bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence and Risk Factors associated with Post-operative Nausea and Vomiting in Elective Adult Surgical Patients at Wolaita Sodo Teaching Referral Hospital: An Institutional Based Cross-sectional Study
Authors: Temesgen Ashagrie Sintayhu , Wolde Getahun Dendir 
Published: August 2020

Abstract
Background

Postoperative nausea and vomiting is among the most common postoperative complications, despite modern anesthetics and surgical techniques. It can occur during the operation and persisting in the postoperative period cause reduces patient comfort, delayed discharge from the hospital and an increase in costs. The risk factors that affect the incidence of post-operative nausea and vomiting are multifactorial in origin and occur in 20 to 30% of all patients and can extend up to 60–70% in high-risk patients. The objective of this study was to determine the incidence and associated risk factors of postoperative nausea and vomiting.
Methods

An institution-based, cross-sectional study was conducted from March to August 2019 in Wolaita Sodo University teaching referral hospital (WSUTRH). A total of 371 adult elective patients who operated during this period were included in the study. Data were collected by interviewing patients and reviewing their cards then entered and analyzed using SPSS version 25. Variables with P value less than < 0.2 in the bivariate analysis were fitted into the multivariable logistic regression analysis to identify factors associated with postoperative nausea and vomiting and a P value of < 0.05 was considered statistically significant.
Results

The incidence of postoperative nausea and vomiting 24hour after surgery was 29.1%. In multivariable analysis, previous history of PONV (AOR = 5.1, 95%CI = 4.00-6.58), use of opioids (AOR = 4.91, 95%CI = 3.08–10.37), use of inhalational anesthetic agent (AOR = 2.38, 95%CI = 1.45–5.30), and long duration of surgery AOR = 6.65, 95%CI = 5.52–8.30) were significantly associated with the incidence of postoperative nausea and vomiting.
Conclusions

The incidence of postoperative nausea and vomiting was high compared to other studies done in different settings. Previous history of PONV, use of opioids, use of inhalational anesthetic agents and long duration of surgery are predictors of postoperative nausea and vomiting. We recommend routine preoperative PONV risk evaluation and give antiemetic premedication for those high-risk patients.
Health Professional Assisted Kangaroo Mother Care Practice in Ethiopian Health Facilities: Evidence from the 2016 Ethiopian Demographic and Health Survey Data
Authors: Kassaw Mesfin Wudu , Abebe Ayele Mamo , Abate Biruk Beletew , Kassie Ayelign Mengesha , Tegegne Kirubel Dagnaw 
Published: August 2020

Abstract
Background Worldwide, 15 million babies born prematurely every year and over one million babies died because of premature birth complications. However, three-fourths of deaths from preterm birth complications are preventable without intensive care units. One of the prevention methods is Kangaroo Mother Care, which is a method of holding a small neonate in skin-to skin contact, upright prone position on the maternal chest. An evidence stated that KMC can prevent up to half of all deaths in babies weighing <2000 gm at birth. Ethiopian guidelines also mentioned that all LBW babies need to receive KMC. The aim of this study was to assess health professional assisted Kangaroo mother care practice and association among mothers who gave birth in a health facility in Ethiopia.Methods This study produced from the 2016 Ethiopian Demographic and Health Survey data (EDHS). The 2016 EDHS used a stratified two stage sampling method to select a representative sample for the country, Ethiopia. According to the 2016 EDHS data, all the regions were stratified into urban and rural areas. The study sample refined from EDHS and used in this secondary analysis is 2,760 mother-child pairs. A logistic regression model was used to assess the associations with the size of a child at birth. Results mothers who gave birth in a health facility and practiced kangaroo mother care were 1808 (62.1%), 95% CI (60,3, 63.9).The others 1102(37.9%), 95%CI(36.1, 39.7) of mothers did not practiced KMC, although they were gave birth in health facilities under the support of trained health professionals. In the multivariable logistic regression analysis, only wealth index, poorest ((AOR), (95%CI)), ((0.60), (0.43, 0.81)), and poorer ((0.62), (0.46, 0.86)) were associated with health professionals assisted KMC practice.Conclusions The prevalence of health professional assisted KMC practice was low, which was far lower than the expectation for mothers who gave birth in health facilities. Low socio-economic status was protective for not practicing KMC. The reason might be that mothers from higher income households might not initiate breast feeding, which might contribute for not practicing KMC. Thus, the minister of health or other researchers should study further why mothers from high income did not practicing KMC in considering the assumption of this author.
Three-year Longitudinal Skill-based Teaching Curriculum for All Residents
Authors: Rowat Jane , Johnson Krista , Antes Lisa , White Katherine , Rosenbaum Marcy , Suneja Manish 
Published: August 2020

