bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preparedness of outpatient health facilities for ambulatory treatment with all-oral short DR-TB treatment regimens in Zhytomyr, Ukraine: A cross-sectional study
Authors: Gils Tinne , Laxmeshwar Chinmay , Duka Marve , Malakyan Khachatur , Siomak Olga Valentinovna , Didik Vitaly Stephanovich , Lytvynenko Natalia , Terleeva Yana , Isaakidis Petros , Donchuk Dimitri 
Published: March 2020

Abstract
Background: Ukraine has a high burden of drug-resistant tuberculosis (DR-TB). Mental health problems, including alcohol use disorder (AUD), are common comorbidities. One in five DR-TB patients has Human Immunodeficiency virus (HIV). As part of health reform, the country is moving from inpatient-care to ambulatory primary care for tuberculosis (TB). In Zhytomyr oblast, Médecins Sans Frontières (MSF) is supporting outpatient care for DR-TB-patients on all-oral short DR-TB-regimens. This study describes the preparedness of ambulatory care facilities in Zhytomyr oblast, Ukraine to provide good quality ambulatory care. Methods: This is a retrospective analysis of routinely collected program data. Before discharge of every patient from the hospital, MSF teams assess outpatient facilities available using a standardised checklist. The assessment evaluates access, human-resources, availability of medicines, infection control, laboratory and diagnostic services, and psychosocial support. Results: We visited 68 outpatient facilities in 22 districts between June 2018 and September 2019. Twenty-seven health posts, 24 TB-units, 13 ambulatories, two family doctors and one polyclinic, serving 30% of DR-TB patients in the oblast by September 2019, were included. All facilities provided directly observed treatment, but only seven (10%) provided weekend-services. All facilities had at least one medical staff member, but TB-training was insufficient and mostly limited to TB-doctors. TB-medicines and storage space were available in all facilities, but only five (8%) stored ancillary medicines. HIV-patients had to visit a separate facility to access HIV-care. Personal protective equipment for infection control was unavailable in 32 (55%) facilities. Basic laboratory services were available in TB-units, but only 4 (17%) performed audiometry. Only ten (42%) TB-units had psychosocial support available, and nine (38%) psychiatric support. Conclusion: Outpatient facilities in Zhytomyr oblast are not yet prepared to provide comprehensive care for DR-TB patients. Capacity of all facilities needs strengthening with TB-training, infection control measures and infrastructure. Integration of psychosocial services, treatment of co-morbidities and adverse events at the same facility are essential for successful decentralisation. The health reform is an opportunity to establish quality, patient-centred care.
The fraction of Nitrous Oxide in oxygen for facilitating Lung collapse During One-Lung Ventilation with double lumen tube
Authors: liang chao , Lv Yuechang , Shi Yu , Cang Jing , Xue Zhanggang 
Published: March 2020

Abstract
Backgroud To the best of our knowledge, it is still unclear what is the proper fraction of nitrous oxide(N 2 O) in oxygen(O 2 ) for fast lung collapse. Therefore, we designed this prospective trial to determine the 50% effective concentration (EC 50 ) and 95% effective concentration (EC 95 ) of N 2 O in O 2 for fast lung collapse. Methods We studied 38 consecutive patients undergoing video-assisted thoracoscopic surgery(VATS). The lung collapse score(LCS) of each patient during one lung ventilation was evaluated by the same surgeon. The first patient received 30% N 2 O in O 2 , and subsequent N 2 O fraction in O 2 was determined by the LCS of previous patient using Dixon up-and-down method. The testing interval was set at 10%, and the lowest concentration was 10% (10%, 20%, 30%, 40%, or 50%). The EC 50 and EC 95 of N 2 O in O 2 for fast lung collapse were analyzed using probit test. Results The N 2 O fraction in O 2 at which all patients showed success lung collapse was 50%, according to the up-and-down method. The EC 50 and EC 95 of N 2 O in O 2 for fast lung collapse were 27.7% (95% confidence interval, 19.9%–35.7%) and 48.7% (95% confidence interval, 39.0%–96.3%), respectively. Conclusions In patients undergoing VATS, the EC 50 and EC 95 of N 2 O in O 2 for fast lung collapse were 27.7% and 48.7%, respectively.
Sedative and analgesic validity and administration routes of dexmedetomidine and fentanyl combined with ketamine in awake fiberoptic intubation: An exploratory randomized controlled trial
Authors: Li Chunzhu , Peng Jiali , Sun Yu , Hu Rong , Wang Hao , Yan Jia , Jiang Hong 
Published: March 2020

