bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Knowledge I seek because culture doesn’t work anymore … It doesn’t work, death comes”: The experiences of third generation female caregivers (“gogos”) in South Africa discussing sex, sexuality and HIV and AIDS with children in their care
Authors: Simmonds Jane , Parry Charles , Abdullah Fareed , Burhams Nadine Harker , Christofides Nicola 
Published: July 2020

Abstract
Background Sexual reproductive health communication between parents and children has been shown to promote safer sexual choices. Where third generation female caregivers, often grandmothers or other older females, commonly called gogos in South Africa, are primary care givers, the responsibility of talking about sex and related issues has shifted to them. This study explored the experiences of gogos in Alexandra, Johannesburg, talking about sex, sexuality and HIV and AIDS with the children in their care aged 10-18 years. Methods Ten primary caregivers were purposively sampled. Data were collected through in-depth individual interviews. Thematic analysis was performed and inductive codes and themes identified. Results All gogos sampled found it difficult to discuss sex, sexuality and HIV and AIDS due to culture and traditional values impacting on personal experiences and generation and gender barriers. Perceived low self-efficacy due to low levels of knowledge and limited skills in speaking about sex and HIV and AIDS also contributed to the low levels of sexual reproductive health communication. Conclusions This study highlights the need for interventions that focus on improving gogos’ knowledge about HIV and AIDS in addition to providing them with the skills to talk about sex, sexuality and HIV and AIDS with children in their care.
“I’m not a teenager, I’m 22. Why can’t I snap out of it?”A Qualitative Exploration of Seeking Help for a First-Episode Eating Disorder During Emerging Adulthood
Authors: Potterton Rachel , Austin Amelia , Allen Karina , Lawrence Vanessa , Schmidt Ulrike 
Published: July 2020

Abstract
Background: Eating disorders (EDs) typically have their onset during adolescence or the transition to adulthood. Emerging adulthood (~18-25 years) is a developmental phase which conceptually overlaps with adolescence but also has unique characteristics (e.g. increased independence). Emerging adults tend to come to ED services later in illness than adolescents, and emerging adulthood’s unique characteristics may contribute to such delays. Objective: This study aimed to explore attitudes towards ED symptoms, and their implications for help-seeking, amongst emerging adults receiving ED treatment through FREED, an early intervention care pathway. Method: Participants were 14 emerging adults (mean age 20.9 years; SD=2.0), all currently receiving specialist treatment for a first-episode, recent-onset (< 3 years) ED. Semi-structured interviews relating to experiences of help-seeking were conducted, and data were analysed thematically. Results: Symptom egosyntonicity, gradual reappraisal and feelings of exclusion from ED discourse were key attitudinal phases prior to help-seeking, each of which had distinct implications for help-seeking. Conclusions: Emerging adults with first-episode EDs show a distinct set of help-seeking-related challenges and opportunities (e.g. help-seeking for others; help-seeking at transitions; self-sufficiency). This research might be used to inform the development and evaluation of interventions which aim to facilitate help-seeking amongst emerging adults with first-episode recent-onset EDs.
Pre-hospital blood transfusion – a survey of European practice
Authors: Thies Karl-Christian , Truhlář Anatolij , Keene Damian , Hinkelbein Jochen , Rützler Kurt , Brazzi Luca , Vivien Benoît 
Published: July 2020

Abstract
Background
Blood products are a lifesaving commodity in the treatment of major trauma.
Although there is little evidence for use of pre-hospital blood products (PHBP) in seriously injured patients, an increasing number of emergency medical services have started using PHBP for treatment of major haemorrhage.
Aim of this survey was to establish the degree of prehospital blood product use throughout Europe and discover main indications. The second aim was to evaluate opinions about PHBP and also the experience and the personal views of its users.

Methods
The subcommittee for Critical Emergency Medicine of the European Society of Anaesthesiology (ESA) held an online survey of European Helicopter Emergency Services (HEMS) and all French Services d’Aide Médicale Urgente (SAMU) regions. It contained 13 questions both open and multiple-choice about the frequency transfusions are carried out, the PHBP used and the perceived benefit. The survey was distributed to the corresponding HEMS leads in 14 European countries.

