bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bilateral asymmetric tonic seizure in insulo-opercular epilepsy: an anatomo-electro-clinical study
Authors: Hu Xiangshu , Li Kaihui , Wang Xiao , Yang Ping , Tan Qinghua , Li Danfang , Wang Xiaobo , Zeng Fang , Jin Yang , Fei Lingxia , Li Hua , Chen Junxi , Guo Qiang 
Published: November 2020

AbstractBackgroundInsulo-opercular seizures are highly heterogeneous in seizure semiology and electrical features. Bilateral asymmetric limb posturing, as a classical pattern of supplementary sensorimotor area (SMA) seizure, also occurs in insulo-opercular epilepsy. This study was aimed to study the anatomo-electro-clinical correlations in bilateral asymmetric tonic seizures (BATS), in order to advance the understanding of insulo-opercular epilepsy.MethodsEight patients with insulo-opercular epilepsy as confirmed by stereoelectroencephalography (SEEG) and manifesting BATS as the major ictal motor sign, in Guangdong Sanjiu Brain Hospital Epilepsy Center from 2014 to 2018, were employed in this study. The BATS of the patients were evaluated, and the semiologic features and concomitant intracerebral EEG changes were quantified. Then the variables were examined with Cluster Analysis, and the semiologic features were correlated with anatomic localization using the Kendall correlation test.ResultsOf the 8 patients, the most frequent initial motor sign was bilateral asymmetric tonic posturing (62.5%). Facial tonic-clonic sign also had a high prevalence in the evolution of seizures (87.5%). The results of Cluster Analysis showed that the semiologic features were subdivided into two main groups, one group comprising exclusively BATS and the other including signs of focal tonic seizure, aura, focal limb tonic-clonic seizure (TCS), facial TCS, hypermotor behavior, eye movement, autonomic changes and generalized TCS. The BATS was strongly associated with the posterior long gyrus (PLG) of insula (t = 0.732) and parietal operculum (t = 1.000); the hypermotor behaviors were associated with the anterior long gyrus (ALG) (t = 0.770); and the autonomic changes were associated with the anterior limiting sulcus (ALS) (t = 0.734) and middle short gyrus (MSG) (t = 0.700).ConclusionsThe seizure semiology of insulo-opercular epilepsy is characterized, in temporal order, by BATS, with or without simultaneous hypermotor behaviors, and frequently ends up with facial tonic-clonic signs, which is different from that of the SMA seizure. The early spread network involving the posterior insular lobe and parietal operculum may contribute to this pattern of manifestation.
Impact of narcissistic leadership on employee work outcomes in banking sector of Pakistan
Authors: Asrar-ul-Haq Muhammad , Anjum Talha 
Published: November 2020

AbstractBackgroundNarcissism has been studied as a positive as well as a negative trait. It is a personality disorder in which a person is preoccupied with power, self and vanity. Narcissists often pursue leadership and work for their personal interests which ultimately affect others’ well-being. It affects employee performance and leads toward turnover. The purpose of this study is to examine how narcissistic leadership can impact subordinates’ job-related outcomes.MethodData are collected from 310 banking professionals using Likert scale survey questionnaire and analyzed through SEM using AMOS.ResultsResults show that narcissistic leadership has a negative impact on subordinate job satisfaction and well-being, whereas a positive relationship with stress and intentions to quit. However, its relationship with job performance was observed to be insignificant.ConclusionBosses with narcissistic tendencies drive hardworking employees away. The initial problem in narcissistic individuals is their elevated ego. To reverse the trend of narcissism, changes should be made at different levels, i.e., home, school, college or university. In order to tackle narcissism at work place, different established strategies can be used to deal with such individual/leader.
Innovations in Thermal Processing: Hot-Melt Extrusion and KinetiSol® Dispersing
Authors: Tan Deck Khong , Davis Daniel A. , Miller Dave A. , Williams Robert O. , Nokhodchi Ali 
Published: November 2020

