bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic implications of tricuspid annular plane systolic excursion/pulmonary arterial systolic pressure ratio in septic shock patients
Authors: Zhang Hongmin , Lian Hui , Zhang Qing , Chen Xiukai , Wang Xiaoting , Liu Dawei 
Published: June 2020

Abstract
Background
To explore the association between the ratio of tricuspid annular plane systolic excursion (TAPSE) and pulmonary arterial systolic pressure (PASP), and long- and short-term outcomes in mechanically ventilated septic shock patients.

Methods
Septic shock patients admitted to the intensive care unit (ICU) were screened for enrollment. Echocardiographic parameters including TAPSE and tricuspid regurgitation velocity, haemodynamic and respiratory parameters, and prognostic data were obtained.

Results
One hundred eighteen subjects were enrolled in this study, among whom 75 survived and 43 died at the one-year follow-up. ROC curve analysis revealed that the TAPSE/PASP ratio was able to assess one-year all-cause mortality with an area under the curve of 0.817 (95% CI: 0.739–0.896, p < 0.001) and the optimal cutoff value was 0.50 mm/mmHg. Kaplan-Meier survival analysis showed that one-year all-cause mortality was significantly higher in patients with TAPSE/PASP ≤0.5 mm/mmHg than in patients with TAPSE/PASP > 0.5 mm/mmHg (log-rank 32.934, p < 0.001). According to the Cox regression survival analyses, the TAPSE/PASP ratio was independently associated with one-year all-cause mortality (HR 0.007, 95% CI:0.000–0.162, p = 0.002) and ICU mortality (HR 0.027, 95% CI:0.001–0.530, p = 0.017). According to the multivariable analysis, the TAPSE/PASP ratio was an independent variable associated with mechanical ventilation (MV) duration (standard coefficient − 0.240, p = 0.010).

Conclusion
The TAPSE/PASP ratio demonstrated prognostic value for one-year all-cause mortality, ICU mortality and MV duration in mechanically ventilated septic shock patients.
The HIV care continuum and HIV-1 drug resistance among female sex workers: a key population in Guinea-Bissau
Authors: Lindman Jacob , Djalo Mamadu Aliu , Biai Ansu , Månsson Fredrik , Esbjörnsson Joakim , Jansson Marianne , Medstrand Patrik , Norrgren Hans ,   the SWEGUB CORE group, N’Buna Babetida , Biague Antonio , Biai Ansu , Camara Cidia , da Silva Zacarias Jose , Esbjörnsson Joakim , Jansson Marianne , Karlson Sara , Lindman Jacob , Medstrand Patrik , Månsson Fredrik , Norrgren Hans , Sahin Gülsen Özkaya , Wilhelmson Sten 
Published: June 2020

AbstractIntroductionFemale sex workers (FSW) are considered a key group for HIV transmissions in sub-Saharan Africa. The HIV Care Continuum and HIV drug resistance (HIVDR) among FSW has not been well studied in most countries in West Africa. In the current study we describe the HIV Care continuum and prevalence of HIVDR among FSW in Guinea-Bissau.MethodsA venue-based recruitment and peer-referral of FSW was used in seven cities in Guinea-Bissau from October 2014 to September 2017. We administered a questionnaire, performed discriminatory HIV-testing and collected blood specimens for CD4 count, viral load and HIVDR genotyping.ResultsThe survey included 440 FSW. The overall HIV-prevalence among FSW was 26.8%. Of the HIV-1 (HIV-1 single- or dually HIV-1/HIV-2) infected FSW (N = 104), 58.7% were previously diagnosed with HIV-1 at enrolment and 41.4% reported taking antiretroviral therapy (ART) compared to 28.6% of the HIV-2 single-infected FSW (N = 14). Among HIV-1 infected FSW on ART (N = 43), 55.8% were virally suppressed (< 1000 copies/ml) and of all HIV-1 infected FSW, 29.8% were virally suppressed. Among ART experienced FSW (N = 22), 50.0% had HIVDR. HIVDR was also found in 9.4% of treatment naïve FSW (N = 53).ConclusionThe majority of FSW who knew their HIV status received ART, however a large proportion of FSW were not aware of their HIV positive status. This translated into a great majority of the HIV-infected FSW not being virally suppressed. Amongst treatment naïve FSW nearly a tenth had HIVDR, suggesting that sexual transmission of HIVDR is occurring in this at-risk-population.
Pilot prospective open-label one-arm trial investigating intrathecal Adenosine in neuropathic pain after lumbar discectomy
Authors: Aghamohammadi Dawood , Eydi Mahmood , Pishgahi Alireza , Esmaeilinejad Azam , Dolatkhah Neda 
Published: June 2020