Abstract
BACKGROUND. Despite significant teaching responsibilities and national accreditation standards, many residents do not receive adequate instruction in teaching methods. Published reports of residents-as-teachers programs vary from brief one-time exposures to curricula delivered over several months. A majority of interventions described are one or two-day workshops with no clear follow-up or reinforcement of skills. A three-year longitudinal teaching skills curriculum was implemented with these goals: 1) deliver an experiential skill-based teaching curriculum allowing all residents to acquire, practice and implement specific skills; 2) provide spaced skills instruction promoting deliberate practice/reflection; and 3) help residents gain confidence in their teaching skills.METHODS. One hundred percent of internal medicine residents (82/82) participated in the curriculum. Every 10 weeks residents attended a topic-specific experiential skills-based workshop. Each workshop followed the same pedagogy starting with debriefing/reflection on residents’ deliberate practice of the previously taught skill and introduction of a new skill followed by skill practice with feedback. Every year, participants completed: 1) assessment of overall confidence in each skill and 2) retrospective pre-post self-assessment. A post-curriculum survey was completed at the end of three years.RESULTS. Residents reported improved confidence and self-assessed competence in their teaching skills after the first year of the curriculum which was sustained through the three-year curriculum. The curriculum was well received and valued by residents.CONCLUSIONS. A formal longitudinal, experiential skills-based teaching skills curriculum is feasible and can be delivered to all residents. For meaningful skill acquisition to occur, recurrent continuous skill-based practice with feedback and reflection is important.
Internationalization of Medical Education in China: An Overview of Students' Outward Mobility in a Medical University
Authors: Jiang Qin , Sun Hong , Duan Wei , Wu Yang , Yuan Feng , Liu Shenjun 
Published: August 2020

Abstract
Background: Challenged by globalization, internationalization of medical education has become an irreversible trend. By analyzing students’ outward mobility in a medical university, eastern China, this study tries to investigate the internationalization of medical education in China.Methods: The data, obtained from international affairs office of Xuzhou Medical University, China, provided information about outward students’ backgrounds, destinations, program types and funding plans in the past nine years, and were analyzed with the use of MS Excel.Results: Students’ outward mobility has increased in the past nine years, though with a low number. Students with characteristics of undergraduate, traditional discipline related, the second and third year were more motivated in going outward. Traditional destinations like US and UK were still popular, Australia and other European countries were not hot. Developed countries and regions in Asia were becoming more and more vigorous, but developing countries were deep in freeze. Outward students demonstrated great interest in short-term programs, but little in course study and research program. The effect of financial support in students’ outward mobility was obvious, yet the investment was quite limited. Conclusion: The results suggest that students’ outward mobility has been improving in the past nine years. However, European countries and developing countries did not receive enough attention, and communication in interdisciplinary fields was insufficient, neither was it in course and research collaborations. Our findings provide important reference information for policy-makers of various countries and universities. At the same time, since a big potential for future mobility can be seen, the university should do the best to call for concerted efforts from governments, education institutions and the society to further improve internationalization of medical education.
QALYs and DALYs are Better with Concurrent ChemoRT than Induction Chemo Followed by ChemoRT in Nasopharyngeal Carcinoma.
Authors: Nittala Mary R , Kanakamedala Madhava R. , Mundra Eswar K. , Woods Williams C. , Smith Maria L. , Hamilton Robert D. , Jefferson Gina D , Jackson Lana , Packianathan Satyaseelan , Vijayakumar Srinivasan 
Published: August 2020

