bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mild Increases in Plasma Creatinine after High-Risk Abdominal Surgery Are Associated with Long-Term Renal Injury: A Retrospective Cohort Study
Authors: JOOSTEN Alexandre , Ickx Brigitte , Mokhtari ZAKARIA , Obbergh Luc Van , Lucidi Valerio , Collange Vincent , Naili Salima , Ichai Philippe , Samuel Didier , Antonio Sa Cunha , Alexander Brenton , Legrand Matthieu , Taccone Fabio Silvio , Harrois Anatole , Duranteau Jacques , Vincent Jean-Louis , Rinehart Joseph , Linden Philippe Van der 
Published: November 2020

Abstract
Background: The impact of mild acute kidney injury (AKI) observed in the immediate postoperative period after major surgery on long term renal function remains poorly defined. According to the “Kidney Disease: Improving Global Outcomes” (KDIGO) classification, a mild injury corresponds to a KIDIGO stage 1, characterized by an increase in creatinine of at least 0.3 mg/dl within a 48-hour window or 1.5 to 1.9 times the baseline level within the first week post-surgery. We tested the hypothesis that patients who underwent moderate-to high-risk abdominal surgery and developed mild AKI in the following days would be at an increased risk of long-term renal injury compared to patients with no postoperative AKI.Methods: In this single centre retrospective study, all consecutive adult patients with a plasma creatinine value ≤ 1.5 mg/dl who underwent high-risk abdominal surgery between 2014-2019 and who had at least three recorded creatinine measurements (before surgery, during the first seven postoperative days, and at long-term follow up [6 months-2 years]) were included. AKI was defined using a “modified” (without urine output criteria) KDIGO classification as mild (stage 1 characterised by an increase in creatinine of > 0.3 mg/dl within 48-hours or 1.5-1.9 times baseline) or moderate-to-severe (stage 2-3 characterised by increase in creatinine 2 to 3 times baseline or to ≥ 4.0 mg/dl). Development of long-term renal injury was compared in patients with and without postoperative AKI Results: Among the 815 patients included, 109 (13.4%) had postoperative AKI (81 mild [KDIGO 1] and 28 moderate-to-severe [KDIGO 2-3]). The median long-term follow-up was 360, 354 and 353 days for the three groups respectively (P=0.190). Patients who developed mild AKI had a higher risk of long-term renal injury than those who did not (odds ratio 3.1 [95%CI 1.7-5.5]; P<0.001). In multivariable analysis, mild postoperative AKI was independently associated with an increased risk of developing long-term renal injury (adjusted odds ratio 4.5 [95%CI 1.8-11.4]; P=0.002).Conclusions: Mild AKI after high-risk abdominal surgery is associated with a higher risk of long-term renal injury one year after surgery.
Intraoperative Hypotension during Liver Transplant Surgery is Associated with Postoperative Acute Kidney: A Retrospective Cohort Study
Authors: JOOSTEN Alexandre , Lucidi Valerio , Ickx Brigitte , Obbergh Luc Van , Germanova Desislava , Berna Antoine , Alexander Brenton , Desebbe Olivier , Carrier Francois-martin , Cherqui Daniel , Adam Rene , Duranteau Jacques , Saugel Bernd , Vincent Jean-Louis , Rinehart Joseph , Linden Philippe Van der 
Published: November 2020

