bluuebunny/crossref_metadata_2025_split huggingface dataset:
Benefit of selective shunt use during carotid endarterectomy under regional anesthesia
Authors: Rocha-Neves João M , Pereira-Macedo Juliana , Dias-Neto Marina F , Andrade José Paulo , Mansilha Armando A 
Published: May 2020

Objectives Carotid cross-clamping during endarterectomy exposes the patient to intraoperative neurological deficits due to embolism or cerebral hypoperfusion. To prevent further cerebrovascular incidents, resorting to shunt is frequently recommended. However, since this method is also considered a stroke risk factor, the use is still controversial. This study aims to shed some light on the best approach regarding the use of shunt in symptomatic cerebral malperfusion after carotid artery cross-clamping. Methods From January 2012 to January 2018, 79 patients from a tertiary referral hospital who underwent carotid endarterectomy with regional anesthesia for carotid artery stenosis and manifested post-clamping neurologic deficits were prospectively gathered. Shunt use was left to the decision of the surgeon and performed in 31.6% (25) of the patients. Demographics, comorbidities, imaging tests, and clinical/intraoperative features were evaluated. For data assessment, univariate analysis was performed. Results Regarding 30-day stroke, 30-day postoperative complications (stroke, surgical hematoma, hyperperfusion syndrome), and cranial nerve injury, no significant differences were found ( P = 0.301, P = 0.460, and P = 0.301, respectively) between resource to shunt and non-shunt. Clamping and surgery times were significantly higher in the shunt group ( P < 0.001 and P = 0.0001, respectively). Conclusions Selective-shunting did not demonstrate superiority for patients who developed focal deficits regarding stroke or other postoperative complications. However, due to the limitations of this study, the benefit of shunting cannot be excluded. Further randomized trials are recommended for precise results on this matter with current sparse clinical evidence.
Syndrome of inappropriate antidiuretic hormone secretion following bipolar transurethral resection of the prostate
Authors: Rezvani Sean , Taktak Samih , Brough Richard 
Published: May 2020

Syndrome of inappropriate antidiuretic hormone secretion following minimally invasive surgery is extremely rare, having only been reported in a handful of cases. We present the second documented case of syndrome of inappropriate antidiuretic hormone secretion following transurethral resection in an 80-year-old male undergoing bipolar transurethral resection of the prostate for bladder outflow obstruction. Level of evidence: 5
The application of a neural network to predict hypotension and vasopressor requirements non-invasively in obstetric patients having spinal anesthesia for elective cesarean section (C/S)
Authors: Gratz Irwin , Baruch Martin , Takla Magdy , Seaman Julia , Allen Isabel , McEniry Brian , Deal Edward 
Published: May 2020

Abstract
Background
Neural networks are increasingly used to assess physiological processes or pathologies, as well as to predict the increased likelihood of an impending medical crisis, such as hypotension.

Method
We compared the capabilities of a single hidden layer neural network of 12 nodes to those of a discrete-feature discrimination approach with the goal being to predict the likelihood of a given patient developing significant hypotension under spinal anesthesia when undergoing a Cesarean section (C/S). Physiological input information was derived from a non-invasive blood pressure device (Caretaker [CT]) that utilizes a finger cuff to measure blood pressure and other hemodynamic parameters via pulse contour analysis. Receiver-operator-curve/area-under-curve analyses were used to compare performance.

Results
The results presented here suggest that a neural network approach (Area Under Curve [AUC] = 0.89 [p < 0.001]), at least at the implementation level of a clinically relevant prediction algorithm, may be superior to a discrete feature quantification approach (AUC = 0.87 [p < 0.001]), providing implicit access to a plurality of features and combinations thereof. In addition, the expansion of the approach to include the submission of other physiological data signals, such as heart rate variability, to the network can be readily envisioned.