Abstract
Objectives
Adenosine has an analgesic and anti-inflammatory role and its injections are used for perioperative pain management. We aimed to study efficacy of intrathecal injection of adenosine for post-operative radicular pain after lumbar discectomy. Forty patients with unilevel lumbar discectomy who had radicular lower limb pain were treated by 1000 micrograms of intrathecal injection of adenosine in this single-arm prospective open-label trial between November 2015 to October 2016. Radicular pain severity using visual analogue scale (VAS) and pain killer consumption per day were assessed during a 3 months follow up period.

Results
Radicular pain severity was significantly reduced in 3 month follow-up period in comparison to the baseline (F = 19,760, df = 2.53, p-value < 0.001). Further, painkiller medication consumption rate in average during 3 month follow-up period after injection was significantly lower in comparison to baseline (F = 19.244, df = 1.98, p-value < 0.001). This study suggests that intrathecal injection of 1000 micrograms adenosine is a safe and effective method for post-operative neuropathic pain management after uni-level disk surgeries.
Trial registration IRCT201608171772N20, Retrospectively registered on 2016-08-28.
Development of a new virtual reality test of cognition: assessing the test-retest reliability, convergent and ecological validity of CONVIRT
Authors: Horan Ben , Heckenberg Rachael , Maruff Paul , Wright Bradley 
Published: June 2020

Abstract
Background
Technological advances provide an opportunity to refine tools that assess central nervous system performance. This study aimed to assess the test-retest reliability and convergent and ecological validity of a newly developed, virtual-reality, concussion assessment tool, ‘CONVIRT’, which uses eye-tracking technology to assess visual processing speed, and manual reaction time (pushing a button on a riding crop) to assess attention and decision-making. CONVIRT was developed for horse jockeys, as of all sportspersons, they are most at risk of concussion.

Methods
Participants (N = 165), were assessed with CONVIRT, which uses virtual reality to give the user the experience of riding a horse during a horserace. Participants were also assessed with standard Cogstate computer-based concussion measures in-between two completions of the CONVIRT battery. The physiological arousal induced by the test batteries were assessed via measures of heart rate and heart rate variability (LF/HF ratio).

Results
Satisfactory test-retest reliability and convergent validity with Cogstate attention and decision-making subtests and divergent validity in visual processing speed measures were observed. CONVIRT also increased heart rate and LF/HF ratio, which may better approximate participant arousal levels in their workplace.

Conclusions
CONVIRT may be a reliable and valid tool to assess elements of cognition and CNS disruption. The increased ecological validity may also mean better informed ‘return-to-play’ decisions and stronger industry acceptance due to the real-world meaningfulness of the assessment. However, before this can be achieved, the sensitivity of the CONVIRT battery needs to be demonstrated.
Pottery production and trades in Tamil Nadu region: new insights from Alagankulam and Keeladi excavation sites
Authors: Odelli E. , Selvaraj T. , Perumal J. , Palleschi V. , Legnaioli S. , Raneri S. 
Published: June 2020

Abstract
This research is part of a wider scientific Italian-Indo project finalised to shed lights on pottery fabrication and trade circulation in Tamil Nadu region during Early Historical Period. The recent archaeological excavations carried out in Alagankulam—a famous harbour trading with the eastern and western world—and in Keeladi—the most ancient civilization centre attested in Tamil Nadu region—provided numerous fragments of archaeological ceramics. The typological analysis enabled the identification of different pottery classes, suggesting the presence of local productions, possible imports and imitations. Studied shards included common Indian vessels, fine wares and luxury ware repertoire. The provenance identification of some of the studied typologies is still debated in the literature; for long time, the misattribution of several ceramic classes has led to wrong interpretations on the commercial connections between India and the Western and Eastern Mediterranean area. The minero-petrographic and spectroscopic investigation of several ceramic fragments from the two investigated archaeological sites enabled the systematic compositional characterization of specific ceramic classes both locally manufactured and imported. The obtained results contributed to draw short-range and long-range connections in Tamil Nadu area.
Parental attitudes and family helmet use for all-terrain vehicles and bicycles
Authors: Wymore Cole , Denning Gerene , Hoogerwerf Pamela , Wetjen Kristel , Jennissen Charles 
Published: June 2020

Abstract
Background
Helmets prevent head trauma in both all-terrain vehicle (ATV) and bicycle crashes. This pilot study’s objective was to compare family helmet use and participant attitudes regarding helmets for ATVs versus bicycles.