Abstract
BACKGROUND: Acute kidney injury (AKI) occurs frequently after liver transplant surgery and is associated with significant morbidity and mortality. While the impact of intraoperative hypotension (IOH) on postoperative AKI has been well demonstrated in patients undergoing a wide variety of non-cardiac surgeries, it remains poorly studied in liver transplant surgery. We tested the hypothesis that IOH is associated with AKI following liver transplant surgery. METHODS: This historical cohort study included all consecutive patients who underwent liver transplant surgery between 2014 and 2019 except those with a preoperative creatinine > 1.5 mg/dl and/or who had combined transplantation surgery. IOH was defined as any mean arterial pressure (MAP) < 65 mmHg and was classified according to the percentage of case time during which the MAP was < 65 mmHg into three groups, based on the interquartile range of the study cohort: “short” (Quartile 1, < 8.6% of case time), “intermediate” (Quartiles 2-3, 8.6-39.5%) and “long” (Quartile 4, > 39.5%) duration. AKI stages were classified according to a “modified” “Kidney Disease: Improving Global Outcomes” (KDIGO) criteria. Logistic regression modelling was conducted to assess the association between IOH and postoperative AKI. The model was run both as a univariate and with multiple perioperative covariates to test for robustness to confounders. RESULTS: Of the 205 patients who met our inclusion criteria, 117 (57.1%) developed AKI. Fifty-two (25%), 102 (50%) and 51 (25%) patients had short, intermediate and long duration of IOH respectively. In multivariate analysis, IOH was independently associated with an increased risk of AKI (adjusted odds ratio [OR] 1.05; 95%CI 1.02-1.09; P < 0.001). Compared to “short duration” of IOH, “intermediate duration” was associated with a 10-fold increased risk of developing AKI (OR 9.7; 95%CI 4.1-22.7; P < 0.001). “Long duration” was associated with an even greater risk of AKI compared to “short duration” (OR 34.6; 95%CI 11.5-108.6; P < 0.001).CONCLUSION: Intraoperative hypotension is independently associated with the development of AKI after liver transplant surgery. The longer the MAP stays < 65 mmHg, the higher the risk the patient will develop AKI in the immediate postoperative period, and the greater the likely severity. Trial Registration: Not Applicable
Five Regions, Five Retinopathy Screening Programmes: A Systematic Review of the Portuguese Experience
Authors: Pereira Andreia Marisa Penso , Laureano Raul Manuel da Silva , Neto Fernando Buarque de Lima 
Published: November 2020

Abstract
Background: The implementation of a population-based screening programme for diabetic retinopathy involves several challenges, often leading to postponements and setbacks at high human and material costs. Thus, it is of the utmost importance to promote the sharing of experiences, successes and difficulties. However, factors such as the existence of regional programmes, specificities of each country's health systems, organizational and even linguistic barriers, make it difficult to create a solid framework that can be used as a basis for future projects. Methods: Web of Science and PubMed platforms were searched using appropriate key words. Were found 423 articles, 28 of which were selected and analysed. Web sites of all Portuguese governmental and non-governmental organizations, with a relevant role on the research topic, were inspected and 75 official documents were retrieved and analysed.Results: Since 2001, five regional screening programmes were gradually implemented under the guidelines of Portuguese General Health Department. However, complete population coverage was still not achieved. Among the main difficulties reported are the complex articulation between different levels of care providers, the low number of orthoptic technician in the national health system, the high burden that images grading and treatment of positive cases represents for hospitals ophthalmology services, and low adherence rates. Yet, the comparison between strategies adopted in the different regions allowed the identification of potential solutions: hire orthoptic technician for primary health care units, eliminating the dependence of hospital professionals; use artificial intelligence algorithms for automatic retinographies grading, avoiding ophthalmologists overload; adoption of proximity strategies, as the use of portable retinographers, to promote adherence to screening.Conclusion: Access to diabetic retinopathy screening remains remarkably variable in Portugal and needs urgent attention. However, several characteristics of effective screening programmes were found in Portuguese screening programmes, what seems to point toward promising outcomes.Registration PROSPERO registration ID CRD42020200115
Use of Selective Serotonin Reuptake Inhibitors During Pregnancy and Prevalence of Congenital Malformations: A Protocol for Systematic Review and Meta-analysis of Observational Studies from 2009-2020.
Authors: Fela-Thomas Ayodele Lucy , Nna Emmanuel Okechukwu , Anyahara Nnaemeka , Ojo Oluwafemi T , Motilewa Olugbemi , Okoh Emeka E , Alao Micheal A , Kaoje Umar A , Osi-Ogbu Ogugua , Ikeagwulonu Chinaza Richard , Okoye Ifeoma Joy 
Published: November 2020