Results
In total there were 172 valid responses; overall 48% of all respondents have prehospital access to packed red cells, 22% to fresh plasma and 14% use lyophilised plasma. Besides blood product administration, 94% of all services use tranexamic acid. Sixty five percent of all replies came from French and from German services (37% and 28% respectively). PHBP were mainly used for trauma related emergencies. France has the highest uptake of use of blood products at 89%, whereas the rate in Germany was far lower at 6%.
Fifty five percent of the service leads felt that PHBP are beneficial, and even lifesaving in individual cases despite being needed infrequently.

Conclusions
We found remarkable dissimilarities in practice between the different European countries. Even if there is not an absolute consensus amongst providers on the benefit of PHBP, the majority feel they are beneficial. The difference in practice is possibly related to the perceived lack of evidence on prehospital blood transfusion. We suggest to include the use of PHBP in trauma registries in order to consolidate the existing evidence.
Hole Diameter Ratio for Prediction of Anatomical Outcomes in Stage III or IV Idiopathic Macular Holes
Authors: Qi Yue , Yu Yanping , You Qisheng , Wang Zengyi , Wang Jing , Liu Wu 
Published: July 2020

Abstract
Purpose: To determine whether preoperative hole diameter ratio (HDR) is a predictive factor for postoperative anatomical outome for stage III or IV idiopathic macular holes (IMHs).Methods: One-hundred and one eyes with stage III or IV IMH were included in this retrospective case series study. All cases were treated with vitrectomy combined with internal limiting membrane (ILM) peeling and room air tamponade. The macular hole (MH) minimum and maximum diameter was measured on preoperative optical coherence tomography (OCT) images. The HDR was defined as the minimum to maximum diameter ratio. Results: Eighty-one eyes (80.2%) got a Type I closure after surgery (group A). Postoperative unclosed MHs were found in 20 eyes (19.8%) (group B). The preoperative minimal diameter (703.6±116.1mm vs. 597.6±120.1mm, P<0.01) and HDR (0.6±0.1 vs. 0.5±0.1, P=0.01) were both significantly smaller in postoperative closed eyes. The closure rate of IMHs with HDR<0.6 was significantly higher than those with HDR³0.6 (90.2% vs. 65.0%P=0.002) .Conclusions: Preoperative HDR<0.6 is predictive for a good postoperative anatomical outcome in stage III or IV IMHs.
Effectiveness of extracorporeal blood purification (hemoadsorption) in patients with severe coronavirus disease 2019 (COVID-19)
Authors: Asgharpour Masoumeh , Mehdinezhad Hamed , Bayani Masoumeh , Zavareh Mahmoud Sadeghi Haddad , Hamidi Seyed Hossein , Akbari Roghayyeh , Ghadimi Reza , Bijani Ali , Mouodi Simin 
Published: July 2020

Abstract
BackgroundExtracorporeal blood purification has been proposed as one of the therapeutic approaches in patients with coronavirus infection, because of its beneficial impact on elimination of inflammatory cytokines. MethodsThis controlled trial has been conducted on critically ill COVID-19 patients admitted in the state hospital affiliated to Babol University of Medical Sciences, Iran who received different antiviral and antibacterial drugs, and different modalities of respiratory treatments and did not have positive clinical improvement. No randomization and blindness was considered. All of the participants underwent three sessions of resin-directed hemoperfusion using continuous renal replacement therapy with a mode of continuous venovenous hemofiltration (CVVH). ResultsFive men and five women with a mean age of 57.30±18.07 years have been enrolled in the study; and six of them have improved after the intervention. Peripheral capillary oxygen saturation (SpO2) changed after each session. Mean SpO2 before the three sessions of hemoperfusion was 89.60%±3.94% and increased to 92.13%±3.28% after them (p<0.001). Serum IL-6 showed a reduction from 139.70±105.62 to 72.06±65.87 pg/mL (p=0.073); and c-reactive protein decreased from 136.25±84.39 to 78.25±38.67 mg/L (P=0.016).ConclusionsExtracorporeal hemoadsorption could improve the general condition in most of recruited patients with severe coronavirus disease; however, large prospective multicenter trials in carefully selected patients are needed to definitely evaluate the efficacy of hemoperfusion in COVID-19 patients.Trial registrationThe research protocol has been registered in the website of Iranian Registry of Clinical Trials with the reference number IRCT20150704023055N2.
Malaria distribution and performance of malaria diagnostic methods in Malaysia (1980-2019): a systematic review
Authors: Rahim Mohd Amirul Fitri A. , Munajat Bakhtiar , Id Zulkarnain Md 
Published: July 2020

