) in controls; p<0.001]. IPD patients also had the highest proportions with intensive care unit (ICU) admission (20.7%), inpatient mortality (26.1%) and longest median length of stay [9 (IQR 8-17) days]. On multivariable analysis, IPD was negatively associated with prior pneumococcal vaccination (adjusted relative risk ratio=0.20, 95%CI 0.06–0.69; p=0.011). Risk factors for mortality among pneumococcal disease patients were ICU admission, diagnosis of IPD, age ≥85yrs and Charlson’s score >3.Conclusion: Patients with pneumococcal disease (especially IPD) were younger and had less co-morbidities than controls, but had higher risk of severe clinical outcomes and mortality. Pneumococcal vaccination effectiveness against IPD was estimated to be about 80%, and should be encouraged among high-risk patients.
A three-arm, multicenter, open-label randomized controlled trial of hydroxychloroquine and low-dose prednisone to treat recurrent pregnancy loss in women with undifferentiated connective tissue diseases: Protocol for the immunosuppressant regimens for Living FEtuses (ILIFE) Trial
Authors: Yang Shaoying , Ni Ruoning , Lu Yikang , Wang Suli , Xie Feng , Zhang Chunyan , Lu Liangjing 
Published: June 2020

Abstract
Background: Undifferentiated connective tissue disease (UCTD) is known to induce adverse pregnancy outcomes, and even recurrent spontaneous abortion (RSA) by placental vascular damage and inflammation activation. Anticoagulation can prevent pregnancy morbidities. However, it is unknown whether the addition of immune suppressant to anticoagulation can prevent spontaneous pregnancy loss in UCTD patients. The purpose of this study is to evaluate the efficacy of hydroxychloroquine (HCQ) and low-dose prednisone on recurrent pregnancy loss for women with UCTD.Methods: The Immunosuppressant for Living Fetuses (ILIFE) Trial is a three-arm, multicenter, open-label randomized controlled trial with the primary objective of comparing hydroxychloroquine combined with low-dose prednisone and anticoagulation with anticoagulation alone in treating UCTD women with recurrent spontaneous abortion. The third arm of using hydroxychloroquine combined with anticoagulant for secondary comparison. A total of 426 eligible patients will be randomly assigned to each of the three arms with a 1:1:1 allocation ratio. The primary outcome is the rate of live births. Secondary outcomes include adverse pregnancy outcomes and progression of UCTD.Discussion: This is the first multi-center, open-label, randomized controlled trial which evaluates the efficacy of immunosuppressant regimens on pregnancy outcomes and UCTD progression. It will provide evidence on whether the immunosuppressant ameliorates the pregnancy prognosis in UCTD patients with RSA and the progression into defined connective tissue disease. Trial registration: ClinicalTrials.gov, NCT03671174. Registered on 14 September 2018. https://www.clinicaltrials.gov/ct2/show/NCT03671174
Self- Care Practices and Associated Factors among Adult Diabetic Patients in Public Hospitals of Dire Dawa Administration, Eastern Ethiopia
Authors: Getie Asmare , Geda Biftu , Alemayhu Tadesse , Bante Agenehu , Aschalew Zeleke , Alemu Biresaw wassihun 
Published: June 2020