Abstract
Background: Awake fiberoptic bronchoscope intubation (AFOBI) is the gold standard technique for the management of patients with difficult airways. Adequate sedation and analgesia are essential for successful AFOBI. The aim of this study was to evaluate the sedative and analgesic validity and administration routes of dexmedetomidine and fentanyl combined with ketamine in awake fiberoptic intubation. Methods: Patients undergoing head and neck surgery under general anesthesia with predicted difficult airways were included. Participants were randomly assigned to 6 different groups (n=6): groups 1-3 were intravenous (IV), while groups 4-6 were intranasal(IN) (group 1: dexmedetomidine (DEX) 1 μg/kg + fentanyl (FEN) 1 μg/kg; groups 2-3: DEX 1 μg/kg+ FEN 0.7 μg/kg + ketamine (KTM) 0.1/0.2 mg/kg; group 4: DEX 1.5 μg/kg + FEN 1.4 μg/kg; and groups 5-6: DEX 1 μg/kg + FEN 1 μg/kg + KTM 0.4/0.6 mg/kg). The visual analog scale (VAS) score during intubation, time required for the modified observer’s assessment of alertness/sedation scale (OAA/S) score to reach above 2 and for the bispectral index (BIS) to decrease to 60-80, motor activity assessment scale (MAAS) score, changes in vital signs and adverse effects were recorded. Results: Among the IV groups, the VAS score of group 1 (5.65±2.11) was higher than those of group 2 (1.89±2.16, P =0.012) and group 3 (1.15±0.98, P =0.001). Among the IN groups, the VAS score was lower in group 6 (0.86±1.27) than in group 4 (7.20±2.70, P <0.001) and group 5 (3.93±2.73, P =0.031). Participants in group 5 and group 6 were less likely to cough when intubated than those in group 4 ( P =0.002), while the differences among IV groups were not significant. There were no significant differences in the other endpoints. Conclusions: Our study indicates that the addition of subanesthetic doses of ketamine, either intravenous or intranasal, could reduce the fentanyl and dexmedetomidine consumption used in AFOBI and provide better sedative and analgesic effects. Trial registration: Chinese Clinical Trial Registry (www.chictr.org.cn; ChiCTR1900021185), prospectively registered on February 1st, 2019.
The effects of dialysis modalities on the progression of coronary artery calcification in dialysis patients
Authors: NIU Qingyu , ZHAO Huiping , ZUO Li , WANG Mei , GAN Liangying 
Published: March 2020

Abstract
Objective Hemodialysis (HD) tend to have more hemodynamic changes than peritoneal dialysis (PD), which aggravates inflammation and oxidative stress. Whether HD and PD have different effects on the progression of vascular calcification? Therefore, we produced a study to explore the relationship of dialysis modalities and coronary artery calcification (CAC) progression. Methods This was a prospective cohort study. CT scans were performed at enrollment and 2 years later for each patient. Demographic and clinical data were collected. Tobit regression was used to compare delta CAC score between HD and PD patients. Results (1) 155 patients were enrolled, including 69 HD and 86 PD patients. (2) The baseline CAC scores were 97 (1, 744) in HD and 95 (0, 324) in PD; the follow-up CAC scores were 343 (6, 1379) in HD and 293 (18, 997) in PD. There were no significant differences in baseline, follow-up and delta CAC scores between 2 groups (P>0.05). (3) In Tobit regression, after adjusted for variables, there was no significant difference of CAC progression in HD and PD groups (P>0.05). (4) Logistic regression showed that older patients with diabetes and higher time-averaged serum phosphate (P) had faster progression of CAC (P<0.05), but HD wasn’t associated with faster CAC progression comparing with PD (P=0.091). Conclusions There was no evidence that different modalities have different effect on CAC progression. Older, DM and higher time-averaged P were associated with fast CAC progression.
Impact of Breath-Hold Level on Positional Error in Hepatobiliary Radiotherapy with Breath-Hold Respiratory Control
Authors: Huang Tzu-Jie , Tien Yun , Wu Jian-Kuen , Huang Wen-Tao , Cheng Jason Chia-Hsien 
Published: March 2020