Abstract
Background: Malaysia has already achieved remarkable accomplishments in reaching zero indigenous human malaria cases in 2018. Prompt malaria diagnosis, surveillance and treatment played a key role in the country’s elimination success. Looking at the dynamics of malaria distribution during the last decades might provide important information regarding the potential challenges of such an elimination strategy. This study was performed to gather all data available in term of prevalence or incidence on Plasmodium infections in Malaysia over the last four decades. Methods: A systematic review of the published English literature was conducted to identify malaria distribution from 1980 to June 2019 in Malaysia. Two investigators independently extracted data from PubMed, Scopus, Web of Science and Elsevier databases for original papers.Results: The review identified 46 epidemiological studies in Malaysia over the 39-year study period, on which sufficient information was available. The majority of studies were conducted in Malaysia Borneo (31/46; 67.4%), followed by Peninsular Malaysia (13/46; 28.3%) and in both areas (2/46; 4.3%). More than half of all studies (28/46; 60.9%) were assessed by both microscopy and PCR. Furthermore, there was a clear trend of decreases of all human malaria species with increasing P. knowlesi cases throughout the year of sampling period. The summary estimates of sensitivity were higher for P. knowlesi than other malaria species for both microscopy and PCR. Nevertheless, the specificities of summary estimates were similar for microscopy (40 – 43%) but varied for PCR (2 – 34%).Conclusions: This study outlined the epidemiological changes in Plasmodium species distribution in Malaysia. Malaria cases shifted from predominantly caused by human malaria to simian malaria, which accounted for the majority of indigenous cases particularly in Malaysia Borneo. Therefore, malaria case notification and prompt malaria diagnosis in regions where health services are limited in Malaysia should be strengthened and reinforced to achieving the final goal of malaria elimination in the country.
Superior Mesenteric Artery thrombosis in COVID-19 pneumonia: An underestimated diagnosis - First case report in Asia
Authors: Karna Sunaina Tejpal , Panda Rajesh , Maurya Ajeet Pratap , Saigal Saurab 
Published: July 2020

Abstract
The COVID-19 disease caused by novel Coronavirus was first reported in Wuhan, China in December 2019 with 5% patients having severe lung injury. Though this disease primarily presents as a lower respiratory tract infection, multiple digestive manifestations have been reported which are often overlooked. The present case report describes the unusual progression of COVID-19 disease from pneumonia to a procoagulant state leading to superior mesenteric artery thrombosis and subsequent gut ischemia necessitating emergency laparotomy. Coagulopathy in COVID-19 is due to an imbalance in the coagulation homeostasis with increase in thrombocytes in contrast to thrombocytopenia documented in cases of dissemination intravascular coagulation and sepsis. Early recognition of abdominal symptoms, diagnosis of pathology and timely surgical intervention may definitely improve outcome. In the management of any patient with COVID-19 disease, we advocate a comprehensive integrated approach with early recognition of digestive symptoms and their timely intervention which should run parallel to the respiratory management.
Favorable intensity of short-duration exercise stress combined with adenosine triphosphate to avoid artifacts in myocardial perfusion single-photon emission computed tomography
Authors: Shinoda Yukinori , Tachibana Koichi , Minamisaka Tomoko , Fukuoka Hidetada , Inui Hirooki , Ueno Keisuke , Inoue Soki , Mine Kentaro , Ueda Kumpei , Hoshida Shiro 
Published: July 2020