Abstract
Background: As traditional measures such as overall survival (OS) or disease-free survival (DFS) alone does not give a holistic view of the outcomes of a treatment paradigm, we determine to add the evidence of quality-adjusted life year (QALY) and disability-adjusted life year (DALY) to the outcomes of the nasopharyngeal carcinoma patients (NCP) treated with definitive chemoradiation therapy (chemoRT) with or without induction chemotherapy.Methods: This is a retrospective analysis of 85 NCPs treated at an academic state institution. The OS estimated by Kaplan–Meier method and the multivariate Cox regression model determined the co-variables associated with the OS. The relationship between QALYs gained and DALYs saved were calculated from age of the disease onset, duration of the disease, quality of life (QoL) and disability weights.Results: Of the 85 eligible NCPs of this cohort, the disease frequency distribution per the World Health Organization (WHO) classification was 41.2% for Type-I, 42.4% for Type-II, and 16.5% for Type-III. The median follow-up (24 months). The 5-year OS of patients treated with concurrent chemoRT vs. induction chemo followed by concurrent chemoRT was 54.7 vs. 14.8% for WHO Type I, 60.1 vs. 58.3% for WHO Type II, and 83.3 vs. 50.0% for WHO Type III (p= 0.029). The average DALYs saved with concurrent chemoRT was 12.2 years vs. 5 years for induction chemo followed by concurrent chemoRT. The average QALYs gained with concurrent chemoRT was 6.9 years vs. 3.1 years for induction chemo followed by concurrent chemoRT.Conclusion: Patients treated with concurrent chemoRT had an increased QoL when compared to induction chemo followed by concurrent chemoRT. The average DALYs saved were higher in the patients treated with concurrent chemoRT than treated with induction chemo followed by concurrent chemoRT.
Clinical Utility of Complex Assessment With Evoked Potentials in Acute Lymphoblastic Leukemia Survivors: Comparison of Various Treatment Protocols
Authors: Kroczka Slawomir , Stepien Konrad , Witek-Motyl Izabela , Kwiecinska Kinga , Kapusta Eryk , Biedron Agnieszka , Skorek Pawel , Skoczen Szymon 
Published: August 2020

Abstract
Background: One of the largest success in a pediatric hematology is a prominent improvement of survival in acute lymphoblastic leukemia (ALL). Simultaneously, it encourages to focus on long-term effects of the treatment such as neurotoxicity. One of the few diagnostic methods that allow an objective assessment of sensory organization are evoked potentials (EP).Methods: We analyzed the group consisted of 167 ALL long-term survivors, aged 4.9-28.4 years, without auditory, visual and sensory deviations. Patients were treated with New York (NY, n=35), previous modified Berlin-Frankfurt-Münster (pBFM, n=47) and BFM95 (n=85) protocols. In order to assess the impact of radiotherapy on recorded EP, a joint analysis of NY and pBFM groups was performed. The control group consisted of 35 patients, aged 6-17 years. The analyzed patients underwent a complex assessment with visual EP (VEP), somatosensory EP (SEP) and brainstem auditory EP (BAEP) in accordance with current standards.Results: ALL treatment contributed to the shortening of wave I latency (1.59 vs 1.90, P=0.003) and prolongation of I-III (2.23 vs 2.04, P=0.004) and I-V (4.57 vs 4.24, P=0.002) interwave latencies in BAEP. A significant effect was also noticed in P100 (106.32 vs 101.57, P<0.001) and N135 (151.42 vs 138.22, P<0.001) latencies for VEP and N18 amplitude (3.24 vs 4.70, P=0.007) and P25 latency (21.32 vs 23.39, P<0.001) for SEP. The distribution of abnormalities between protocols was similar in BAEP (NY - 68.6%, pBFM - 61.7%, BFM95 - 69.4%, P=0.650), VEP (NY - 68.6%, pBFM - 42.5%, BFM95 - 58.3%, P=0.053) and significantly different for SEP (NY - 62.9%, pBFM - 36.2%, BFM95 - 53.0%, P=0.045). The harmful effect of radiotherapy was most clearly marked in numerous disturbances of SEP parameters.Conclusions: The presented analysis indicates a high frequency of subclinical abnormalities in EP regardless of the analyzed protocol. To our knowledge current study is the largest and one of the most complex research examining the role of EP in ALL patients. The obtained results indicate the possibility of using a single, objective and non-invasive measurement of EP in ALL survivors in order to stratify the risk of developing sensory abnormalities in adulthood.
Antimicrobial resistance in Neisseria gonorrhoeae isolates and gonorrhoea treatment in the Republic of Belarus, Eastern Europe, 2009-2019
Authors: Aniskevich Aliaksandra , Shimanskaya Iryna , Boiko Iryna , Golubovskaya Tatyana , Golparian Daniel , Stanislalova Iryna , Jacobsson Susanne , Adaskevich Aliaksandr , Unemo Magnus 
Published: August 2020

