bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of acyclovir use on survival of patients with ventilator-associated pneumonia and high load herpes simplex virus replication
Authors: Schuierer Lukas , Gebhard Michael , Ruf Hans-Georg , Jaschinski Ulrich , Berghaus Thomas M. , Wittmann Michael , Braun Georg , Busch Dirk H. , Hoffmann Reinhard 
Published: January 2020

AbstractBackgroundHerpes simplex virus (HSV) replication can be detected in the respiratory secretions of a high proportion of ventilated intensive care unit (ICU) patients. However, the clinical significance remains poorly defined. We investigated whether patients with ventilator-associated pneumonia not responding to antibiotics and in whom high levels of HSV could be detected in respiratory secretions benefit from acyclovir treatment.MethodsRespiratory secretions (bronchoalveolar lavage fluid or tracheal aspirates) were tested for HSV replication by quantitative real-time PCR. ICU survival times, clinical parameters, and radiographic findings were retrospectively compared between untreated and acyclovir treated patients with high (> 105HSV copies/mL) and low (103–105HSV copies/mL) viral load.ResultsFifty-seven low and 69 high viral load patients were identified. Fewer patients with high viral load responded to antibiotic treatment (12% compared to 40% of low load patients,p = 0.001). Acyclovir improved median ICU survival (8 vs 22 days,p = 0.014) and was associated with a significantly reduced hazard ratio for ICU death (HR = 0.31, 95% CI 0.11–0.92,p = 0.035) in high load patients only. Moreover, circulatory and pulmonary oxygenation function of high load patients improved significantly over the course of acyclovir treatment: mean norepinephrine doses decreased from 0.05 to 0.02 μg/kg body weight/min between days 0 and 6 of treatment (p = 0.049), and median PaO2/FiO2ratio increased from 187 to 241 between day 3 and day 7 of treatment (p = 0.02). Chest radiographic findings also improved significantly (p < 0.001).ConclusionsIn patients with ventilator-associated pneumonia, antibiotic treatment failure, and high levels of HSV replication, acyclovir treatment was associated with a significantly longer time to death in the ICU and improved circulatory and pulmonary function. This suggests a causative role for HSV in this highly selected group of patients.
Impact of sodium–glucose cotransporter 2 inhibitors on renal function in participants with type 2 diabetes and chronic kidney disease with normoalbuminuria
Authors: Nakamura Akinobu , Miyoshi Hideaki , Kameda Hiraku , Yamashita Kumiko , Kurihara Yoshio 
Published: January 2020

Abstract
Background
We compared the effects of sodium–glucose cotransporter 2 (SGLT2) inhibitors on renal function in participants with type 2 diabetes and chronic kidney disease (CKD) classified by degree of albuminuria.

Methods
A retrospective review of the clinical records of Japanese participants with type 2 diabetes (age > 20 years; SGLT2 inhibitor treatment > 2 years; estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2) was conducted. Based on the urinary albumin-to-creatinine ratio (UACR) or urinary protein-to-creatinine ratio (UPCR) at the start of SGLT2 inhibitor administration, participants were categorized into three groups: normoalbuminuria (A1; UACR < 30 mg/g Cr or UPCR < 0.15 g/g Cr), microalbuminuria (A2; UACR 30 to < 300 mg/g Cr or UPCR 0.15 to < 0.50 g/g Cr), and macroalbuminuria (A3; UACR ≥ 300 mg/g Cr or UPCR ≥ 0.50 g/g Cr). The study outcome was a comparison of the rates of change in renal function evaluated by eGFR at 2 years after starting SGLT2 inhibitor among the three groups.

Results
A total of 87 participants (40 females, 47 males) were categorized into three groups: A1 (n = 46), A2 (n = 25), and A3 (n = 16). eGFR was similarly decreased at 2 years before starting SGLT2 inhibitor in all three groups. However, the decline in eGFR was ameliorated at 2 years after starting SGLT2 inhibitor, and eGFR was rather increased in the A1 and A2 groups. Interestingly, the rate of change in eGFR at 2 years after starting SGLT2 inhibitor in the A1 group was significantly higher than that in the A3 group.