AbstractThermal processing has gained much interest in the pharmaceutical industry, particularly for the enhancement of solubility, bioavailability, and dissolution of active pharmaceutical ingredients (APIs) with poor aqueous solubility. Formulation scientists have developed various techniques which may include physical and chemical modifications to achieve solubility enhancement. One of the most commonly used methods for solubility enhancement is through the use of amorphous solid dispersions (ASDs). Examples of commercialized ASDs include Kaletra®, Kalydeco®, and Onmel®. Various technologies produce ASDs; some of the approaches, such as spray-drying, solvent evaporation, and lyophilization, involve the use of solvents, whereas thermal approaches often do not require solvents. Processes that do not require solvents are usually preferred, as some solvents may induce toxicity due to residual solvents and are often considered to be damaging to the environment. The purpose of this review is to provide an update on recent innovations reported for using hot-melt extrusion and KinetiSol® Dispersing technologies to formulate poorly water-soluble APIs in amorphous solid dispersions. We will address development challenges for poorly water-soluble APIs and how these two processes meet these challenges.
Site-specific Concurrent Validity of the ActiGraph GT9X Link in the Estimation of Activity-related Skeletal Loading
Authors: HIGGINS SIMON , HIGGINS LAUREN Q. , VALLABHAJOSULA SRIKANT 
Published: November 2020

ABSTRACT
To inform the development of bone-specific physical activity (PA) assessment methods and contribute to bone-specific PA guidelines, accelerometer outcomes that provide the most valid estimates of skeletal loading in adults must be identified.

Purpose
The aims of this project were twofold: 1) to assess the concurrent validity of raw accelerometer outputs with ground reaction forces (GRF) and loading rates (LR) calculated from force plate across a range of simulated habitual PA and 2) to identify the optimal wear site among the ankle, hip, and wrist with the strongest relationships between accelerometer and force plate and/or skeletal outcomes.

Methods
Thirty healthy young adults (23.0 ± 4.5 yr, 50% female) wore a triaxial accelerometer at the right ankle, hip, and wrist while performing eight trials of walking, jogging, running, low box drops, and high box drops over an in-ground force plate. Repeated-measures correlations and linear mixed models were used to assess concurrent validity of accelerometer and force plate outcomes across wear sites.

Results
Strong repeated-measures associations were observed between peak hip resultant acceleration and resultant LR (r
rm 1169 = 0.74, P < 0.001, 95% confidence interval = 0.718, 0.769) and peak hip resultant accelerations and resultant GRF (r
rm 1169 = 0.69, P < 0.001, 95% confidence interval = 0.660, 0.720) when data were combined across activities. By contrast, small to moderate associations were seen between ankle-based outcomes and corresponding GRF and LR during walking and jogging (r
rm 209 = 0.17–0.34, all P < 0.001). No significant associations were seen with wrist-based outcomes during any activity. In addition, linear mixed models suggested that 24%–50% of the variability in peak GRF and LR could be attributed to measured accelerations at the hip.

Conclusion
Peak accelerations measured at the hip were identified as the strongest proxies for skeletal loading assessed via force plate.
Frequency and clinical significance of prostatic involvement in men with febrile urinary tract infection: a prospective observational study
Authors: Arjunlal Thayyil Shahilal , Deepanjali Surendran , Manikandan Ramanitharan , Medha Rajappa 
Published: November 2020

Background: Frequent asymptomatic involvement of the prostate has been demonstrated in men with febrile urinary tract infection (fUTI). In view of this, men with fUTI are often given a longer duration of antibiotic treatment; however, evidence to support this is limited.Methods: We prospectively studied adult men with fUTI admitted under the Department of Medicine in a tertiary care hospital in southern India. fUTI was defined as fever of ≥38°C with at least one symptom/sign of UTI and pyuria, requiring hospitalization. We estimated serum total prostate-specific antigen (PSA) levels at enrollment, one month and three months after treatment completion. We assessed prostatic volume by transrectal ultrasonography (TRUS) and estimated the serum high sensitivity C-reactive protein (hs-CRP) levels at baseline and after three months.Results: We enrolled 64 men (median [IQR] age 53 [45-60] years); 50 patients completed follow-up. At baseline, 24 (38%) of 64 patients had elevated serum PSA values compared to age-specific upper limit. The median (IQR) serum PSA level was 2.15 (1.18-3.02) ng/mL and median (IQR) serum hs-CRP level was 2.23 (1.85-2.74) mg/dL (N=64). At three months, serum PSA levels decreased by ≥25% in 47 (94%) of 50 patients. The median (IQR) of prostatic volume was 25.4 (18.9-34) mL at baseline (N=64), and ≥10% decrease in prostatic volume was observed in 24 (48%) of 50 patients at three months. The change in the serum PSA levels did not correlate with clinical findings like prostatic tenderness or with prostatic volume changes. Further, serum PSA levels did not correlate with hs-CRP levels. On follow-up, seven patients had lower urinary tract symptoms; only one of them had recurrent fUTI. Conclusions: Asymptomatic prostatic involvement, although common in men with fUTI, does not seem to influence the treatment outcomes.
In-vitro inhibitory effect of maternal breastmilk components on rotavirus vaccine replication and association with infant seroconversion to live oral rotavirus vaccine
Authors: Kazimbaya Katayi Mwila , Chisenga Caroline C. , Simuyandi Michelo , Phiri Cynthia Mubanga , Laban Natasha Makabilo , Bosomprah Samuel , Permar Sallie R. , Munsaka Sody , Chilengi Roma 
Published: November 2020