Abstract
Background: Increasing antimicrobial resistance (AMR) in Neisseria gonorrhoeae , including to first-line treatment options, is a great concern worldwide. However, very limited gonococcal AMR data are available in Eastern Europe. We investigated the AMR in N. gonorrhoeae isolates (n=522) cultured in three regions of the Republic of Belarus, 2009-2019, antimicrobial treatment recommended nationally, and treatment given to 1652 gonorrhoea patients in two of the regions (Minsk, 2013-2018; Mogilev, 2010-2019). Methods: Determination of minimum inhibitory concentrations (MICs) of eight antimicrobials was performed using Etest and, where available, resistance breakpoints from the European Committee on Antimicrobial Susceptibility Testing were applied. β-lactamase production was examined using a Nitrocefin test. Gonorrhoea treatment was analysed from medical records. Results: In total, 27.8% of isolates were resistant to tetracycline, 24.7% to ciprofloxacin, 7.0% to benzylpenicillin, 2.7% to cefixime, and 0.8% to azithromycin. No isolates were resistant to ceftriaxone, spectinomycin, or gentamicin. However, four (0.8%) isolates had a ceftriaxone MIC of 0.125 mg/L, which is exactly at the resistance breakpoint (MIC>0.125 mg/L). Only one (0.2%) isolate, from 2013, produced β-lactamase. From 2009-2019, the levels of resistance to ciprofloxacin and tetracycline were relatively stably high. Resistance to cefixime was not identified before 2013, but peaked at 22.2% in 2017. Only sporadic isolates with resistance to azithromycin were found in 2009 (n=1), 2012 (n=1) and 2018-2019 (n=2). Overall, 862 (52.2%) patients received first-line treatment in accordance with national guidelines (ceftriaxone 1 g). However, 154 (9.3%) patients received a nationally recommended alternative treatment (cefixime 400 mg or ofloxacin 400 mg), and 636 (38.5%) patients were given treatment non-compliant to the Belarusian national gonorrhoea guideline. Conclusions: Ceftriaxone 1 g, in combination with azithromycin 2 g particularly when chlamydial infection has not been excluded, should be recommended as empiric first-line treatment. Spectinomycin 2 g, where available, together with azithromycin 2 g could be an alternative treatment. When susceptibility has not been confirmed by testing, fluoroquinolones should not be used for treatment. Timely updating of and high compliance to national evidence-based gonorrhoea treatment guidelines that are based on quality-assured AMR data is imperative. Continued and expanded gonococcal AMR surveillance in Belarus is crucial.
The evaluation of annuloplasty in bicuspid aortic valve repair using cardiac magnetic resonance
Authors: Jasinski Marek , Miszalski-Jamka Karol , Gocol Radoslaw , Wenzel-Jasinska Izabella , Bielicki Grzegorz , Berezowski Mikolaj , Kosiorowska Kinga , Lukaszewski Marceli , Kansy Andrzej , Deja Marek 
Published: August 2020

Abstract
Background: The incompetent bicuspid aortic valve (BAV) can be replaced or repaired using various surgical techniques. This study sought to assess the efficacy of external annuloplasty and postoperative reverse remodeling using cardiac magnetic resonance (CMR) and compare the mid-term results of external and subcommissural annuloplasty. Methods: Out of a total of 200 BAV repair performed between 2004 and 2018, 21 consecutive patients (median age 54 years) with regurgitation requiring valve repair with annuloplasty without concomitant aortic root surgery were prospectively referred for CMR and transthoracic echocardiography (TTE) one year after the operation. Two aortic annulus stabilization techniques were used: external, circumferential annuloplasty (EA), and subcommissural annuloplasty (SCA). Results: 11 patients received EA and 10 patients were treated using SCA. There was no in-hospital mortality and all patients survived the follow-up period. CMR showed strong correlation between postoperative aortic recurrent regurgitant fraction and left ventricular end-diastolic volume (r=0.62; p=0.003) as well as left ventricular ejection fraction (r=-0.53; p=0.01). Patients treated with EA as compared with SCA had larger anatomic aortic valve area measured by CMR (3.5cm2 (2.5; 4.0) vs. 2.5cm2 (2.0; 3.4); p=0.04). In both EA and SCA group, aortic valve area below 3.5cm2 correlated with no regurgitation recurrency. EA (vs. SCA) was associated with lower peak transvalvular aortic gradients (10mmHg (6; 17) vs. 21mmHg (15; 27); p=0.04). Conclusions: The repair of the bicuspid aortic valve provides significant mid-term postoperative reverse remodeling, provided no recurrent regurgitation and durable reduction annuloplasty can be achieved. External, circumferential annuloplasty is associated with better hemodynamics compared to subcommissural annuloplasty.
Analysis of STAG3 Mutations in Chinese Non-Obstructive Azoospermia Patients with Germ Cell Maturation Arrest
Authors: Liu Wen , Gao Xuan , Zhang Haobo , Liu Ran , Cao Yongzhi , Yu Ruimei , Fang Ge , Ma Jinlong , Zhao Shidou 
Published: August 2020