Conclusions
These results demonstrate that more favorable effects of SGLT2 inhibitors on renal function were observed in participants with type 2 diabetes and CKD with normoalbuminuria compared with those with macroalbuminuria.
Trial registration UMIN-CTR: UMIN000035263. Registered 15 December 2018
Futureproofing triathlon: expert suggestions to improve health and performance in triathletes
Authors: Kennedy Michael D. , Knight Camilla J. , Falk Neto Joao Henrique , Uzzell Katie S. , Szabo Sara W. 
Published: January 2020

Abstract
Background
Given the multi-modal nature of triathlon (swimming, cycling, running), training for a triathlon event has numerous potential health benefits including physical fitness. However, triathletes also have a high prevalence of health issues including overuse injury, illness, fatigue, and burnout. To address the ongoing prevalence of health issues, roundtable discussions were organized at the International Triathlon Union Science of Triathlon 2017 conference to develop strategic objectives deemed necessary to “futureproof triathlon”. Futureproofing as a concept serves to design new approaches and ways of thinking to reduce consequences in the future. In this case, the futureproof process aimed to develop key recommendations for triathlon.

Methods
This qualitative study had 22 participants including athletes, coaches, practitioners, academics, and policy makers who participated in roundtable discussions at the Science of Triathlon conference. Seven of these participants completed follow-up semi-structured interviews on the same topics. The data collected from the roundtable discussions and the semi-structured interviews was analyzed using thematic analysis.

Results
Five main themes were produced: “Critical appraisal and application of knowledge”; “Integrated approaches to developing, disseminating, and using research and expertise”; “Appropriate development and use of measures for monitoring training and recovery”; “Knowing your athletes and adopting holistic approaches to athlete/person-development”, and; “Challenging accepted cultural and sporting norms”. Participants indicated the need to reduce the knowledge gap between research and practice as well as a more collaborative approach to triathlon research development amongst coaches/practitioners and academics. It was stated that current monitoring tools require more research to determine which are most useful to informed decision making for coaches/practitioners. It was cautioned that data driven assessments should be used judiciously and be athlete centered. Triathlon as a sport should also have a greater focus on healthy participation and development of youth athletes.

Conclusions
A series of applied implications were developed based on these five themes as guiding principles for how to futureproof triathlon. Additionally, roundtable and interview participants who held varying positions and opinions within the sport of triathlon agreed that the unique challenge of training for and competing in a triathlon should not be forgotten in the futureproofing of the sport.
Intensive, personalized multimodal rehabilitation in patients with primary or revision total knee arthroplasty: a retrospective cohort study
Authors: Larsen Jesper Bie , Mogensen Lisbeth , Arendt-Nielsen Lars , Madeleine Pascal 
Published: January 2020

Abstract
Background
Recent evidence has shown that many patients suffer from persistent pain and impaired function after primary or revision total knee arthroplasty (TKA). Post-surgical complications may in addition decrease physical performances and lead to more pain and impacted quality of life.
The purpose of the study was to assess the changes in pain intensity and functional capacity among patients with post-surgical complications after TKA three weeks of intensive, personalized multimodal rehabilitation.

Methods
A retrospective cohort study consisting of 217 patient of which 166 had primary TKA and 51 had revision TKA was conducted. On average, primary TKA patients and revision TKA patients were 3.7 and 2.7 months post-surgical, respectively. All patients have had post-surgical complications and were referred to an inpatient rehabilitation department, where they received a personalized three-week intensive, multimodal rehabilitation protocol. The rehabilitation consisted of sessions targeting neuromuscular function, postural control, and flexibility, sessions focusing on improving muscle strength and cardiovascular function and sessions with focus on gait retraining. The frequency of training was 2–4 sessions/day. The primary outcome was the Knee injury and Osteoarthritis Outcome Score (KOOS) and secondary outcomes were pain intensities measured using numerical rating scale, 6 min. walking test, stair-climbing test and range of motion for knee flexion and extension. Outcome measures were assessed at baseline upon referral and at follow-up before discharge.

Results
All outcomes, except pain at rest in the revision group, improved significantly. KOOS subscales, improved 8.5 to 14.2 in the primary TKA group (p < 0.001) and 6.9 to 10.8 in the revision group (p < 0.001). For the TKA group, effect sizes were medium-to-large for all KOOS subscales, 6 min. walking test, stair-climbing test, and pain intensity during activity. For the revision group, effect sizes were medium-to-large for KOOS subscales symptoms and activity of daily living, 6 min. walking test, stair-climbing test, and knee flexion.