BackgroundDespite contributing to a significant reduction in rotavirus associated diarrhoea in highly burdened low- and middle-income countries, live attenuated, oral rotavirus vaccines have lower immunogenicity and efficacy in these settings in comparison to more developed countries. Breastmilk has been implicated among factors contributing to this lowered oral vaccine efficacy. We conductedin-vitroexperiments to investigate the inhibitory effects of maternal antibody and other non-antibody components in breastmilk on rotavirus vaccine strain (Rotarix) multiplication in MA104 cell culture system and assessed associations within-vivovaccine seroconversion in vaccinated infants.MethodsBreastmilk samples were collected from mothers before routine rotavirus vaccination of their infant at 6 weeks of age. For each sample, whole breastmilk, purified IgA, purified IgG and IgG and IgA depleted breastmilk samples were prepared as exposure preparations. A 96 well microtitre plate was set up for each sample including a control in which only MA104 cells were grown as well as a virus control with MA104 cells and virus only. The outcome of interest was 50% inhibition dilution of each of the exposure preparations calculated as the titer at which 50% of virus dilution was achieved. Samples from 30 women were tested and correlated to vaccine seroconversion status of the infant. HIV status was also correlated to antiviral breastmilk proteins.ResultsThe mean 50% inhibitory dilution titer when whole breastmilk was added to virus infected MA104 cells was 14.3 (95% CI: 7.1, 22.7). Incubation with purified IgG resulted in a mean 50% inhibitory dilution of 5 (95%CI -1.6, 11.6). Incubating with purified IgA resulted in a mean 50% inhibitory dilution of 6.5 (95% CI -0.7, 13.7) and IgG and IgA depleted breastmilk did not yield any inhibition with a titer of 1.06 (95%CI 0.9, 1.2). Higher milk IgA levels contributed to a failure of infants to seroconvert. HIV was also not associated with any antiviral breastmilk proteins.Discussion and conclusionWhole breastmilk and breastmilk purified IgG and IgA fractions showed inhibitory activity against the rotavirus vaccine Rotarix™ whilst IgA and IgG depleted breastmilk with non-antibody breastmilk fraction failed to show any inhibition activityin-vitro. These findings suggest that IgA and IgG may have functional inhibitory properties and indicates a possible mechanism of how mothers in rotavirus endemic areas with high titres of IgA and IgG may inhibit viral multiplication in the infant gut and would potentially contribute to the failure of their infants to serocovert. There was not association of HIV with either lactoferrin, lactadherin or tenascin-C concentrations.
When and how do hospital nurses cope with daily stressors? A multilevel study
Authors: Martínez-Zaragoza Fermín , Benavides-Gil Gemma , Rovira Tatiana , Martín-del-Río Beatriz , Edo Silvia , García-Sierra Rosa , Solanes-Puchol Ángel , Fernández-Castro Jordi 
Published: November 2020