Abstract
Background: The effect of antidepressants on the foetus is of great public concern on account of teratogenicity. However, evidence on this is quite controversial. This study aims to determine the risk of congenital malformations in offsprings of pregnant women placed on Selective Serotonin Reuptake Inhibitors (SSRIs) during pregnancy compared to the offsprings of pregnant women not on SSRIs. It also aims to assess if significant increase in risk occurs across trimesters. METHODS AND ANALYSIS:A search strategy is developed using MeSH, text words and entry terms. Nine databases will be searched: PubMed, Embase, CINAHL, AJOL, Google Scholar, Web of Science, Cochrane Library, Research gate and Scopus. Only Observational studies from 2009-2020, retrievable in the English Language will be included. The primary measurable outcome is risk of teratogenicity with SSRI use in pregnancy. All identified studies, imported into End note version 9, will be screened based on the inclusion/exclusion criteria; data will be exported into Microsoft excel. Extractable data will include first author’s name and year of publication, proportion of congenital malformations in women on SSRIs and women without SSRIs, trimester, time of initiation and duration of treatment. Pedro quality scores and Cochrane risk of bias for individual study will be reported. All studies will be assessed for methodological, clinical and statistical heterogeneity. Publication bias will be assessed using the funnel plot. Subgroup analysis will be performed. The different trimesters and time of initiation of treatment will be used as moderators. Meta-regression will be done using duration of treatment. The CMA version 3 will be used for statistical analysis and forest plots. Discussion:The study will require no ethical approval, it is based on published data. The results obtained from this review will provide relevant information on the use of SSRIs in pregnancy and the risk of congenital malformations. Furthermore, it will provide vital information on the levels and trend of risk at each trimester. The final report will be made available to mental health experts providing care to pregnant women.Trial Registration Number: This protocol is registered in PROSPERO, with number CRD42020213505
Estimated Number of Short-Stay Service Recipients in Hokkaido Prefecture, Japan, from 2020 to 2045: Estimation by Machine Learning and Review of Changing Trend by Cartogram
Authors: Ouchi Junko , Hattori Kanetoshi 
Published: November 2020

Abstract
Background: For effective allocations of limited human resources, it is significant to have accurate estimates of future elderly care demands at the regional level, especially in areas where aging and population decline vary by region, such as Hokkaido prefecture in Japan.Objectives: The present study aimed to estimate the numbers of short-stay service recipients in all administrative units in Hokkaido from 2020 to 2045 with the machine learning approaches and reviewed the changing trends of spatial distributions of the service recipients with cartograms.Methods: A machine learning approach was used for the estimation. To develop the model to estimate, population data in Japan from 2015 to 2017 were used as input signals, whereas data on the numbers of short-stay service recipients at each level of needs for long-term care (levels 1–5) from 2015 to 2017 were used as a supervisory signal. Three models were developed to avoid problems of repeatability. Then, data of the projected population in Hokkaido every 5 years from 2020 to 2045 were fed into each model to estimate the numbers of the service recipients for the 188 administrative units of Hokkaido. The medians of the estimations from the models were considered as the final results; the estimates for 188 administrative units were presented with continuous area cartograms on the map of Hokkaido.Results: The developed models predicted that the number of the service recipients in Hokkaido would peak at 18,016 in 2035 and the number of people at level 3 in particular would increase. The cartograms for levels 2 and 3 from 2020 to 2030 and level 3 for 2035 were heavily distorted in the populated areas in Hokkaido.Discussion: The large correlation coefficients indicated the accuracy of estimations by the developed models. The growing number of the service recipients especially at level 3 by 2035 was assumed to be related to aging of the first baby boomers in Japan. The distortions of the cartograms suggested that the majority of the service recipients would be concentrated in the populated areas in Hokkaido. Future allocations of human resources were discussed on the basis of the findings.
Increased Risk of Legionella Pneumonia as Community-acquired Pneumonia after Heavy Rainfall in 2018 in West Japan
Authors: Mitsui Miho , Ito Akihiro , Ishida Tadashi , Tachibana Hiromasa , Nakanishi Yosuke , Yamazaki Akio , Washio Yasuyoshi 
Published: November 2020