Conclusion
Patients with post-surgical complications after primary or revision TKA experienced clinical relevant improvement in self-reported outcomes, pain relief, and improved physical performances after three weeks of personalized multimodal rehabilitation. The results suggest that an intensive, multimodal approach might be useful to obtain clinically relevant improvements.
Program for data extraction in primary health records: a valid tool for knowledge production in general practice?
Authors: Holte Martin , Holmen Jostein 
Published: January 2020

Abstract
Objectives
Research in general practice demands it-tools which give the practitioner trusty results. Medrave 4 is a program designed for extraction of data from all areas of the health record. We wanted to do research on the database in a health center, but found no proof of the quality of the data extracted by Medrave 4. Today the database contains about 40,000 records. In this study we wanted to examine if the program could extract correct data.

Results
From the database 20 records were randomly selected from five different time periods, making a total of 100 records. 14 records did not meet the inclusion criteria, resulting in 86 records included in the study. In phase one these variables were registered manually from the records: Age, gender, systolic and diastolic blood pressure (from free text) and six different laboratory tests. In phase two, Medrave 4 extracted the same variables from the same records. Medrave 4 found correct systolic and diastolic blood pressure values in 79 records (92%). The laboratory results were extracted correct in all 86 records (100%). We conclude that Medrave 4 can be a useful tool in quantifying the work of general practitioners.
Evaluation of antimicrobial resistance, biofilm forming potential, and the presence of biofilm-related genes among clinical isolates of Pseudomonas aeruginosa
Authors: Kamali Esmat , Jamali Ailar , Ardebili Abdollah , Ezadi Freshteh , Mohebbi Alireza 
Published: January 2020

Abstract
Objectives
Pseudomonas aeruginosa is known as a leading cause of nosocomial infections worldwide. Antimicrobial resistance and biofilm production, as two main virulence factors of P. aeruginosa, are responsible for the persistence of prolonged infections. In this study, antimicrobial susceptibility pattern and phenotypic and genotypic characteristics of biofilm of P. aeruginosa were investigated.

Results
A total of 80 clinical P. aeruginosa isolates were obtained. Isolates showed resistance to all antibiotics with a rate from 12.5% (n = 10) against amikacin and piperacillin/tazobactam to 23.75% (n = 19) to levofloxacin. Multidrug-resistant P. aeruginosa accounted for 20% (n = 16). 83.75% (n = 67) of isolates showed biofilm phenotype. All three biofilm-related genes were found simultaneously in 87.5% (n = 70) of P. aeruginosa and 13.5% (n = 10) of the isolates had none of the genes tested. From the results of the present study, combination therapy including an anti-pseudomonal beta-lactam (piperacillin/tazobactam or ceftazidime) and an aminoglycoside or carbapenems (imipenem, meropenem) with fluoroquinolones in conjunction with an aminoglycoside can be used against Pseudomonas infections. However, reasonable antimicrobial use and high standards of infection prevention and control are essential to prevent further development of antimicrobial resistance. Combination strategies based on the proper anti-pseudomonal antibiotics along with anti-biofilm agents can also be selected to eradicate biofilm-associated infections.
Feasibility study on recruitment in general practice for a low back pain online information study (part of the ADVIN Back Trial)
Authors: Riis Allan , Rathleff Michael Skovdal , Hartvigsen Jan , Thomsen Janus Laust , Afzali Tamana , Jensen Martin Bach 
Published: January 2020

Abstract
Objective
In a future full-scale randomised controlled trial, we plan to compare satisfaction with a standard website versus satisfaction with a participatory driven web-application. The participatory driven web-application may facilitate the delivery of targeted evidence-based advice and information to patients with low back pain in general practice (ClinicalTrials.gov Identifier: NCT03088774). This feasibility study is intended to inform a future randomised controlled trial. The aim is to report on the lessons learned from recruitment to report on reasons for loss to follow-up.

