bluuebunny/crossref_metadata_2025_split huggingface dataset:
Severe Acute Respiratory Syndrome Coronavirus-2 and Pulmonary Tuberculosis Coinfection: Double Trouble
Authors: Singh Abhijeet , Gupta Ayush , Das Kamanashish 
Published: July 2020

Abstract
Background: The ongoing pandemic of novel coronavirus disease 2019 (COVID-19) has received worldwide attention by becoming a major global health threat. We encountered one case with COVID-19 and tuberculosis (TB) coinfection which has not been frequently reported. Case presentation: A 76 year old female presented with acute respiratory symptoms superimposed on chronic symptoms, suggestive to have pneumonia. Oropharyngeal throat swab sample for COVID-19 was positive as detected by real-time reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay. GeneXpert Ultra detected Mycobacterium tuberculosis complex with Rifampicin resistance indeterminate. Patient was treated with appropriate management. Conclusion: Clinicians should suspect coinfection with TB during ongoing pandemic of COVID-19 as therapeutic strategies need to be determined timely to improve outcome and prevent transmission in community.
Neutrophil-to-lymphocyte ratio is a prognostic factor for colon cancer: a propensity score analysis
Authors: Mazaki Junichi , katsumata Kenji , Kasahara Kenta , Tago Tomoya , Wada Takahiro , Kuwabara Hiroshi , Enomoto Masanobu , Ishizaki Tetsuo , Nagakawa Yuichi , Tsuchida Akihiko 
Published: July 2020

Abstract
Background: A large number of patients suffer recurrence after curative resection, and mortality from colon cancer remains high. The role of systemic inflammatory response, as reflected by neutrophil-to-lymphocyte ratio (NLR), in cancer recurrence and death has been increasingly recognized. This study aimed to analyze long-term oncologic outcomes of Stage II-III colon cancer to examine the prognostic value of NLR using a propensity score analysis.Methods: A total of 375 patients with colon cancer underwent radical surgery between 2000 and 2014 at Tokyo Medical University Hospital. Long-term oncologic outcomes of these patients were evaluated according to NLR values. A cut-off NLR of 3.0 was used based on receiver operating characteristic curve analysis. Primary outcomes were overall survival (OS) and relapse-free survival (RFS). An analysis of outcomes according to tumor sidedness was also performed.Results: Patients with lower NLR values (“lower NLR group”) were more likely to have lymph node metastasis compared to those with higher NLR values (“higher NLR group”) before case matching. After case matching, clinical outcomes were similar between the two groups. There were no significant differences in 5-year OS and 5-year RFS rates between the two groups before case matching based on propensity scores. After case matching, 5-year OS rates were 94.5% in the lower NLR group (n = 135) and 87.0% in the higher NLR group (n = 135), showing a significant difference (p = 0.042). Five-year RFS rates were 87.8% in the lower NLR group and 77.9% in the higher NLR group, also showing a significant difference (p = 0.032). Among patients with left-sided colon cancer in the matched cohort, 5-year OS and 5-year RFS rates were 95.2% and 87.3% in the lower NLR group (n = 88), respectively, and 86.4% and 79.2% in the higher NLR group (n = 71), respectively, showing significant differences (p = 0.014 and p = 0.047, respectively).Conclusions: The NLR is an important prognostic factor for advanced colon cancer, especially for left-sided colon cancer.
Efficacy of Melatonin on Postoperative Outcomes After Hysterectomy: A Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Laosuwan Prok , Dechaworawut Kamolwan , Rodanant Oraluxna , Charuluxananan Somrat 
Published: July 2020