Abstract
Background : Respiratory motion management with breath hold for patients with hepatobiliary cancers remains a challenge in the precise positioning for radiotherapy. We compared different image-guided alignment markers for estimating positional errors, and investigated the factors associated with positional errors under breath-hold control. Methods : Spirometric motion management system (SDX) for breath holds was used in 44 patients with hepatobiliary tumor. Among them, 28 patients had a stent or embolized materials (lipiodol) as alignment markers. Cone-beam computed tomography (CBCT) and kV-orthogonal images were compared for accuracy between different alignment references. Breath-hold level (BHL) was practiced, and BHL variation (ΔBHL) was defined as the standard deviation in differences between actual BHLs and baseline BHL. Mean BHL, ΔBHL, and body-related factors were analyzed for the association with positional errors. Results : Using the reference CBCT, the correlations of positional errors were significantly higher in those with stent/lipiodol than when the vertebral bone was used for alignment in three dimensions. Patients with mean BHL >1.4 L were significantly taller (167.6 cm vs. 161.6 cm, p=0.03) and heavier (67.1 kg vs. 57.4 kg, p=0.02), and had different positional error in the craniocaudal direction (-0.26 cm [caudally] vs. +0.09 cm [cranially], p=0.01) than those with mean BHL <1.4 L. Positional errors were similar for patients with ΔBHL<0.03 L and >0.03 L. Conclusion : Under rigorous breath-hold respiratory control, BHL correlated with body weight and height. With more accurate alignment reference by stent/lipiodol, actual BHL but not breath-hold variation was associated with craniocaudal positional errors.
RLC-Score (R-status, Lymphovascular invasion, C-reactive protein) predicts survival following radical cystectomy for muscle-invasive bladder cancer
Authors: Struck Julian , Hupe Marie C. , Heinisch Annika , Ozimek Tomasz , Hennig Martin J. P. , Klee M. , von Klot Christoph A. J. , Kalogirou Charis , Kuczyk Markus A. , Merseburger Axel S. , Kramer Mario W. 
Published: March 2020

Abstract
Background:The TNR-C score (tumor stage, lymph node density, resection margin status, and serum CRP) correlates with cancer specific survival (CSS) in patients with bladder cancer (BCa) undergoing radical cystectomy (RC). Our retrospective single center study aimed to evaluate CRP as a prognostic parameter in patients with BCa undergoing RC, to externally validate the TNR-C score, and based on the findings, to develop our own outcome score for muscle-invasive bladder cancer (MIBC) patients undergoing RC that can identify patients with a high risk of progression. Material and methods:In total, 254 patients who underwent RC at Hanover Medical School between 1996 and 2007 were reviewed. The clinicopathologic parameters assessed included age; co-morbidities; pre-/postoperative serum levels of CRP; leucocytes; hemoglobin; creatinine; urinary diversion; tumor grading, staging, and lymph node status; lymph node density (LND); lymphovascular invasion (LVI); metastases; and resection margin status. Regarding outcome, overall survival (OS) was assessed. Results:Single parameters of the TNR-C-score, such as T-stage (p=0.012) and R-status (p=0.002), were independent prognostic parameters for overall survival (OS). Univariate analysis showed a significant association of OS with the T-stage (pT2, p=0.001), R-status (p<0.001), LVI (p=0.011), and preoperative CRP level (p=0.02). The multivariate analysis excluding lymph node (LN) positive and metastatic patients showed a significant association of the R-status (R; p<0.001), LVI (L; p=0.021), and preoperative CRP level >5 mg/L (C; p=0.008) with OS. Based on these parameters, the RLC-score was developed. The median OS in the low, intermediate, and high-risk groups according to the RLC score was 62, 22, and 6.5 months, respectively. The score had a high predictive accuracy of 0.752.Conclusion:The RLC-score identifies BCa patients at a higher risk of disease progression and overall mortality after RC. Regarding the TNR-C score, only T-stage and R-status were independent prognostic factors for OS. Nevertheless, the survival curves showed a significantly lower OS for TNR-C high risk group members than low and intermediate risk group members. Overall, our study supports the role of CRP in prognostic score models for BCa.
Urinary tract infection is associated with hypokalemia: a case control study
Authors: Shen Ai-Ling , Lin Hsiu-Li , Lin Hsiu-Chen , Tseng Yuan-Fu , Hsu Chien-Yeh , Chou Che-Yi 
Published: March 2020