Results
We recruited 12 women and 8 men from two general practices with each practice recruiting for 3 months. Full follow-up data was available in only three patients (15%). Based on the high loss to follow-up, we do not consider it feasible to conduct the full-scale confirmatory trial as planned. Modifying inclusion criteria to include only patients expressing an interest in using online health information or randomising patients directly at the general practice, supporting them in accessing the web-application, and letting patients respond with their immediate satisfaction may improve the speed of recruitment and follow-up rates. Furthermore, the participatory driven web-application can be included in a larger multi-faceted intervention, making the combined intervention seem more relevant to study participants.
Using examination performance data and focus groups to inform teaching – a case study from final year students of veterinary medicine
Authors: McAloon Conor G. , Kelly Emmet , Rackard Sue , McAloon Catherine , Beltman Marijke , O’Grady Luke , Viora Lorenzo , Crowe Mark , Doherty Michael L. , Ryan Eoin G. 
Published: January 2020

Abstract
Background
Student feedback has played an important role in the maintenance of quality and standards in higher education. Perhaps the most commonly used method to capture feedback is a series of questions or statements where students indicate their degree of satisfaction or agreement. Focus groups offer an alternative means of capturing ‘richer’ qualitative data relating to students’ thoughts on course structure. Aside from student evaluations, student examination performance has been used as a method to evaluate the efficacy of curriculum changes at programme level. However, this data is utilised less so at a ‘finer detail’ level to identify specific issues with the delivery of teaching.

Case presentation
The purpose of this report was to outline the approach taken using qualitative and quantitative data to identify problems with a specific area of teaching, inform a new teaching approach and to assess the impact of those changes. Following quantitative and qualitative analysis, a practical class on dairy herd fertility performance was highlighted as an area for improvement. After the introduction of the newly formatted practical class with a greater focus on self-directed learning, there was a significant increase in the average score (p < 0.001) and a decrease in the proportion of students failing (p < 0.001) the question that assessed the analysis of dairy herd fertility data. In addition, the R-squared value between students’ performance in the fertility question and their performance in the overall examination increased from 0.06 to 0.11.

Conclusions
The combination of qualitative focus group data and quantitative analysis of examination performance data represent robust methods for identifying problems associated with specific aspects of veterinary teaching.
A case of stage IV gastric cancer with para-aortic lymph node metastasis showing pathological complete response after neoadjuvant chemotherapy
Authors: Katsura Yuki , Okabayashi Takehiro , Matsumoto Manabu , Ozaki Kazuhide , Shibuya Yuichi 
Published: January 2020

Abstract
Background
Stage IV advanced gastric cancer with para-aortic lymph node metastasis (PALM) is considered unresectable. Systemic chemotherapy is the treatment of choice for such tumors, while conversion surgery may be a treatment option in the case chemotherapy is effective but R0 resection is possible. We report a case of stage IV gastric cancer with PALM that showed pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) using S-1, oxaliplatin, and trastuzumab (SOX+HER).

Case presentation
A 69-year-old woman who was diagnosed with type 4 stage IV gastric cancer with PALM underwent five courses of NAC with the SOX+HER regimen. The primary tumor and the PALM shrank after treatment, suggesting that the NAC induced a partial response. We performed a total gastrectomy plus distal pancreaticosplenectomy with para-aortic lymph node dissection. Histological analysis revealed no remnant cancer cells in the primary tumor or the lymph nodes, confirming a pCR. The postoperative course was uneventful, and the patient was discharged on day 14 after the operation. S-1 was started as adjuvant chemotherapy, and the patient remains alive without recurrence 2 months after surgery.

Conclusion
This case shows the possibility of conversion surgery after SOX+HER therapy for stage IV advanced gastric cancer with PALM.
Electrical interferential current stimulation versus electrical acupuncture in management of hemiplegic shoulder pain and disability following ischemic stroke-a randomized clinical trial
Authors: Eslamian Fariba , Farhoudi Mehdi , Jahanjoo Fatemeh , Sadeghi-Hokmabadi Elyar , Darabi Parvin 
Published: January 2020

Abstract
Background
Hemiplegic Shoulder Pain (HSP) is among common complications occurring after stroke leading to disability. This study was conducted to compare the effects of electrical Interferential Current stimulation (IFC) and Electrical Acupuncture (EAC) on pain intensity, range of motion, and functional ability in patients with HSP and also comparing the two modalities regarding improvement of above indices.