Abstract
Background: Myocardial perfusion single-photon emission computed tomography (SPECT) imaging with stress is a useful examination for detecting coronary artery disease. Since the presence of artifacts is remaining challenges, we aimed to define the minimum intensity of low-grade exercise stress levels combined with drug stress to reduce undesired artifacts and their related factors.Methods: We divided patients with suspicious coronary artery disease into 4 groups as follows: group A, adenosine triphosphate (ATP) for 6 min; group A+25 W, ATP+25 W exercise for 6 min; group A+35 W, ATP+35 W exercise for 6 min; group A+45 W, ATP+45 W exercise for 6 min) and enrolled only those whose summed stress scores were <3. Undesired artifacts were evaluated on the basis of heart-to-liver activity (H/L) ratio and heart-to-10 pixels below the heart (H/below the H) ratio. Results: The logarithmic values of H/L and H/below the H ratios were significantly higher in groups A+35 W and A+45 W than in group A (p<0.05, each). In all the patients, the logarithmic values of H/L and H/below the H ratios positively correlated with the increment of rate pressure product (RPP, p=0.002 and p=0.005, respectively) after stress in the univariate analysis. The left ventricular end-diastolic volume (LVEDV) after stress (p=0.002) negatively correlated with the logarithmic value of H/below the H ratio, but not H/L ratio. Although the increment of RPP was independently associated with the logarithmic values of both H/L (p=0.001) and H/below the H ratios (p=0.005), LVEDV was also independently associated with the logarithmic value of H/below the H ratio (p<0.001) in multivariate regression analysis under adjusting with age and sex.Conclusion: ATP plus ≥35 W exercise stress for 6 min was useful for reducing undesired artifacts after stress in myocardial perfusion SPECT. LVEDV after stress in addition to the increment of RPP was independently associated with the H/below the H ratio, but not the H/L ratio.
Composition and function of rhizosphere microbiome of Panax notoginseng with discrepant yields
Authors: Li Mengzhi , Chen Zhongjian , Qian Jun , Wei Fugang , Zhang Guozhuang , Wang Yong , Wei Guangfei , Hu Zhigang , Dong Linlin , Chen Shilin 
Published: July 2020

Abstract
Background: Panax notoginseng is a highly valuable medicinal plant. Reduced P. notoginseng yield is a common and serious problem that arises in a continuous cropping system. Variation in the composition and function of soil microbial community is considered the primary cause of yield reduction.Methods: This study used shotgun metagenomic sequencing approaches to describe the taxonomic and functional features of P. notoginseng rhizosphere microbiome and screen microbial taxa and functional traits related to yields. Results: At the family and genus level, a total of 43 families and 45 genera (relative abundance > 0.1%) were obtained, and the correlation with the yield of P. notoginseng was further analyzed. Nitrosomonadaceae, Xanthomonadaceae, Mycobacterium and Arthrobacter that were enriched in soils with higher yields were positively correlated with P. notoginseng yields, thereby suggesting that they might increase yields. Negative correlation coefficients indicated that Xanthobacteraceae, Caulobacteraceae, Oxalobacteraceae, Chitinophagaceae, Sphingomonas, Hyphomicrobium, Variovorax and Phenylobacterium might be detrimental to P. notoginseng growth. A total of 85 functional traits were significantly (P < 0.05) correlated with P. notoginseng yields. Functional traits, likely steroid biosynthesis and MAPK signaling pathway were positively correlated with P. notoginseng yields. In contrast, functional traits, such as bacterial secretion system, ABC transporters, metabolism of xenobiotics by cytochrome P450 and drug metabolism–cytochrome P450, were negatively associated with yields. Conclusions: This study describes an overview of the rhizosphere microbiome of P. notoginseng with discrepant yields and identifies the taxa and functional traits related to yields. Our results provide valuable information to guide the isolation and culture of potentially beneficial microorganisms and to utilize the power of the microbiome to increase plant yields in a continuous cropping system.
Heterogeneity analysis of COVID - 19 clinical phenotype in Wuhan
Authors: Yin Qin , Xie Jiao , Zhang Jixian , Fu Zhen , Zhu Wangcai , Xia Wenguang , Yu Yihan 
Published: July 2020

Abstract
BackgroundSince the outbreak of coronavirus disease 2019 (COVID-19), some studies reported the clinical characteristics of COVID-19 patients in hospital. However, these studies did not investigate the clinical symptoms heterogeneity of COVID-19 patients in the outpatient. This study aimed to describe the heterogeneity of clinical characteristics of outpatient COVID-19 patients.MethodsCOVID-19 patients visiting the respiratory outpatient department of our hospital from January 1st to February 28st 2020 were retrospectively analyzed. Based on the complaints, the patients were classified into four groups including group A (patients without symptoms), group B (patients with fever), group C (patients with respiratory symptoms but without fever), and group D (patients with extra-respiratory symptoms but without fever). The difference of clinical characteristics, basic diseases, laboratory examination of outpatient, characteristics of chest CT imaging among all the groups were analyzed and compared.ResultsA total of 309 COVID-19 patients were included with 126 men and 183 women. The common symptoms included fatigue (59.87%, 95% CI: 54.17-65.38%), loss of appetite (51.13%, 95% CI: 45.41-56.83%), fever (50.81%, 95% CI: 45.09-56.51%), muscle soreness (41.42%, 95% CI:35.88-47.14%), and dry cough (35.28%, 95% CI:29.95-40.89%). The percentages of group A to group D were 2.91%, 50.81%, 18.12%, and 28.16%, respectively. The most common symptoms in Group D included fatigue, loss of appetite, muscle soreness. ConclusionThe heterogeneity of clinical symptoms for COVID-19 patients in the outpatient is significant. We should pay attention to patients without symptoms or those with only extra-respiratory symptoms, who are prone to missed diagnosis.
Risk Factors for Neonatal Bronchopulmonary Dysplasia in Extremely Preterm Premature Rupture of Membranes: A Retrospective Study
Authors: Nakamura Eishin , Matsunaga Shigetaka , Ono Yoshihisa , Takai Yasushi , Seki Hiroyuki 
Published: July 2020