Conclusion
This pilot study has demonstrated that increased coherence in Arterial Stiffness (AS) variability obtained from the pulse wave analysis of a continuous non-invasive blood pressure device appears to be an effective predictor of hypotension after spinal anesthesia in the obstetrics population undergoing C/S.
This allowed us to predict specific dosing thresholds of phenylephrine required to maintain systolic blood pressure above 90 mmHg.
A melting, encapsulated, calcified pulmonary nodule in a healthy 51-year-old woman: a case report
Authors: Chang Hsu-Chao , Lee Yi-Hsin , Yang Mei-Chen 
Published: May 2020

Abstract
Background
Foreign body aspiration is less common in healthy adults, which makes diagnosis difficult. Early detection of smaller/sharp foreign bodies in the distal airway is more difficult because patients might have no symptoms and imaging studies could appear normal.
Here we describe the course of a small, sharp foreign body (chicken bone) lodged in the distal airway of a healthy middle-aged woman. The chicken bone was initially thought to be an old calcified tuberculoma. However, it was encased in a dilated bronchus without obvious surrounding lymphadenitis or parenchymal infiltration, and it melted with time. Two years later, histopathological examination revealed that the calcified lesion was an aspirated chicken bone with a concomitant tuberculoma.

Case presentation
A 51-year-old woman showed an old calcified tuberculoma in the upper right lung lobe during routine examinations. It was “encased” in a dilated bronchus, although it was not raised from the surrounding lung parenchyma. The size of the calcified part decreased (“melted”) with time, and the surrounding inflammation progressed 2 years later, a phenomenon never described in association with tuberculosis. Bronchoscopy revealed a fragment of chicken bone lodged in the next two branches of the upper right posterior bronchus. Surgical segmentectomy was performed, and histopathological examination revealed that the calcified lesion was formed by a fragment of chicken bone as well as a tuberculoma. Eventually, the patient recalled an episode of choking on a chicken bone 5 years ago; she believed that she had coughed it out completely at that time.

Conclusions
The “melting” and “encased” phenomena observed in the present case could be useful imaging findings for early detection of small foreign body aspiration in the distal airway.
Systematic review and meta-analysis of clinical outcomes comparison between different initial dialysis modalities in end-stage renal disease patients due to lupus nephritis prior to renal transplantation
Authors: Swai Joel , Zhao Xiexiong , Noube Julie-Raisa , Ming Gui 
Published: May 2020

AbstractBackgroundRegarding lupus disease activity, morbidity and survival, limited literature concluded conflicting results when comparing hemodialysis versus peritoneal dialysis as initial renal replacement therapies (RRT) prior to transplantation, in lupus nephritis end-stage renal disease (LN-ESRD) patients. This study was aimed to compare the risks of lupus flares, all-cause infections, all-cause cardiovascular events, and mortality, between hemodialysis versus peritoneal dialysis as initial RRT - modality before renal-transplant in LN-ESRD patients, by systematic review and meta-analysis.MethodsPubMed, EMBASE, and SCOPUS were searched for observational-studies comparing LN-ESRD -patients undergoing hemodialysis (Group1) versus peritoneal-dialysis (Group 2) prior to renal-transplantation, by their risks of lupus flare, all-cause infections, all-cause cardiovascular events, and mortality as outcome measures. Relative-Risks of outcomes between the groups measured overall effects at a 95% significance level. RevMan 5.3 computer software was used for analysis.ResultsFrom search, 16 eligible studies reported 15,636 LN-ESRD -patients prior to renal transplantation with 4616 patients on hemodialysis, 2089 on peritoneal dialysis, 280 directly underwent kidney transplantation, 8319 were eliminated with reasons and 332 participants’ details were not reported. Hemodialysis group had higher risk of all-cause cardiovascular events, Relative-Risk = 1.44 (Confidence Interval:1.02, 2.04),p-Value< 0.05. With regards to risks for mortality, flare and all-cause infections, there were trends that were not statistically significant (p-Value> 0.05).ConclusionExcept for all-cause cardiovascular events in which peritoneal dialysis is superior to hemodialysis offering better outcomes, both treatment modalities offer more or less similar clinical outcomes as effective initial choices of RRT in LN-ESRD patients prior to renal transplant.The protocol registrationPROSPERO 2019CRD42019131600.
Prospective evaluating the appropriate use of piperacillin /tazobactam in cardiac center of a tertiary care hospital
Authors: Mekdad Sanaa Saeed , AlSayed Leenah 
Published: May 2020