Methods
In this randomized clinical trial, 46 patients with HSP caused by ischemic stroke were recruited and assigned into 2 groups. Conventional exercise trainings were applied for both groups. Group A received additional IFC with medium frequency of 4000 HZ, and Group B received additional EAC two times a week for a total of 10 sessions. Pain severity, daily function, and shoulder Range of Motion (ROM) were evaluated using Visual Analogue Scale (VAS), Shoulder Pain and Disability Index (SPADI), and goniometry, respectively before and 5 weeks after the treatment.

Results
Both groups showed relative improvement in pain severity, SPADI score, and its subscales, and also active and passive shoulder ROM after the treatment. However, IFC group compared to EAC group had higher mean changes of active ROM in abduction (28.00 ± 3.81 vs. 12.25 ± 2.39) and functional subscale of SPADI (11.45 ± 1.88 vs. 5.80 ± 1.66) after the treatment. On the contrary, EAC group showed higher percentage of VAS changes (46.14 ± 6.88 vs. 34.28 ± 5.52), indicating better pain improvement compared to IFC group. Other parameters did not show significant difference between two groups.

Conclusion
Both IFC and EAC caused short term improvement in functional state, increased motion, and decreased pain in patients with HSP. Although pain control was more evident in acupuncture group, IFC resulted in better effects on function and active ROM of abduction, and seems to have higher efficacy.

Trial registration
This clinical trial was registered in the Iranian Registry of Clinical Trials at 2016-07-16 with a registry number of IRCT201602153217N10.
Dissection-related carotid-cavernous fistula (CCF) following surgical revascularization of chronic internal carotid artery occlusion: a new subtype of CCF and proposed management
Authors: Liu Ao-Fei , Li Chen , Yu Wengui , Lin Li-Mei , Qiu Han-Cheng , Zhang Yi-Qun , Lv Xian-Li , Wang Kai , Liu Ce , Jiang Wei-Jian 
Published: January 2020

Abstract
Background
The development of carotid-cavernous fistulas (CCFs) during surgical recanalization of chronic internal carotid artery occlusion (ICAO) may be secondary to severe ICA dissection rather than a focal tear of the cavernous ICA seen in typical traumatic CCFs. The purpose of this study is to investigate the causal relationship between the CCFs and severe ICA dissections and to characterize technical outcomes after treatment with stenting.

Methods
Five patients underwent treatment with self-expanding stents due to intraprocedural CCF and ICA dissection following surgical removal of ICAO plaque. The stents were telescopically placed via true channel of the dissection. Safety of the procedure was evaluated with 30-day stroke and death rate. Procedural success was determined by the efficacy of CCF obliteration and ICAO recanalization with angiography.

Results
All CCFs were associated with spiral and long segmental dissection from the cervical to cavernous ICA. After stenting, successful dissection reconstruction with TICI 3 was achieved in all patients, with complete (n = 4) or partial CCF (n = 1) obliteration. No patient had CCF syndrome, stroke, or death during follow-up of 6 to 37 months; but one patient had pulsatile tinnitus, which resolved 1 year later. Angiography at 6 to 24 months demonstrated CCF obliteration in all 5 patients and durable ICA patency in 4 patients.

Conclusions
Intraprocedural CCFs with spiral and cervical-to-cavernous ICA dissection during ICAO surgery are dissection-related because of successful obliteration after stenting for dissection reconstruction. Self-expanding stenting through true channel of the dissection, serving as implanting stent-autograft, may be an optimal therapy for the atypical CCF complication from ICAO surgery.
Impact of internship programs on professional and personal development of business students: a case study from Pakistan
Authors: Anjum Sadia 
Published: January 2020

AbstractThis study aims to evaluate the impact of internship programs on the professional as well as on personal development and skills of business students in Pakistan. The data of the study consisted of 800 undergraduating business students of 4-year degree programs from 15 universities of Pakistan. The study used structured questionnaire (35 close-ended questions assessed using 5-point Likert scale) comprised of six parts: Part I: Demographic information, Part II: Reasons for participation in internship, and Part III to VI: Assessment of information related to professional and personal growth and skills. The study employed descriptive analysis to evaluate demographic information and central tendencies of the responses. Furthermore, scale measurement analysis is used to check distribution normality of study data and reliability of the questionnaire. The results of the study depict the impact of internship programs on the professional and personal growth and skills of the business students of Pakistan.