Abstract
Background: Melatonin became a part of multimodal analgesia in several recent studies because of its analgesic, anxiolytic and anti-inflammatory properties. Incidence of anxiety and pain in patients undergoing hysterectomy is not low. Moreover, preoperative anxiety is related to postoperative pain. The hypothesis of this study was whether melatonin could improve pain and other postoperative conditions after hysterectomy.Methods: A randomized, double-blinded, placebo-controlled trial involved recruitment of 54 patients, aged between 18 and 65 years old, planned to undergo hysterectomy, with or without oophorectomy under spinal anesthesia. The patients were allocated to receive 4 mg prolonged-release melatonin at night before surgery and in the morning before surgery or 2 doses of placebo at the same time point. Morphine consumption within 24 hours with patient-controlled analgesia machine and visual analog scale (VAS) pain score were recorded. In addition, quality of sleep, Thai standard anxiety level score, fatigue, general well-being and satisfaction score were measured by a blinded assessor and analyzed.Results: Mean of cumulative dose of morphine consumption in melatonin and placebo group were 33.04 ±10.42 and 42.63 ±8.21 mg, respectively. (p < 0.001) Mean of postoperative VAS pain scale was lower in the melatonin group at recovery room arrival (T0) (23.41 vs 8.07, p = 0.01). However, there was not a significant difference between postoperative groups at 1(T1), 6 (T6) and 24 h (T24). Fatigue and general well-being score in the melatonin group were better than the placebo group.Conclusion: Prolonged-release formulation of melatonin decreased pain intensity in post anesthetic care room and lowered doses of postoperative morphine within 24 hours after surgery. Postoperative fatigue, general well-being and satisfaction scores were better in the treatment group. However, there was no anxiety and sleep quality improvement. Melatonin may be an additional choice of multimodal analgesia for hysterectomy. Clinical trial registration: TCTR20140516001, Registered 16 May, 2014, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=1076, Efficacy of melatonin on postoperative outcomes after hysterectomy: a randomised, doubl-blinded, placebo-controlled trial
Combined subcostal and posterior transversus abdominis plane block for postoperative pain relief after abdominoplasty
Authors: Sayed Haytham El , Fadhul A Shaheed , Falalki Mohamed Al , Awad M Nasr 
Published: July 2020

Abstract
Background: Abdominoplasty is a common aesthetic surgery. Adequate pain management during the postoperative period is of great importance. Previous studies have failed to achieve safe and reliable effective analgesic techniques beyond the recovery room. This research aims to investigate the outcome of the abdominoplasty operation for the patients' received transversus abdominis plan block in comparison with the non-blocked patients.Methods: 58 patients, undergoing elective abdominoplasty, received general anesthesia. Patients were randomly assigned to two equal groups of 29 patients each. Combined subcostal and posterior transversus abdominis plane block group and non-blocked group. For both groups, the standard postoperative analgesic regimen consisted of IV Paracetamol 1 g every 6 hours. Values of visual analog scale values were recorded postoperatively, once the patient had a visual analog scale ≥ 4, IV opioids administered and visual analog scale recorded every 30 min till pain improved. The primary outcome was opioids consumption in the first 72 hours postoperatively, the secondary outcome was the value of visual analog scale at rest and movement (or with knee flexion) in the first 72 hours postoperatively, time to first ambulation, time to first incentive spirometer 900 ml/min were recorded and also the incidence of postoperatively mechanical ventilatory support (CPAP) requirements.Results: Morphine consumption in the first 72 hours was 6.97±1.97 in the non-blocked group and 4.38±2.04 in the blocked group (p < 0.05). Pethidine consumption in the first 72 hours was 208.62±85.64 in the non-blocked group and 20.69±25.06 in the blocked group (p < 0.05). VAS was lower in the blocked group during the first 72 hours were (p < 0.05). Time to first ambulation was 12.41±5.04 hours in the non-blocked group and 4.62±1.08 hours in the blocked group (p < 0.05), time to first incentive spirometer 900 ml/min was 11.45±5.05 hours in the non-blocked group and 4.27±1.09 hours in the blocked group (p < 0.05).Conclusion: Combined subcostal and posterior transversus abdominis plane block is a promising regional anesthetic technique for postoperative pain relief in abdominoplasty surgery, it offers a longer postoperative analgesic effect duration and fewer analgesic requirements with less postoperative complications.
Sero-Prevalence and Risk Factors of Hepatitis C Virus Infection Among Children Diagnosed With Cancer in Lagos Nigeria.
Authors: Okoli Chukwudi , Salako Abideen , Nwafia Ifeyinwa 
Published: July 2020