Abstract
BackgroundHypokalemia is a common clinical problem. The association between urinary tract infection (UTI) and hypokalemia is not clear. Hypokalemia is common in patients with UTI in clinical observation. The aim of the study is to determine if UTI is associated with hypokalemia.Methods Patients hospitalized with UTI and the control group were retrieved from the Longitudinal Health Insurance Database 2005. The control group was patients hospitalized with other reasons and were matched for the confoundings of UTI and hypokalemia. We analyze the risk of hypokalemia using logistic regression and calculate the odds ratio (OR) and 95% confidence interval (CI) of OR.ResultsWe analyzed 44952 UTI patients and 44952 matched control patients. The percentage (10.3%, n=4625) of hypokalemia was higher in UTI patients than that (5.2%, n=2342) in control patients (chi-square, p < 0.001). UTI was associated with hypokalemia (p < 0.001) and the OR was 2.04 (95% CI 1.94 - 2.16). Cerebrovascular accident, chronic obstructive pulmonary disease, diabetes, hypertension, congestive heart failure, and medications including diuretics, beta-blockers, insulin, and laxatives were also associated with hypokalemia. Recurrent UTI was associated with hypokalemia in patients with UTI.ConclusionsHypokalemia is linked to urinary tract infection and potassium should be tested in UTI patients. The association of hypokalemia and UTI is independent of patients’ comorbidities and medications.
A Comparison Of Text Mining Versus Diagnostic Codes To Identify Opioid Use Problem: A Retrospective Study​
Authors: Alzeer Abdullah , Jones Josette F , Bair Matthew J , Liu Xiaowen , Alfantoukh Lina A , Patel Jay , Dixon Brian E 
Published: March 2020

Abstract
Background As opioid prescriptions have risen, there has also been a rise in opioid overdose deaths and substance use disorders. Public health systems have tried to improve their ability to detect and intervene in opioid use disorders to prevent death due to overdose. The objective of this study is to compare two approaches to identify opioid use problems (OUP) using electronic health record data- text mining versus diagnostic codes.Methods Our sample consisted of adults on long-term opioid therapy (LTOT), defined as at least ≥ 70 days of supply within 90 days, and who visited a large multi-hospital network within a two-year period, between 1 January 2013 and 31 December 2014. We excluded patients with active cancer or schizophrenia. Text mining results were validated by a semi-assisted human review process and positive predictive value and level of agreement was reported. Each algorithm sought to identify patients who visited a health care facility due to an opioid poisoning event, opioid abuse, or opioid dependence. Population characteristics for positive OUP identified by text mining and ICD cohorts were compared. Chi-square and Fishers exact test were used for categorical data analysis and independent t-test was used to compare means for continuous variables. We further compared the demographics of the cohorts identified by the two methods.Results We identified 14,298 eligible LTOT patients. Text mining of relevant electronic clinical notes yielded 127 positive OUP cases compared to 45 cases using International Classification of Disease (ICD)-9 codes for the same population. Just eight OUP patients were identified using both methods. The two cohorts differed significantly with respect to age, gender, and other characteristics.Conclusions Compared to diagnostic codes, text mining identified more OUP cases with distinct characteristics. Incorporating text-mining techniques into OUP surveillance methods may support better detection of OUP and more accurate estimates of prevalence.
Bone regeneration potential of human dental pulp stem cells derived from elderly patients and induced by a helioxanthin derivative
Authors: Sato Marika , KAWASE-KOGA YOKO , Yamakawa Daiki , Fujii Yasuyuki , Chikazu Daichi 
Published: March 2020