Abstract
Background: Determination of the optimal timing for termination of pregnancy in cases of preterm premature rupture of membranes (pPROM) during the extremely preterm period is still difficult. Bronchopulmonary dysplasia (BPD) is a major disease widely taken into account when determining the prognosis of respiratory disorders in a neonate. Many aspects of this disease remain unclear. With the aim of further improving the prognosis of neonates born to mothers with pPROM, this study examined cases who were diagnosed with pPROM before 28 weeks of gestation. The study analysed risk factors for neonatal BPD and the optimal timing for termination of pregnancy in pPROM cases.Methods:Subjects were 73 cases of singleton pregnancy who were diagnosed with pPROM during the period from 22 weeks and 0 days to 27 weeks and 6 days of gestation. The following factors were retrospectively examined: the gestational week at which a diagnosis of pPROM was made; the gestational week at which delivery occurred; the period for which the volume of amniotic fluid was maintained; and neonatal BPD as a complication. A receiver operating characteristic (ROC) curve was drawn in order to analyse the relationship between the duration of oligohydramnios and the onset of BPD.Results: The mean gestational week at which a diagnosis of amniorrhexis was made was 24.5±1.9 weeks (mean±SD), and that at which delivery occurred was 27.0±3.0 weeks. Fifty-seven cases (78.1%) were diagnosed with oligohydramnios, the mean duration of which was 17.4±20.5 days. The mean birth weight of neonates was 1000±455 g, of which 49 (67.1%) were diagnosed with BPD following birth. No neonates died in this study. Multivariate analysis of various risk factors for the onset of BPD indicated that oligohydramnios is an independent risk factor for BPD. The ROC curve indicated that the cut-off value was 4 days. In this case, the levels of sensitivity and specificity for predicting the onset of neonatal BPD were 0.941 and 0.917 respectively.Conclusion: Our findings suggest that oligohydramnios is an independent risk factor for BPD in cases who are diagnosed with pPROM before 28 weeks of gestation.
COVID-19 related deaths in an urban academic medical center in Brooklyn – A descriptive case series
Authors: McCracken James Andrew , Nakeshbandi Mohamed , Arace Jeffrey , Riley Wayne J , Sharma Roopali 
Published: July 2020

Abstract
Background Available studies are lacking in analysis of baseline demographics and hospital presentation of patients at risk of expiring due to coronavirus disease 2019 (COVID-19), particularly Black American patients. We conducted a retrospective chart review to determine similarities in demographics and hospital presentation among patients who expired due to COVID-19 at an academic medical center in Brooklyn, New York. Study design and methods This is a retrospective observational study of 200 patients who expired due to complications of COVID-19. Patients were included in this study if they had laboratory-confirmed SARS-CoV-2 infection and expired during their admission. Data were collected on patients who expired between March 17 and April 16, 2020. Results A vast majority of patients were Black Americans (89%) with no history of international travel who had more than one comorbidity (81%), with the most common comorbidities being hypertension (84·5%), diabetes mellitus (57·5%), and obesity (41·5%). Fifty-five percent of our patient population had three or more comorbidities. Among patients with available data, C-reactive protein, lactate dehydrogenase, and ferritin values were elevated above normal limits at admission. Dyspnea was the most common presenting symptom (92·5%). Most (90·5%) presented within the first week of symptoms, with a median time of symptoms prior to expiration being 8·42 days (IQR 5·57 – 12·72). Interpretation Socioeconomic status and healthcare inequalities have greatly affected the Black population of Brooklyn, New York, and these disparities become even more apparent in COVID-19 infection. Patients presenting with numerous comorbidities and elevated inflammatory markers represent a population at high risk of in-hospital mortality.