Methods
A convenience sampling of adults attending a 2017 university-sponsored health fair who had at least one child < 18 years living at home were surveyed. Demographics, frequency of helmet use, and information about factors influencing helmet use were collected. Descriptive (frequencies) and bivariate (Fisher’s exact test) analyses were performed. Qualitative themes of written responses were also examined.

Results
Subjects (N = 98) were 26–57 years old (mean 40 years). Three-quarters (76%) were female. The percentage always wearing a helmet riding bicycles was 63% (subjects), 58% (spouses/partners), and 51% (children), compared to 11, 14 and 37% on ATVs, respectively. Moreover, the percentage never wearing a helmet while on an ATV was 68% for subjects, 71% for spouses, and 47% for children. Despite helmet use differences between bicycles and ATVs, the importance of children wearing a helmet on these vehicles was rated highly and equally important, 9.28 and 9.58 on a 1–10 scale, respectively. Higher proportions of subjects’ oldest children wore a bike helmet 100% of the time if at least one parent always wore a helmet (81%), compared to children whose parents both wore helmets < 100% of the time or didn’t ride (21%) (p < 0.0001). The proportion of children wearing ATV and bicycle helmets less than 100% of the time was significantly higher if parents reported barriers to effectively enforcing helmet use than if they did not (p = 0.04 and p = 0.004, respectively). Many reported a “strict no helmet, no bike/ATV riding rule” as being most effective in getting their children to always wear a helmet.

Conclusions
This study is the first to explore family helmet use while riding bicycles vs ATVs. Although parent’s belief in the importance of helmet use was high for both, helmet use was greater when riding bicycles. Further research is needed to better understand the social and environmental influences that shape parental helmet attitudes and practices in order to improve safety interventions for increasing pediatric helmet use.
Evaluating teen driving knowledge and behaviors following educational outreach
Authors: Monroe Kathy , Nichols Michele , Crew Marie , Brown Leslie , King William 
Published: June 2020

Abstract
Background
Teen driving educational events are an effective strategy to increase adolescent drivers’ awareness of safe driving practices. The objectives of this study were to evaluate changing rates of self-reported driving practices and knowledge of the state Graduated Driver Licensing laws (GDL) by teens over a nine-year period in a single state.

Methods
This was a prospective observational study of high school students ages 14 to 19 years old. Paper surveys were sent to the high schools participating in teen driving educational events (9 schools in 2009 and 4 schools in 2018). Students in those schools completed surveys prior to the events. Students completing the anonymous survey were invited to the event. Questions evaluated awareness of state GDL and safe and risky driving behaviors. Statistical comparisons of survey answers from 2009 to 2018 were analyzed using the z test of proportions (2 tailed, alpha 0.05).

Results
A total of 397 students participated in 2018 with ages ranging from 14 to 19 years. Racial distribution was 81% white, 14% black, and there were 57% female participants. Only 69% (n = 273) reported “always” wearing their seatbelt. When asked about high risk behaviors, 78% (n = 309) of adolescents reported they personally “never” text while driving; 97% (385); never drive after drinking, and 87% (n = 344) never ride with someone who has been drinking. Compared to 2009 participants (1304 students, 9 schools from central part of state), the students in 2018 (4 schools scattered across state) reported wearing seatbelts “always” (n = 69% vs 39%; p < 0.001); “never texting while driving” (78% vs 33%; p < 0.001); and “never drinking and driving” (97% vs 88%; p < 0.001). No significant difference in rates of students having taken a driving education class nor driving over speed limit were reported.