Abstract
Background: Human dental pulp stem cells (DPSCs) have the ability to differentiate into multiple lineage cell types including adipogenic, neurogenic, and osteogenic cells. Dental pulp stem cells can be easily collected from extracted teeth and are now considered to be a type of mesenchymal stem cell with higher clonogenic and proliferative potential than bone marrow stem cells. Previous studies have described the osteogenic ability of DPSCs that were isolated from only young patients. However, in fact, elderly patients more frequently require bone regenerative therapy—for example, in alveolar bone defects resulting from periodontal disease—than young patients. We previously reported that 4-(4-methoxyphenyl)pyrido[40,30:4,5]thieno[2,3-b]pyridine-2-carboxamide (TH), a helioxanthin derivative, induces osteogenic differentiation of DPSCs derived from young patients. However, the effect of TH on the osteogenic differentiation potential of DPSCs derived from elderly patients remains unknown. Therefore, the present study aimed to examine and compare the osteogenic differentiation potential of TH-induced DPSCs from elderly patients and young patients to explore the potential clinical use of DPSCs for elderly patients.Methods: Dental pulp stem cells were obtained from the dental pulp of teeth of healthy young patients (18-39 years old) and healthy elderly patients (40-67 years old) and cultured in regular medium and osteogenic medium with or without TH. We assessed the morphological characteristics, proliferation, and osteogenic differentiation of DPSCs from both young and elderly patients. Moreover, DPSC sheets were transplanted into mouse calvarial defects to investigate osteogenesis of TH-induced DPSCs in vivo.Results: We demonstrated that osteogenic conditions with TH induce the osteogenic differentiation and osteogenesis of DPSCs from elderly patients as well as young patients more than osteogenic conditions without TH. Conclusions: Our results suggested that the osteogenic differentiation potential of DPSCs from elderly patients is as high as that of DPSCs from young patients. Moreover, TH-induced DPSCs show increased osteogenic differentiation potential, and they can be a useful cell source for bone regenerative therapy for not only young patients but also elderly patients.
Spatial and temporal patterns of Ross River virus in South East Queensland, Australia: identification of hot spots at the rural-urban interface
Authors: Murphy Amanda K. , Clennon Julie A. , Vazquez-Prokopec Gonzalo , Jansen Cassie C. , Frentiu Francesca D. , Hafner Louise M. , Hu Wenbiao , Devine Gregor J. 
Published: March 2020

Abstract
Background: Ross River virus (RRV) is responsible for the most common vector-borne disease of humans reported in Australia. The virus circulates in enzootic cycles between multiple species of mosquitoes, wildlife reservoir hosts and humans. Despite regular outbreaks, ongoing morbidity and substantial economic costs, the underlying determinants of epidemics remain unclear. Public health concern about RRV has recently increased due to rising incidence rates in Australian urban centres, along with increased circulation in Pacific Island countries. Australia experienced its largest recorded outbreak of 9,544 cases in 2015, with the majority reported from South East Queensland (SEQ). We aimed to provide a detailed analysis of disease trends and explore potential links between disease patterns and transmission pathways of RRV.Methods: We assessed the spatial and temporal distribution of notified RRV cases, and associated epidemiological features in SEQ, from 2001-2016. This included fine-scale analysis of disease patterns across the suburbs of the capital city of Brisbane, and those of 8 adjacent Local Government Areas, and host spot analyses to identify locations with significantly high incidence.Results: The mean annual incidence rate for the region was 41/100,000 with a consistent seasonal peak in cases between February and May. The highest RRV incidence was in adults aged from 30-64 years (mean incidence rate: 59/100,000), and females had higher incidence rates than males (mean incidence rates: 44/100,000 and 34/100,000, respectively). Spatial patterns of disease were heterogeneous between years, and there was a wide distribution of disease across both urban and rural areas of SEQ. Overall, the highest incidence rates were reported from predominantly rural suburbs to the north of Brisbane City, with significant hot spots located in peri-urban suburbs where residential, agricultural and conserved natural land use types intersect.Conclusions: Although RRV is endemic across all of SEQ, transmission is most concentrated in areas where urban and peri-urban environments intersect. The drivers of RRV transmission across rural-urban landscapes should be prioritised for further investigation, including identification of specific vectors and hosts that mediate human spillover.