Abstract
Background STAG3 is essential for male meiosis and testis of male Stag3-/- mice shows the histopathological type of germ cell maturation arrest (MA). Whether mutations of the STAG3 gene exist in Chinese idiopathic non-obstructive azoospermia (NOA) patients needs to be determined. Methods We recruited 58 Chinese NOA men with MA who underwent testis biopsy and 192 fertile men as the control group. The 34 exons of the STAG3 gene were amplified using polymerase chain reaction (PCR) and sequenced. Results We identified eight novel single nucleotide polymorphisms (SNPs), including two missense SNPs (c.433T>C in exon2 and c.553A>G in exon3), three synonymous SNPs (c.539G>A, c.569C>T in exon3, and c.1176C>G in exon8), and three SNPs in introns. The allele and genotype frequencies of the novel and other SNPs have no significant differences between two groups. Conclusions Our results indicated that mutations in the coding sequence of the STAG3 gene were uncommon in NOA patients with MA in Chinese population. Future studies in large cohorts of different ethnic populations will be needed to determine the association between the STAG3 gene and NOA.
Expression of Alpha-Enolase 1 (ENO1) in Villi from Patients with Recurrent Miscarriage and Its Effect on Proliferation and Invasion of Villous Trophoblasts
Authors: Tang Huai-Yun , Pan Lin-Qing , Tang Li-Sha , Cui Yu-Gui , Liu Jia-Yin 
Published: August 2020

Abstract
Recurrent miscarriage (RM) is a common reproductive endocrine disease in women of childbearing age. At present, the etiology of RM in approximately 50% women remains unknown. The purpose of this study was to explore the possible mechanism(s) of enolase 1 (ENO1) in RM and to seek a new target for clinical diagnosis and treatment of the disease. In this study, we detected the expression difference of ENO1 in villous tissues between the RM group and the control group, and we found that ENO1 was significantly lower in the RM group. Immunohistochemistry was also performed to examine the localization and expression of ENO1 in villous cytotrophoblast cells, and we found that ENO1 was mainly expressed in the cytoplasm, cell membrane, and nucleus of trophoblast cells. The villous trophoblast cell membrane coloration in the control group was significantly darker than that in the RM group, suggesting that ENO1 is expressed at low levels on the cell membrane of trophoblast cells of RM. ENO1 knockdown significantly inhibited cell migration and proliferation compared with the blank control group. Therefore, we conclude that ENO1 may mediate the occurrence of RM by downregulating the proliferation and invasion of villous trophoblasts. The specific mechanism needs further clarification.
High accuracy classification of COVID-19 coughs using Mel-frequency cepstral coefficients and a Convolutional Neural Network with a use case for smart home devices&nbsp;
Authors: Dunne Rob , Morris Tim , Harper Simon 
Published: August 2020

Abstract
Diagnosing COVID-19 early in domestic settings is possible through smart home devices that can classify audio input of coughs, and determine whether they are COVID-19. Research is currently sparse in this area and data is difficult to obtain. However, a few small data collection projects have enabled audio classification research into the application of different machine learning classification algorithms, including Logistic Regression (LR), Support Vector Machines (SVM), and Convolution Neural Networks (CNN). We show here that a CNN using audio converted to Mel-frequency cepstral coefficient spectrogram images as input can achieve high accuracy results; with classification of validation data scoring an accuracy of 97.5% correct classification of covid and not covid labelled audio. The work here provides a proof of concept that high accuracy can be achieved with a small dataset, which can have a significant impact in this area. The results are highly encouraging and provide further opportunities for research by the academic community on this important topic.