Conclusion
Results are encouraging that participants in 2018 report more use of seatbelts, less texting while driving, less drinking while driving and lower numbers of being in MVC than in 2009. However, rates of high-risk driving behaviors are still concerning.
Effect of lock boxes and education on safe storage of medications
Authors: Webb Alicia C. , Nichols Michele H. , Shah Nipam , Monroe Kathy W. 
Published: June 2020

Abstract
Background
Safe medication storage is a proven barrier to ingestions in the pediatric population, but caregivers are often unaware of the importance of safe storage practices or do not have a safe place to store medications. Caregivers may also not be fully aware that the patterns of opioid use and misuse have recently reached crisis levels. The objectives of this study were to define medication storage practices and knowledge of the opioid crisis of participants and to assess the effectiveness of an emergency department intervention on safe medication storage.

Methods
This was a prospective interventional study of caregivers in an urban pediatric emergency department (ED) on safe medication storage and the opioid crisis. Questions assessed the caregivers’ current perceptions and practices related to medication storage and disposal, and opioid crisis awareness. The intervention included verbal instruction about recommended safe storage methods and the opioid crisis, provision of a medication safety handout, and distribution of a medication lock box. A follow-up phone survey conducted 2 weeks later asked participants about use of and satisfaction with the lock box. Frequencies of safe storage behaviors were calculated, and the chi-square statistic was used to compare storage behavior after the intervention.

Results
Fifty caregivers of 112 children were enrolled. Only 4% reported they currently stored medications in a locked or latched place. Thirty-eight percent reported their main barrier to storing medications safely was that they did not have a locked or latched storage location. Fifty percent were unaware of the opioid crisis. Ninety-two percent reported they would use a lock box if given one. Twenty-eight participants (56%) responded to the follow-up phone call survey 2 weeks later. At follow up 90% (25/28) reported they placed their medications within the provided lock box (p < 0.00001). Ninety-two percent reported being “very satisfied” with the lock box and how it works.

Conclusions
Despite widespread reporting on this issue, many caregivers remain unaware of safe medication storage practices and the opioid crisis. Providing medication lock boxes removes a commonly reported barrier to safely storing medications and improved reported practices.
Grade 3 well-differentiated neuroendocrine tumor of the rectum: a case report
Authors: Ito Misato , Hirano Yasumitsu , Isii Toshimasa , Kondo Hiroka , Wang Liming , Asari Masahiro , Obara Nao , Yamaguchi Shigeki 
Published: June 2020

Abstract
Background
The 2019 revised World Health Organization (WHO) classification of tumors of endocrine organs classifies grade 3 gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN G3) into well-differentiated tumors (NET G3) and poorly differentiated carcinomas (NEC G3). There are few reported cases of NET G3 occurring in the rectum.

Case presentation
A 71-year-old man complained of bright red blood in his stool. Total colonoscopy revealed a mass in the lower rectum. Pathologic examination yielded a diagnosis of group 1. Computed tomography revealed swollen paraintestinal lymph nodes and multiple liver metastases. We performed laparoscopic abdominoperineal resection not only to avoid the unbearable symptoms caused by tumor growth but to make a pathological diagnosis. The tumor measured 3.5 × 2.8 cm, and the pathological diagnosis was stage IV neuroendocrine carcinoma. He underwent chemotherapy with irinotecan plus cisplatin, followed by carboplatin plus etopside, but his disease did not respond to either regimen. Twenty-seven months after surgery, he died of his disease. Upon re-examination of the surgical specimen, the tumor was consistent with the 2019 WHO classification of NET G3.6

Conclusion
A definite diagnosis of NET G3 or NEC G3 must be made to determine the appropriate treatment strategy for patients with GEP-NEN G3. Further case reports and case series are needed to establish the optimal therapy.
Central hepatectomy for hepatocellular carcinoma in a patient with anti-Gerbich antibody
Authors: Komokata Teruo , Inoue Maki , Aryal Bibek , Yasumura Hiroto , Mori Chinami , Nomoto Mituharu , Kaieda Mamoru , Hanada Shuichi 
Published: June 2020

Abstract
Background
Anti-Gerbich (Ge) alloantibody against high-frequency erythrocyte antigen is extremely rare. Owing to incomplete evidence regarding the degree and severity of adverse events induced by hemolytic transfusion reactions, the transfusion management often remains cumbersome in these patients. We report an anti-Ge alloantibody positive patient with hepatocellular carcinoma (HCC) who underwent central hepatectomy (CH) without the need for an allogeneic blood transfusion.