Abstract
Background
The appropriate use of Piperacillin/Tazobactam (Pip/Taz), including the correct dose, escalating and or de-escalation according to the microbiological culture is essential to reduce the antibiotic resistance. Resistant to antimicrobials in a major global problem and contributes significantly to morbidity, mortality and cost of care. Guidelines exists to ensure appropriate use of Pip/Taz. Antibiotics Stewardship guidelines (https://apps.who.int/iris/bitstream/handle/10665/329404/9789241515481-eng.pdf) provides a detailed recommendation with regards to initiation, monitoring and escalation and de-escalation based on final culture results. Appling such guidelines ensures a more proper utilization of the empiric uses of antibiotics used in the hospital-based setting. Use of Pip/Taz in cases of suspected infection postoperatively is common practice in the cardiac surgery ward where this study was conducted.

Methods
This was a prospective cohort study involving all patients who were admitted to the cardiac surgery unit of a tertiary care center. All patient prescribed at least 1 day of Pip/Taz as an empirical therapy were included and prospectively observed. We aimed to evaluate the use of Pip/Taz and its appropriateness based on Antibiotics Stewardship guidelines (ASG). Any deviation from the guidelines in initiation, escalation, de-escalation based on culture and sensitivity results was considered inappropriate use. Four patients died (1.3%) early as result of complications for surgery but included in the analysis. The study was conducted from October 2017 to October 2018.

Results
Of the 300 patients who received Pip/Taz Cultures were done in 250 patients (83%). The overall appropriate use of Pip/Taz was seen in 166 patients (55.3%).

Conclusion
The empirical use of Pip/Taz in the surgical cardiac unit was largely inappropriate and not entirely driven by the culture test results. Interventions are needed to optimize the use of Pip/Taz including appropriate culture and sensitivity driven use and timely de-escalation or de-escalation when indicated. This will prevent emergence of resistance and reduce the patient toxicity and financial costs.
Human adipose-derived mesenchymal stem cell-conditioned medium ameliorates polyneuropathy and foot ulceration in diabetic BKS db/db mice
Authors: De Gregorio Cristian , Contador David , Díaz Diego , Cárcamo Constanza , Santapau Daniela , Lobos-Gonzalez Lorena , Acosta Cristian , Campero Mario , Carpio Daniel , Gabriele Caterina , Gaspari Marco , Aliaga-Tobar Victor , Maracaja-Coutinho Vinicius , Ezquer Marcelo , Ezquer Fernando 
Published: May 2020

AbstractBackgroundDiabetic polyneuropathy (DPN) is the most common and early developing complication of diabetes mellitus, and the key contributor for foot ulcers development, with no specific therapies available.Different studies have shown that mesenchymal stem cell (MSC) administration is able to ameliorate DPN; however, limited cell survival and safety reasons hinder its transfer from bench to bedside. MSCs secrete a broad range of antioxidant, neuroprotective, angiogenic, and immunomodulatory factors (known as conditioned medium), which are all decreased in the peripheral nerves of diabetic patients. Furthermore, the abundance of these factors can be boosted in vitro by incubating MSCs with a preconditioning stimulus, enhancing their therapeutic efficacy. We hypothesize that systemic administration of conditioned medium derived from preconditioned MSCs could reverse DPN and prevent foot ulcer formation in a mouse model of type II diabetes mellitus.MethodsDiabetic BKSdb/dbmice were treated with systemic administration of conditioned medium derived from preconditioned human MSCs; conditioned medium derived from non-preconditioned MSCs or vehicle after behavioral signs of DPN was already present. Conditioned medium or vehicle administration was repeated every 2 weeks for a total of four administrations, and several functional and structural parameters characteristic of DPN were evaluated. Finally, a wound was made in the dorsal surface of both feet, and the kinetics of wound closure, re-epithelialization, angiogenesis, and cell proliferation were evaluated.ResultsOur molecular, electrophysiological, and histological analysis demonstrated that the administration of conditioned medium derived from non-preconditioned MSCs or from preconditioned MSCs to diabetic BKSdb/dbmice strongly reverts the established DPN, improving thermal and mechanical sensitivity, restoring intraepidermal nerve fiber density, reducing neuron and Schwann cell apoptosis, improving angiogenesis, and reducing chronic inflammation of peripheral nerves. Furthermore, DPN reversion induced by conditioned medium administration enhances the wound healing process by accelerating wound closure, improving the re-epithelialization of the injured skin and increasing blood vessels in the wound bed in a skin injury model that mimics a foot ulcer.ConclusionsStudies conducted indicate that MSC-conditioned medium administration could be a novel cell-free therapeutic approach to reverse the initial stages of DPN, avoiding the risk of lower limb amputation triggered by foot ulcer formation and accelerating the wound healing process in case it occurs.
Approximation on a class of Phillips operators generated by q-analogue
Authors: Alotaibi Abdullah 
Published: May 2020