Abstract
Introduction: HCV is a blood borne viral infection transmitted mainly via blood and blood product transfusion. Children diagnosed with cancers are especially in the high-risk group for infection with blood transmissible infections like HCV because of their dependence on blood and blood product. Children with cancer are also exposed to unwholesome practice like scarification marks. Also children with cancer because of their immunocompromised state lack the ability effectively clear HCV after an acute infection, there are therefore very likely to have chronic infections.Because of the above reason it became necessary to determine the prevalence and risk factors for HCV infection among children with cancer at Lagos .Methods: We designed a descriptive cross-sectional study conducted over a 12 months period at the Oncology ward and outpatient clinics of LUTH.Result: 50 children with cancers were recruited age range 7 months and 17 years. Ninety percent of them has been exposed to blood transfusion while 32% and 18% of them has had surgery and scarification marks respectively. The most diagnosed cancer was ALL with 44%. And 82% of the subjects were on chemotherapy at the time of recruitment. The sero-prevalence of HCV infection among those with cancer was 0%.Conclusion: The sero-prevalence of HCV infection was zero percent despite significant exposure to blood transfusion and other risk factors.
Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996-2016
Authors: França Elisabeth , Ishitani Lenice Harumi , Teixeira Renato , Duncan Bruce B. , Marinho Fatima , Naghavi Mohsen 
Published: July 2020

Abstract
Background: Registered causes in vital statistics classified as garbage codes (GC) are considered indicators of quality of cause-of-death data. Our aim was to describe temporal changes in this quality in Brazil, and the leading GCs according to levels assembled for the Global Burden of Disease (GBD) study. We also assessed socioeconomic differences in the burden of different levels of GCs at a regional level. Methods: We extracted data from the Brazilian Mortality Information System from 1996 to 2016. All three and four digit ICD-10 codes considered as GC were selected and classified into four categories, according to the GBD study proposal. GCs levels 1 and 2 are the most damaging unusable codes, or major GCs. Proportionate distribution of deaths by GC levels according selected variables were performed. Age-standardized mortality rates after correction of underreporting of deaths were calculated to investigate temporal relationships as was the linear association adjusted for completeness between GC rates in states and the Sociodemographic Index (SDI) from the GBD study, for 1996-2005 and 2006-2016. We classified Brazilian states into three classes of development by applying tertiles cutoffs in the SDI state‐level estimates. Results: Age-standardized mortality rates due to GCs in Brazil decreased from 1996 to 2016, particularly level 1 GCs. The most important GC groups were ill-defined causes (level 1) in 1996, and pneumonia unspecified (level 4) in 2016. At state level, there was a significant inverse association between SDI and the rate of level 1-2 GCs in 1996-2005, but both SDI and completeness had a non-expected significant direct association with levels 3-4. In 2006-2016, states with higher SDIs tended to have lower rates of all types of GCs. Mortality rates due to major GCs decreased in all three SDI classes in 1996-2016, but GCs levels 3-4 decreased only in the high SDI category. States classified in the low or medium SDI groups were responsible for the most important decline of major GCs. Conclusion: Occurrence of major GCs are associated with socioeconomic determinants over time in Brazil. Their reduction with decreasing disparity in rates between socioeconomic groups indicates progress in reducing inequalities and strengthening cause-of-death statistics in the country.
Advancing Pediatric Palliative Care In A Low-Middle Income Country: A Descriptive Analysis of the Implementation, A challenging But Not Impossible Task
Authors: Garcia-Quintero Ximena , Parra-Lara Luis Gabriel , Claros-Hulbert Angelica , Cuervo-Suarez Maria Isabel , Gomez-Garcia Wendy , Desbrandes Francois , Arias-Casais Natalia 
Published: July 2020