BackgroundDuring their workday, nurses face a variety of stressors that are dealt with using different coping strategies. One criticism of the contextual models of work stress is that they fail to focus on individual responses like coping with stress. Neverthless, little is know about the momentary determinants of coping in nurses.ObjectivesTo identify the momentary predictors of problem-focused approaching coping and emotion-focused approaching coping, as well as those for seeking social support and refusal coping strategies, during the working day in nurses.DesignThis study uses descriptive, correlational, two-level design with repeated measures.SettingsWards of two University hospitals.ParticipantsA random cohort of 113 nurses was studied.MethodsAn ecological momentary assessment was made of demand, control, effort, reward, nursing task, coping, mood and fatigue, and of coping style by questionnaire. Multilevel two-level statistical analyses were performed in order to identify both within person and between person relationships.ResultsDifferent momentary types of coping were associated with different tasks. The problem-focused coping could be explained by the direct care and medication tasks, demand, planning coping style, mood, and negatively by acceptation coping style. Emotion-focused coping could be explained by documentation and medication tasks (negatively), mood, demand, distraction, and disengagement coping styles. Seeking social support coping could be explained by the task of communication, mood, fatigue (negatively), and seeking emotional support as a coping style. Refusal coping could be explained by mood, and the coping style of focusing and venting emotions. Refusal coping is not specific to any task.ConclusionsThe choice of the coping strategy depends on the task, of their appraisal and on the different styles of coping.
Factors associated with patient satisfaction towards pharmacy services among out-patients attending public health clinics: Questionnaire development and its application
Authors: Ismail Aniza , Gan Yan Nee , Ahmad Norfazilah 
Published: November 2020

IntroductionPatient satisfaction is widely used to measure quality of healthcare by identifying potential areas for improvement. Aim of study is to assess patient satisfaction towards pharmacy services and its associated factors using newly developed questionnaire among outpatients attending public health clinics.Materials and methodsPublic Health Clinic Patient Satisfaction Questionnaire (PHC-PSQ) towards pharmacy services was developed using exploratory factor analysis and Cronbach’s α. A cross-sectional study was conducted among 400 patients visiting the pharmacy in three randomly selected public health clinics recruited via systematic random sampling. Data was collected using a set of questionnaire including PHC-PSQ. Factors associated with patient satisfaction was analysed using multiple linear regression.ResultsFinal PHC-PSQ consisted of three domains (administrative competency, technical competency and convenience of location) and 22 items with 69.9% total variance explained. Cronbach's α for total items was 0.96. Total mean score for patient satisfaction was 7.56 (SD 1.32). Older age and higher education were associated with lower patient satisfaction mean score. Patients who had visited the pharmacy more than once in the past three months, perceived to be in better health status and had a more correct general knowledge of pharmacists expressed higher patient satisfaction mean score.ConclusionsPHC-PSQ is a newly developedtool to measure patient satisfaction towards pharmacy services in public health clinics in Malaysia. Patient satisfaction was relatively high. Age, education, frequency of visit, self-perceived health status and general knowledge of pharmacists were factors significantly associated with patient satisfaction.
High-mannose type N-glycans with core fucosylation and complex-type N-glycans with terminal neuraminic acid residues are unique to porcine islets
Authors: Nanno Yoshihide , Shajahan Asif , Sonon Roberto N. , Azadi Parastoo , Hering Bernhard J. , Burlak Christopher 
Published: November 2020

ObjectivesIslet transplantation is an emerging treatment option for type 1 diabetes but its application is limited by the shortage of human pancreas donors. Characterization of theN- andO-glycan surface antigens that vary between human and genetically engineered porcine islet donors could shed light on targets of antibody mediated rejection.MethodsN- andO-glycans were isolated from human and adult porcine islets and analyzed using matrix-assisted laser-desorption time-of-flight mass spectrometry (MALDI-TOF-MS) and electrospray ionization mass spectrometry (ESI-MS/MS).ResultsA total of 57 porcine and 34 humanN-glycans and 21 porcine and 14 humanO-glycans were detected from cultured islets. Twenty-eight of which were detected only from porcine islets, which include novel xenoantigens such as high-mannose typeN-glycans with core fucosylation and complex-typeN-glycans with terminal neuraminic acid residues. Porcine islets have terminalN-glycolylneuraminic acid (NeuGc) residue in bi-antennaryN-glycans and sialyl-TnO-glycans. No galactose-α-1,3-galactose (α-Gal) or Sdaepitope were detected on any of the islets.ConclusionsThese results provide important insights into the potential antigenic differences ofN- andO-glycan profiles between human and porcine islets. Glycan differences may identify novel gene targets for genetic engineering to generate superior porcine islet donors.
Dynamic hyperinflation induced by the 6-minute pegboard and ring test in hospitalized patients with exacerbated COPD
Authors: Barros Cassia Fabiane de , Felisberto Rosimeire Marcos , Nucci Kelly Cristina Albanezi , Albuquerque Andre Luis Pereira de , Paulin Elaine , Brito Christina May Moran de , Yamaguti Wellington Pereira 
Published: November 2020

Background
The six-minute pegboard and ring test (6-PBRT) has been used to evaluate functional capacity of the upper limbs in stable chronic obstructive pulmonary disease (COPD) patients. To the best of our knowledge, no studies have evaluated dynamic hyperinflation (DH) during exercise with upper limbs in the hospital setting. The aim of this study was to evaluate physiological responses and DH induced by 6-PBRT in hospitalized patients with acute exacerbation of COPD (AECOPD).