AbstractThe main purpose of this article is to introduce a new generalization ofq-Phillips operators generated by Dunkl exponential function. We establish some approximation results for these operators. We also determine the order of approximation, and the rate of convergence in terms of the modulus of continuity of order one and two. Moreover, we obtain some direct theorems.
A systematic review and meta-analysis of anti-epileptic medication non-adherence among people with epilepsy in Ethiopia
Authors: Belayneh Zelalem , Mekuriaw Birhanie 
Published: May 2020

AbstractBackgroundEpilepsy is the common neurological disorder in the world, affecting approximately 50 million people. Anti-epileptic medication non-adherence can be a reason for long term hospitalization, repeated emergency seizure attacks, increased health care cost and frequent absence of work due to poor seizure control. Existed studies of anti-epileptic medication non-adherence in Ethiopia have reported great discrepant and inconsistent results which calls a growing demand of systematic review and meta-analysis. Therefore, this review aimed to show the pooled prevalence of anti-epileptic medication non-adherence among people with epilepsy attending outpatient department.MethodsLiteratures were searched from the PubMed/Medline, Science Direct, PsycINFO, Hinnari and Google Scholar for grey literatures. The data were extracted using a prepared data extraction Microsoft Excel format. The data were analyzed using STATA- version 14 (software). The I2test was used to check the heterogeneity between primary studies with a corresponding 95% confidence interval.ResultsA total of fourteen primary studies of anti-epileptic medication non-adherence were included in the review showing the pooled prevalence of anti-epileptic medication non-adherence to be 39.77 (95% CI: 32.44, 47.10). The highest prevalence [44.13 95% CI: (29.92, 58.34)] was observed among studies used both self-report and medical record review together, and studies used only self-report to screen medication none adherence had the lowest prevalence [37.95% (24.50, 51.41)]. Presence of co-morbid illness [2.27 (95%CI: 1.01, 5.12)], medication side effects [1.84(95% CI: 1.43, 2.38)], substance use or drug abuse [2.01(95% CI: 1.27, 3.20)] had statistically significant association with anti-epileptic medication non-adherence.ConclusionIn this review, we found that there is a high burden of anti-epileptic medication non-adherence among people with epilepsy in Ethiopia. This demonstrates a need for clinicians to give more attention for the monitoring and evaluation of anti-epileptic medication adherence in the health care service. We also highly recommended for the adoption of a standardized and contextualized adherence screening tools.Trial registrationPROSPERO registration number-[CRD42019137631].
Dosing parameters for the effects of high-frequency transcranial magnetic stimulation on smoking cessation: study protocol for a randomized factorial sham-controlled clinical trial
Authors: Carl Ellen , Liskiewicz Amylynn , Rivard Cheryl , Alberico Ronald , Belal Ahmed , Mahoney Martin C. , Quisenberry Amanda J. , Bickel Warren K. , Sheffer Christine E. 
Published: May 2020