Case presentation
A 76-year-old Japanese woman was diagnosed with HCC measuring 9.5 × 8.0 cm in segments 4, 5, and 8 of the liver. This patient with anti-Ge alloantibody had a history of two pregnancies without transfusion. CH was planned, and based on the suggestion from the multidisciplinary team meeting, preoperative autologous donation (PAD) and acute normovolemic hemodilution (ANH) were performed. CH was successfully performed by using CUSA and Thunderbeat® with Pringle maneuver and infra-hepatic inferior vena cava clamping without perioperative need for an allogeneic blood transfusion. She has been alive without recurrence after a follow-up period of 45 months.

Conclusion
To our knowledge, this is the first case report of hepatectomy in a patient with anti-Ge alloantibody. A multidisciplinary team approach, PAD and ANH, and bloodless liver surgical techniques appear to be useful for major hepatectomy in patients with extremely rare blood type.
Methanol extract of Spathodea campanulata P. (Beauv.) leaves demonstrate sedative and anxiolytic like actions on swiss albino mice
Authors: Begum Anawara , Biswas Purobee , Shahed-Al-Mahmud Md. 
Published: June 2020

Abstract
Background
Spathodea campanulata P. Beauv. (Bignoniaceae) is a very common plant in Bangladesh which is locally called “Rudrapalash”. In Nigeria leaves extract of S. campanulata has a reputation of being used as an anticonvulsant. In this connection, the aim of this study was to investigate other neuropharmacological effects like sedative and anxiolytic activities of methanol extract of S. campanulata (MESC) leaves in different mice tests.

Methods
To assay sedative activity mice were subjected to open field and hole-cross test, whereas anxiolytic activity was checked by the elevated-plus maze, light-dark box, and hole-board test. For each test, mice were divided into control group (deionized water, 0.1 ml/mouse, p.o.), standard group (diazepam, 1 mg/kg, i.p) and three test groups (200, 400 and 600 mg/kg MESC, p.o.). The acute toxicity test and phytochemical screening of MESC were performed before the pharmacological study.

Results
The result demonstrated strong sedative and anxiolytic activity of MESC in a dose-dependent manner. All doses of MESC (200, 400 & 600 mg/kg) reduced the number of (square & hole) crossed by mice in both open field and hole cross tests (p < 0.001). On the other hand, in elevated plus-maze and light-dark box test mice opted to stay more in open arms and light box instead of close arms and dark box (p < 0.001). In hole-board test MESC (200, 400 & 600 mg/kg) elevated the number of head dipping (p < 0.001) dose-dependently. Phytochemical investigation indicated the presence of alkaloid, saponin, glycoside, carbohydrate, flavonoid, and tannin in MESC.

Conclusion
The experimental results explicit that S. campanulata leaves possess sedative and anxiolytic activities, hence suggest further chemical investigation to identify specific phytoconstituents responsible for sedative and anxiolytic effects.
Prevalence and associated risk factors of self-medication among patients attending El-Mahsama family practice center, Ismailia, Egypt
Authors: Zeid Wael , Hamed Madeha , Mansour Nadia , Diab Rokaya 
Published: June 2020

Abstract
Background
Self-medication is defined as taking medications without the physician’s prescription. It is a worldwide public health problem, especially in countries with limited resources. Although self-medication can reduce waiting time and save money, it may carry some potential risks, e.g., antibiotic resistance or inappropriate management with subsequent complication. A limited number of self-medication studies have been conducted in Egypt.

Objectives
To determine the prevalence of self-medication practices and to identify the factors associated with self-medication

Methods
A cross-sectional study was conducted on 160 patients. The sample was randomly selected from those who attended the El-Mahsama family practice center, Ismailia, Egypt, from November 2018 to February 2019. The center is affiliated to the Suez Canal University and provides preventive and curative services to a rural community. The participants were interviewed using a semi-structured questionnaire including sociodemographic scale and self-medication knowledge and behavior. Data was analyzed using descriptive and analytic statistical methods.

Results
Frequency of self-medication among the study sample has reached 96%. More than half of the participants (53.6%) reported that the first reason behind using self-medication was cost saving. Meanwhile, the most prevalent conditions that make them use these medications by themselves were headaches (17%), aches and pain (other than headache) (39.2%), and fevers (11.8%). The most frequent self-administered drugs were analgesics (59.5%) and antibiotics (23.5%).

Conclusion
Prevalence of self-medication is high among all socioeconomic levels of patients attending the El-Mahsama family practice center, which serves a rural community in Ismailia governorate, Egypt.