Abstract
Background: Japan experienced a heavy rainfall event from June 28 to July 8, 2018, and many casualties were caused by both heavy rainfall and flooding. Few studies have investigated patients’ characteristics and causative pathogens of community-acquired pneumonia before and after heavy rainfall events. The aim of the present study was to evaluate the causative pathogens and clinical characteristics of hospitalised patients with community-acquired pneumonia before and after the heavy rainfall event using prospective cohort data.Methods: The study was divided into two periods: July to November 2013-2017 (pre heavy rainfall) and July to November 2018 (post heavy rainfall). The patients’ clinical characteristic and causative pathogens before and after the heavy rainfall were investigated. Regarding the causative pathogens, precipitation and seasonal patterns were adjusted.Results: There were no significant differences in the number and clinical characteristics of patients pre and post heavy rainfall. However, the frequency of Legionella pneumonia was significantly higher after than before the heavy rainfall event (8.9% vs 3.0%, P = 0.02) and remained significant after adjusting for precipitation and season. Three of 7 Legionella pneumonia patients engaged in reconstruction work and 2 Legionella pneumonia patients had soil exposure.Conclusions: An increased risk of Legionella pneumonia after not only rainfall and serious flooding, but also following recovery work or soil exposure should be considered. Trial registration: A prospective epidemiological study for patients with pneumonia in a single center in Japan, UMIN000004353. Registered 7 October 2010,　https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000005195
Contrasting Smoking Behaviors of Non-daily Smokers – A Study based on Clustering of Repeated Daily Measures of Nicotine Exposure
Authors: Midya Vishal , Hobkirk Andréa L. , Krebs Nicolle M. , Allen Sophia I. , Reinhart Lisa , Sun Dongxiao , Stennett Andrea L. , Muscat Joshua E. 
Published: November 2020

Abstract
Background: Over one-quarter of all smokers in the U.S. identify as non-daily smokers and this number is projected to rise. Despite the negative health effects of non-daily smoking and high rates of unsuccessful quit attempts, we know little about the variability and correlates of nicotine exposure among non-daily smokers. Methods: A community sample of non-daily smokers (n=60) ages 21 to 60 completed baseline measures of nicotine dependence, a consecutive 7-day at-home protocol to log each smoking session, ecological momentary assessments of mood and activity during smoking, and daily saliva samples for cotinine and nicotine metabolite ratio analysis. Hierarchical cluster analysis categorized participants based on their mean cotinine levels across days. Clusters were compared on biological and behavioral smoking characteristics, nicotine dependence, and activities and emotions during smoking using linear mixed effect regression models.Results: Cluster analysis of cotinine revealed four distinct clusters of nicotine exposure, ranging from high levels (above 200 ng/ml) to very low levels (near 0 ng/ml). Compared to the other clusters, the cluster with the highest mean levels of cotinine also had the largest day-to-day variation in cotinine and was associated with significantly higher levels of nicotine dependence on the Fagerström Test of Nicotine Dependence and the Penn State Cigarette Dependence Index, lower rates of social smoking, and the highest frequency of negative emotions during smoking. Conclusions: Our findings highlight the variability in nicotine exposure across days among non-daily smokers and show that some are exposed to levels near those of daily smokers. The results point to individual differences and existence of several sub-groups of nondaily smokers based on their nicotine exposure, which varied considerably across days for some, but not all groups. The results highlight the need to better characterize non-daily smokers and the factors that maintain smoking behavior to inform personalized cessation treatments for this growing population of smokers.
Epidemiological Modeling Analysis Reveals the Transmission Potential of COVID-19 Asymptomatic Patients:A Prospective Study of Epidemiological Transmission in America
Authors: Zhao Yuhang , Ji Zhonglei , Wang Ping , Meng Xiangwei , Ma Zhixiang , Li Xiyuan , Sun Haihang , Li Wei 
Published: November 2020