AbstractBackgroundDespite the considerable success of comprehensive tobacco control efforts, tobacco use remains one of the greatest preventable causes of death and disease today. Over half of all smokers in the US make quit attempts every year, but over 90% relapse within 12 months, choosing the immediate reinforcement of smoking over the long-term benefits of quitting. Conceptual and empirical evidence supports continued investigation of high frequency repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex in reducing relapse and decreasing cigarette consumption. While this evidence is compelling, an optimal dosing strategy must be determined before a long-term efficacy trial can be conducted. The goal of this study is to determine a dosing strategy for 20 Hz rTMS that will produce the best long-term abstinence outcomes with the fewest undesirable effects.MethodsThis is a fully crossed, double-blinded, sham-controlled, 3x2x2 randomized factorial study. The three factors are duration (stimulation days: 8, 12, and 16); intensity (900 or 1800 pulses per day); and sham control. Participants (n = 258) will consist of adults (18–65) who are motivated to quit smoking cigarettes and who will be followed for 6 months post-quit. Outcomes include latency to relapse, point prevalence abstinence rates, delay discounting rates, cognitive-behavioral skills acquisition, and multiple measures of potential undesirable effects that impact participant compliance.DiscussionThis study integrates existing theoretical concepts and methodologies from neuropsychology, behavioral economics, brain stimulation, clinical psychology, and the evidence-based treatment of tobacco dependence in the development of a promising and innovative approach to treat tobacco dependence. This study will establish an optimal dosing regimen for efficacy testing. Findings are expected to have a significant influence on advancing this approach as well as informing future research on clinical approaches that combine rTMS with other evidence-based treatments for tobacco dependence and perhaps other addictions.Trial registrationClinical TrialsNCT03865472(retrospectively registered). The first participant was fully enrolled on November 26, 2018. Registration was posted on March 7, 2019.
Psychometric evaluation of the modified 19-item Bengali version of WHOQOL scale using Rasch analysis: a cross-sectional study of a rural district in Bangladesh
Authors: Uddin Mohammed Nazim , Amirul Islam Fakir M. 
Published: May 2020

AbstractBackgroundThis investigation aims to validate the psychometric properties of the modified 19-item Bengali version World Health Organization Quality of Life (WHOQOL) instrument in a typical healthy rural population in Bangladesh.MethodThe cross-sectional investigation collected 300 adults aged 18–85 years from Narail, a rural district of Bangladesh using a multi-stage cluster random sampling technique. Face-to-face interviews were conducted between July and August 2018 using an Android phone installed with a mobile data collection application CommCare. SPSS version 25; IBM. and a Rasch analysis software RUMM2030 were used for analyses.ResultsResults showed good overall fit, as indicated by a significant item-trait interaction with Bonferroni correctedpvalues, for physical ($$ {\upchi}_{(20)}^2 $$χ202=32.13,p = 0.041), psychological ($$ {\upchi}_{(16)}^2 $$χ162=14.93,p = 0.529), social ($$ {\upchi}_{(16)}^2 $$χ162=12.62,p = 0.397), and environmental ($$ {\upchi}_{(20)}^2 $$χ202=22.01,p = 0.339) domains. Item fit residual (IFR) values for all domains were within the desired limits, indicating no deviation from the expected relationship between the individual items and the rest of the items of the scale. Person fit residual (PFR) values also showed no person misfit among the samples, indicating item threshold are suitable for Rasch analysis. Reliability of the three domains of the 19-item WHOQOL scale was very good as indicated by a person separation index (PSI) = 0.873 and Cronbach’s Alpha (CA) = 0.881 for physical domain, PSI = 0.739 and CA = 0.746 for psychological domain, and PSI = 0.753 and CA = 0.781 for environmental domain. The social domain (PSI = 0.650 and CA = 0.669) had below acceptable reliability. All items in each domain had ordered thresholds except one item of the environmental domain. All four domains of the 19-item WHOQOL scale showed unidimensionality and was free from local dependency. Each domain also showed similar functioning for adults and older adults, males and females, no education and at least primary level of education, low and high socio-economic conditions.ConclusionThe 19-item modified WHOQOL scale is confirmed as an efficient screening tool for measuring QoL among healthy rural Bangladeshi people. The scale could be implemented more widely. In particular, validations are required for diseases-specific population in Bangladesh to measure the Health Related Quality of life (HR-QoL) assessments for people suffering from chronic or other diseases.