Abstract
Background: The abyss of access to palliative care and pain management in Latin America remains to be an unaddressed global health issue. Efforts to improve the development level of Palliative Care (PC) provision have traditionally targeted services for adults, leaving the pediatric population unaddressed. Examples of such services are scarce and should be portrayed in scientific literature to inform decision-makers and service providers on models of care available to tackle the burden of Pediatric Palliative Cares (PPC) in Low-and middle-income countries (LMIC). The purpose of this study is to describe the implementation of a pediatric palliative care program “Taking Care of You” (TCY), in a tertiary care university hospital in Cali, Colombia. Methods: A program’s database was built with children between 0 to 18 years old and their families, from year 2017 to 2019. Descriptive analysis to evaluate the impact of the program and service delivery was conducted. A theory-based method was directed to describe the PPC program, according to the implementation of self-designed taxonomy, mapping theoretical levels and domains. Clinical outcomes in patients were included in the analysis. Results: Since 2017 the program has provided PPC services to 1.965 children. Most of them had an oncologic diagnosis and were referred from hospitalization services (53%). The number of outpatients increased by 80% every trimester between 2017-2018. A 50% increase was reported in hospitalization, emergency, and intensive care units during the same time period. Conclusions: The program addressed a gap in the provision of PPC to children in Cali. It shows effective strategies used to implement a program, and how the referral times, coordination of care, communication with other hospital services were improved. Providing compassionate/holistic care to children with Life-limiting and threatening diseases, and in end-of-life. The implementation of this program has required the onset of specific strategies and arrangements to promote awareness and education proving it a hard task, yet not impossible.
Multi-dimensional strategic approach to the communicable diseases with systemic risks by using IT2 fuzzy decision-making modelling
Authors: Wang Shubin , Yang Peiqing , Yüksel Serhat , Dinçer Hasan , Ubay Gözde Gülseven 
Published: July 2020

Abstract
Background: Communicable diseases lead to significant social and financial burden for the countries. Therefore, countries should define their social and technical factors for struggling these problems. The main purpose of this study is to determine the effective strategies to minimize socio-economic burden of these diseases.Methods: For this purpose, 8 different criteria are identified based on the literature analysis. In the evaluation process, the significance levels of these factors are calculated by considering interval-valued intuitionistic fuzzy (IVIF) DEMATEL.Results: The findings show that technological infrastructure, social distance, and tendency of obeying rules are the most significant items to control these problems. This situation explains that countries should have the necessary equipment to make the diagnosis quickly and effectively. In addition, countries that have effective laboratories in which vaccines and drugs can be developed can be more successful in combating these pandemics. Additionally, it is also defined that cultural factors play also key role to control these problems.Conclusions: In this framework, it is vital that the people in the country take the rules set by the government seriously and without exception. For this purpose, it should be explained to citizens living in the country that personal hygiene, social distance and not entering crowded environments are very important to manage these problems. For this purpose, role model people in the country can be preferred in different platforms so that it can be more effective on the citizens.
Enhanced Piezoelectricity from Highly Polarizable Oriented Amorphous Fractions in Biaxially Oriented Poly(vinylidene fluoride) with Pure β Crystals
Authors: Huang yanfei , Rui Guanchun , Allahyarov Elshad , Li Ruipeng , Fukuto Masafumi , Zhong Gan-Ji , Xu Jiazhuang , Li Zhongming , Taylor Philip , Zhu Lei 
Published: July 2020

Abstract
Piezoelectric polymers hold great potential for various electromechanical applications, but only show low performance, with |d33| < 30 pC/N. We prepared a highly piezoelectric polymer (d33 = -62 pC/N) based on a biaxially oriented poly(vinylidene fluoride) (BOPVDF, crystallinity = 0.52). After unidirectional poling, macroscopically aligned samples with pure β crystals were achieved, which showed an unprecedentedly high spontaneous polarization (Ps) of 140 mC/m2. Given the theoretical limit of Ps = 188 mC/m2 for the neat b crystal, the high Ps could not be explained by a simple two-phase model (i.e., the crystalline and the amorphous phases). Instead, we deduce that a significant amount (at least 0.25) of an oriented amorphous fraction (OAF) must be present between these two phases. Experimental data suggest that the mobile OAF resulted in the negative and high d33 for the poled BOPVDF. The plausibility of this conclusion was supported by molecular dynamics simulations.
Administration of Yunnan Baiyao improved clinical prognosis of emergency craniotomy in patients with moderate-to-severe TBI: a randomized controlled trial
Authors: Chen Lifeng , Jiang Hongzhen , Xing Guoqiang , Guan Bing , Yang Yang , Ahmed Anwar , Ma Xiaodong 
Published: July 2020