Methods
A cross-sectional study was conducted in a tertiary hospital enrolling patients who were hospitalized due to AECOPD. All included participants underwent an evaluation of lung function and 6-PBRT when they reached minimum clinical criteria. Ventilatory and hemodynamics parameters were monitored during 6-PBRT and until 6 minutes of rest after the test. Symptoms of dyspnea and upper limb fatigue were also measured.

Results
Eighteen patients (71.3±5.1 years) with a mean FEV1 of 43.2±18.3% were included in the study (11 females). Prevalence of DH after 6-PBRT was 50% (considering the drop of 150 ml or 10% of inspiratory capacity, immediately after the end of the test). There was a significant increase in respiratory rate, minute volume, dyspnea, and upper limb fatigue after the end of 6-PBRT (p<0.05). Dyspnea recovered more precociously than the perception of fatigue, being reestablished within four minutes of rest. An increase in heart rate, systolic and diastolic blood pressures was also induced by 6-PBRT (p<0.05), requiring 6 minutes of recovery to return to baseline. No adverse events were observed during 6-PBRT. We concluded that 6-PBRT induces physiological changes during its execution, at safe levels, requiring a maximum of 6 minutes for recovery. Finally, the test proved to be safe and applicable for patients hospitalized due to AECOPD.
Hematologic alterations and early mortality in a cohort of HIV positive African patients
Authors: Ciccacci Fausto , Lucaroni Francesca , Latagliata Roberto , Morciano Laura , Mondlane Elisa , Balama Moises , Tembo Dyna , Gondwe Jane , Orlando Stefano , Palombi Leonardo , Marazzi Maria Cristina 
Published: November 2020

IntroductionInfection with Human Immunodeficiency Virus (HIV) is highly prevalent worldwide, especially in Sub-Saharan Africa, where anaemia is also widespread. HIV infection is known to be associated with anaemia and various other haematologic alterations, but little data on correlation with immunological and virologic conditions in treatment-naïve patients and impact on mortality are available. Our study aims to investigate hematologic features in HIV-infected individuals in Malawi and Mozambique and assesses possible correlations with early morality.Material and methodsWe conducted a retrospective analysis of baseline data (general details, nutritional status, full blood count and HIV infection progress data) and 12 months follow-up status for HIV+ adult patients in 22 health facilities in Malawi (11 sites) and Mozambique (11 sites) run by DREAM program. Anagraphic details, anthropometric characteristics, full blood count, CD4+ count and Viral Load data were collected from electronical medical records (EMR) for all the HIV-positive, treatment-naïve patients starting care in the sites in the period January 2007 –December 2016. Follow-up status after one year since enrolment in care was also considered. All the data extracted from the EMR were included in a dataset and then analysed. Univariate and multivariate analysis were conducted through logistical regression to investigate associations, and survival analysis analysed in a Cox regression model.ResultsOn the whole, 22.657 patients were included; severe and moderate anaemia were observed in 1.174 (8,2%) and 4.703 (21,9%) patients respectively. Gender, nutritional status, CD4+ count, and viral load (VL) were associated with anaemia, leukopenia, and thrombocytopenia. Among 21.166 fully evaluable patients, 8.494 (40,1%) had at least one cytopenia. Any cytopenia was present in 1/3 of patients with normal nutritional status and less advanced HIV infection, and it wouldn’t be diagnosed in a basic HIV care setting. During the first year of treatment, 1.725 subjects (7,6% of the entire sample) died. Anaemia, lower Red blood cells and platelets counts correlated with mortality in the first year of care, independently by body mass index, haemoglobin, CD4+ count and VL.ConclusionsNotwithstanding anaemia is known to be associated with HIV infection at diagnosis, full blood count is not routinely performed in many African countries. Our results emphasize that including the study of a broader set of parameters in the routine HIV care services in Sub-Saharan Africa would provide significant clinical information able to predict other alterations and poor outcomes.