Abstract
Background: Diabetes is a huge growing problem, and causes high and escalating costs to the society. Self- care practice for adults with diabetes is not well addressed in sub-Saharan Africa including Ethiopia. To prevent serious morbidity and mortality, diabetes treatment requires commitment to demanding self-care practice. The aim of this study was to assess self- care practices and its associated factors among adults with diabetes in Dire Dawa public hospitals of Eastern, Ethiopia.METHODS: Cross-sectional study was conducted among 513 adults with diabetes. The study participants were selected through systematic random sampling. Data was collected from February 1st to March 1st, 2018. Patients were interviewed using a structured questionnaire. Data were entered into Epi-data version 3.3.1 and exported to SPSS version 22.0 for analysis. Bivariable and multivariable logistic regression with crude and adjusted odds ratios along with the 95% confidence interval was computed and interpreted accordingly. Good self-care was defined based on mean calculation; a result above the mean value had a good self-care practice, and a P-value of <0.05 was considered to declare a result as statistically significant.RESULT: The result of the study showed that 55.9 %, (95% CI: 51.4, 60.3) of participants had good self-care practices. Good self-care practice was associated with having family support, treatment satisfaction, diabetes education, having glucometer, higher educational status, duration of the disease, high economic status and having good knowledge. There were statistical association between good diabetes knowledge (AOR= 2.14 , 95% CI :1.37, 3.35), family support system (AOR= 2.69, 95% CI:1.56, 4.62), treatment satisfaction (AOR= 2.07, 95% CI:1.18, 3.62), diabetes education (AOR= 2.21, 95% CI: 1.35, 3.63), high economic status (AOR= 1.89, 95% CI: 1.01, 3.48), having glucometer,(AOR=2.69, 95% CI:1.57, 4.63),higher educational status (AOR= 2.68 , 95% CI: 1.31, 5.49), and duration of disease greater than 10 years AOR=2.70, 95% CI: 1.17, 6.26) with good self-care practice.Conclusion: In this study a substantial number of the patients had poor self-care practices especially dietary practice and self-monitoring of blood glucose which have critical roles in controlling diabetes. Provision of diabetes self-care education and counseling especially on importance of self-monitoring of blood glucose, and dietary practice should be considered by responsible bodies.
Mobile X-ray outside the Hospital: a scoping review
Authors: Toppenberg Maria Dietz , Christiansen Thomas Erik Møller , Rasmussen Finn , Nielsen Camilla Palmhøj , Damsgaard Else Marie 
Published: June 2020

Abstract
Background: For several years mobile X-ray equipment has been routinely used for imaging in patients too unwell within the hospital, when transportation to the radiology department was inadvisable. Now, mobile X-ray examinations are also used outside the hospital. Objective: The literature describes that fragile patients may benefit from mobile X-ray, but we need to know if it is an evident alternative to hospital-based examination and in what populations.Data sources: To conduct this scoping review, we searched PubMed, Cinahl, Embase, EconLit and Health Technology Assessment. Study eligibility criteria: English-, Danish-, Norwegian-, German-, Italian-, French- and Swedish-language studies, published 1.1.2009- 1.5.2020 about mobile X-ray outside the hospital were included. Participants and interventions: Participants were patients examined using mobile X-ray as the intervention.Study appraisal and synthesis methods: PRISMA was used when eligible to build up the review. To extract data from the selected articles, we used a structured summary table. Results: We included 12 studies in this scoping review. The results were divided into four topics: 1. Target population 2. Population health 3. Experience of care and 4. Cost effectiveness.The conclusions is that target population could be larger, population health may be improved, image quality seems to be good and mobile X-ray may be cost effective. Limitations: Limitations of language, databases and grey literature may have resulted in studies outside western countries being missed. Conclusions: Mobile X-ray may be used outside hospital. There seems to be potential benefits to both patients and health care staff. Based on the published studies it is not possible to draw a final conclusion if mobile X-ray examination is a relevant diagnostic offer and for whom. Further studies are needed to assess the feasibility of use in fragile patients, also regarding staff, relatives and society.
Risk literacy assessment of general practitioners and medical students using the Berlin Numeracy Test
Authors: Friederichs Hendrik , Birkenstein Roman , Becker Jan C. , Marschall Bernhard , Weissenstein Anne 
Published: June 2020

Abstract
Background: The responsibility for helping patients understand potential health benefits and risks, especially regarding screening tests, falls largely to general practitioners (GPs). The Berlin Numeracy Test (BNT) specifically measures risk literacy (i.e., the ability to understand different aspects of statistical numeracy associated with accurate interpretation of information about risks). This study explored the association between risk literacy levels and clinical experience in GPs vs. medical students. Additionally, the effect of GP risk literacy on evaluation of the predictive value of screening tests was examined.Methods: The participants were 84 GPs and 92 third-year medical students who completed the BNT (total score range 0–4 points). The GPs received an additional case scenario on mammography screening as a simple measure of performance in applying numeracy skills.Results: Despite having an average of 25.9 years of clinical experience, GPs scored no better than medical students on risk literacy (GPs: 2.33 points, 95% confidence interval [CI] 2.08–2.59; students: 2.34, 95% CI 2.07–2.61; P = .983). Of all GPs, 71.6% (n = 58) greatly overestimated the real predictive value.Conclusions: In this study, we found no difference in risk literacy between current students and current GPs. GPs lack risk literacy and consequently do not fully understand numeric estimates of probability in routine screening procedures.
Artemisinin improves neurocognitive deficits associated with sepsis by activating the AMPK axis in the microglia.
Authors: Lin Shao-Peng , Wei Jue-Xian , Ye Shan , Hu Jiasong , Bu Jingyi , Zhu Lidong , Li Qi , Liao Haojun , Wu Yi , Lin Pei-Yi , Chen Sheng-Qiang , Chen Xiao-Hui 
Published: June 2020