Abstract
Background: Although emergency craniotomy has been performed to reduce the mortality of traumatic brain injury (TBI), it is associated with secondary injury and poor prognosis. The efficacy of a wound-healing medicine Yunnan Baiyao (YB) was compared with a TBI medicine Xingnaojing (XNJ) and orthodox therapy (OT). Method: Eighty patients (39±7 yrs.) with moderate-to-severe TBI (Glasgow Coma Scale(GOS), 3-12) received craniotomy before randomly assigned to (n=20) 7 days treatment of: 1) OT; 2) OT+XNJ (20 ml i.v. drip/daily); 3) OT+low dose-YB (oral, 1,000 mg/day); 4) OT+high dose-YB, 2,000 mg/day). Serum S100B and superoxide dismutase (SOD), Glasgow Outcome Scale (GOS) and Karnofsky Performance Scale (KPS) were evaluated.Results: GCS score was lowest on admission that improved more quickly and became significantly higher in XNJ, l-YB, h-YB groups than in OT group (P<0.01). S100B peaked higher but declined more slowly and became significantly higher in OT than in other groups (P<0.01). By Day 7, S100B declined to 20% below baseline in other groups but remained 19.4% above baseline in OT group. OT lost 38% SOD activity on Day 3 and regained 69% of SOD activity on Day 7 whereas other groups lost 16.7%~23.4% SOD on Day 3 but regained 91.8%~99.5% activity on Day 7 (P<0.01). GOS and KPS scores were significantly greater (~25%~30%) in the XNJ, l-YB, h-YB groups than in OT group 1-3 months post-surgery. Conclusion: YB is significantly better than OT and non-inferior to XNJ in improving postoperative recovery and clinical prognosis after emergency craniotomy in patients with moderate-to-severe TBI.
Analysis of Six Bone-Derived Factors in Plasma and CSF of Chinese Patients with Parkinson's Disease
Authors: Chen Xiang , Lin Yuwan , Chen Chaojun , Guo Wenyuan , Zhou Miaomiao , Qiu Jiewen , Zhang Zhiling , Mo Mingshu , Ding Liuyan , Ye Panghai , Wu Yijuan , Zhu Xiaoqin , Ren Yi , Yang Xingling , Zhang Xiaokang , Wu Zhuohua , Xu Pingyi 
Published: July 2020

Abstract
Background: Parkinson's disease (PD) has a close relationship with osteoporosis and bone secretory proteins may be involved in disease progress. Objectives: To detect the six bone-derived factors in plasma and CSF of patients with PD and evaluate their correlations with CRP level, motor impairment and HY stage of the disease.Methods: We included 250 PD patients and 250 controls. Levels of OCN, OPN, OPG, SO, BMP2 and DKK-1 in Plasma and CSF were measured by custom protein antibody arrays. Data were analyzed using Mann-Whitney U-test and Spearman’s rank correlation. Results: Plasma levels of OCN and OPN were correlated with CRP level and HY stage and motor impairment of PD. Furthermore, the plasma assessment with CSF detection may enhance their potential prediction on PD.Conclusions: OCN and OPN may serve as potential biomarkers for PD. The inflammation response may be involved in the cross-talks between the two factors and PD.
Identification of Novel Gene Mutations in Degenerative Lumbar Spinal Stenosis Using Whole Exome Sequencing in Chinese Population
Authors: Jiang Xin , Chen Dong 
Published: July 2020

Abstract
Degenerative lumbar spinal stenosis (DLSS) is a common lumbar disease requiring surgery. Previous studies indicate that genetic mutation may play a part in DLSS. However, there is scarcely specific study regarding the genetic study for DLSS. Whole exome sequencing (WES) is an effective strategy to search for disease-causing genes. To identify probable susceptible genes, we performed a WES in a cohort of 50 patients and 25 controls with DLSS. By bioinformatics analyses, we successfully identified several novel variants including HLA-DRB1, PARK2, ACTR8, AOAH, BCORL1, MKRN2, NRG4, NUP205, etc. To the best of our knowledge, this is the first genetic study of susceptibility genes with DLSS by WES in Chinese patients. In conclusion, our findings revealed that deleterious mutations in these genes may contribute to the development of DLSS.