Abstract
Background:The asymptomatic of COVID-2019 are getting more and more attention from all walks of life. Now, America has become the epicenter of the pandemic, with more reported cases and deaths than other regions of the world. Studying the development asymptomatic populations may play a key role in managing the outbreak effectively. Methods:We propose a new model to predict the course of the epidemic and simulate the transmission of the asymptomatic. The model considers seven stages of infection: susceptible (S), exposed (E), infected (I), asymptomatic (A), confirmed (C), recovered (R), dead (D), we named it as SEIACRD. We used a model to study the interaction between asymptomatic patients and viral transmission.Result:Our model confirms that about 12 million people will be infected with the virus. Changes in mortality rates will be volatile, first falling, then rising. Not only the number of patients, but also the spread of the epidemic will be affected by the ability to detect asymptomatic persons. Contact with asymptomatic infected patients also significantly promoted the spread of the virus. But these methods had no significant effect on changes in patient mortality.Conclusion:American Asymptomatic patients have a strong interaction with epidemic transmission. They are no less at risk of transmission than symptomatic patients. In terms of controlling the number of infections, efforts to improve detection capacity are more effective than simply suppressing the spread of the virus. Extensive testing and effective social distancing measures should be taken to protect more people from the virus.
Occurrence of Carcinogenic illudane Glycosides in Drinking Water Wells
Authors: Skrbic Natasa , Kisielius Vaidotas , Pedersen Ann-Katrin , Christensen Sarah C. B. , Hedegaard Mathilde J. , Hansen Hans Christian Bruun , Rasmussen Lars Holm 
Published: November 2020

Abstract
Background Ptaquiloside (PTA), caudatoside (CAU) and ptesculentoside (PTE) are carcinogenic illudane glycosides found in bracken ferns (Pteridium spp.) world-wide. The environmentally mobile PTA entails both acute and chronic toxicity and comparable risk might be associated with the structurally similar CAU and PTE. It is of great concern if these compounds are present in drinking water wells in bracken dominated regions, since they might pose a threat to human health. This study investigates the presence of PTA, CAU, PTE, and their corresponding hydrolysis products pterosins B (PtB), A (PtA) and G (PtG) in water wells in Denmark, Sweden and Spain. In total, 77 water samples from deep groundwater wells (40 – 100 m) and shallow water wells (8 – 40 m) were collected and preserved in the field, pre-concentrated in the laboratory and analysed by liquid chromatography-mass spectrometry (LC-MS). Results Deep groundwater wells contained neither illudane glycosides nor their pterosins. However, seven private shallow wells contained at least one of the illudane glycosides and/or pterosins at concentrations up to 0.27 µg L-1 (PTA), 0.75 µg L-1 (CAU), 0.05 µg L-1 (PtB), 0.03 µg L-1 (PtA) and 0.28 µg L-1 (PtG). Conclusions Detected concentrations of illudane glycosides in some of investigated wells exceeded the suggested maximum tolerable concentrations of PTA, although they were used for drinking water purpose. Contaminated wells were characterized by shallow depth, lower pH and electrical conductivity compared to deep groundwater wells where no illudane glycosides or pterosins were found.
Person Centered Antenatal Care and Associated Factors in Rwanda: A Secondary Analysis of Program Data
Authors: Miller Phoebe , Afulani Patience , Musange Sabine Furere , Sayingoza Felix , Walker Dilys 
Published: November 2020

Abstract
Background: Research suggests that person centered antenatal care (PCANC) provides an effective tool for addressing maternal deaths in Sub-Saharan Africa through the delivery of health care which is both respectful of, and responsive to, the preferences, needs, and values of women. Yet little is known in Rwanda about either the extent to which PCANC is practiced or the factors that might determine its use. This is the first study to quantitatively examine the extent of and the factors associated with PCANC in Rwanda.Methods: We used quantitative data from a pair-matched cluster randomized control trial (CRCT) in Rwanda. A total of 2,150 surveys were used from 36 health centers across five districts. Eligible women were 16 – 49 years old and were not referred to higher levels of care or had incomplete survey responses. Results: PCANC was found to be sub-optimal with 30% of women leaving antenatal care (ANC) either with questions or confused and 24% feeling disrespected. In bivariate analysis, factors that significantly predict high PCANC are better levels of cognitive maternal empowerment, greater parity, being in the traditional care (control group), and being from Burera district. The study group to which women were assigned and the district in which women received care were significantly associated with PCANC in the multivariate analysis.Conclusions: Given the benefits of PCANC, improvements in PCANC through provider training in Rwanda might promote an institutional culture shift towards a more person-centered model of care. We also found that better measurement tools are needed to more comprehensively measure PCANC and recommend wider use of these validated tools in national surveys to get a systematic understanding of PCANC in Rwanda. Additionally, we recommend thoughtful measures of empowerment during antenatal care to capture the social experiences of women in Rwanda. Trial registration: Not applicable