Abstract
Background and purpose: Artemisinin has been in use as an anti-malarial drug for almost half a century in the world. There is growing evidence that artemisinin also possesses potent anti-inflammatory and immunoregulatory properties. However, the efficacy of artemisinin treatment in neurocognitive deficits associated with sepsis remains unknown. Here, we evaluate the possible protective effects and explore the underlying mechanism of artemisinin on cognitive impairment resulting from sepsis.Methods: Male C57BL/6 mice were pretreated with either vehicle or artemisinin, and then injected with LPS to establish an animal model of sepsis. The cognitive function was then assessed using the Morris water maze. Neuronal damage and neuroinflammation in the hippocampus were evaluated by immunohistochemical and ELISA analysis. Additionally, the protective mechanism of artemisinin was determined in vitro.Results: The results showed that artemisinin preconditioning attenuated LPS-induced cognitive impairment, neural damage, and microglial activation in the mouse brain. The in vitro experiment revealed that artemisinin could reduce the production of pro-inflammatory cytokines and suppress the microglial migration in the BV2 microglia cells. Meanwhile, western blot demonstrated that artemisinin suppressed nuclear translocation of nuclear factor kappa-B and the expression of pro-inflammatory cytokines (i.e. tumor necrosis factor alpha, interleukin-6) by activating adenosine monophosphate-activated protein kinaseα1 (AMPKα1) pathway. Furthermore, knock-down of AMPKα1 markedly abolished the anti-inflammatory effects of artemisinin.Conclusion: Artemisinin is a potential therapeutic agent for sepsis-associated neuroinflammation and cognitive impairment, and its effect was probably mediated by the activation of AMPKα1 signalling pathway in microglia.
Determinants of self-paid rotavirus vaccination status in Kanazawa, Japan, including socioeconomic factors, parents’ perception, and children’s characteristics
Authors: Hara Megumi , Koshida Rie , Araki Kaoru , Kondo Masahide , Hirota Yoshio 
Published: June 2020

Abstract
Background: Japan’s National Immunization Program does not cover rotavirus vaccine and no government subsidies are available. This study aimed to measure the uptake of and determinants that influenced self-paid rotavirus vaccination, including socioeconomic status and relative poverty.Methods: We conducted a cross-sectional study at health check-ups for all children aged 18 months in Kanazawa, Japan, between December 2017 and July 2018. Community nurses collected information on self-paid vaccination history, parents’ perceptions of and recommendations for rotavirus vaccine, and socioeconomic status in interviews using a unified questionnaire. We used multivariable logistic regression to assess vaccine uptake and possible determinants.Results: In total, 1,282 participants were enrolled. The estimated rotavirus vaccine coverage was 72.9%. Rotavirus vaccine uptake was positively correlated with: parents’ perceptions that rotavirus gastroenteritis is serious and that the rotavirus vaccine is effective; pediatricians’ recommendations; information from the city office, articles in magazines and on the Internet; and parents’ education level. Lower household income was negatively correlated with rotavirus vaccination. Vaccine expense, fear of adverse reactions to the vaccine, number of household members and siblings, and children’s characteristics were not correlated with rotavirus vaccination. Poverty was negatively correlated with rotavirus vaccination, even after adjustment for other determinants (adjusted odds ratio 0.49, 95% confidence interval: 0.26–0.90).Conclusion: Parents’ perceptions, socioeconomic status, relative poverty, and pediatricians’ recommendations are determinants of vaccination. This study suggests that appropriate information about rotavirus vaccine, subsidies for those of lower socioeconomic status, and national recommendations are necessary to achieve higher coverage.