bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence-based management of acute rhinosinusitis with herbal products
Authors: Bachert Claus 
Published: December 2020

Abstract
Background
The overuse of antibiotics for unjustified indications such as the management of acute uncomplicated rhinosinusitis has contributed to the emergence of antibiotic-resistant strains of bacteria and prompted the need for alternative treatments. This review assesses the quality of evidence for the management of acute rhinosinusitis with herbal products, with the goal of positioning them among other treatments and identifying future research directions. The MEDLINE database was searched for randomized controlled trials with Sinupret®, Pelargonium sidoides extract, Cyclamen europaeum (CE), cineole, and GeloMyrtol®. Searches with N-acetylcysteine and mometasone furoate nasal spray (MFNS) were performed to compare the strength of evidence of herbal products to these conventional products, which are indicated for acute rhinosinusitis.

Main body
Evidence was strongest for Sinupret, followed by Pelargonium sidoides extract. Their use in acute rhinosinusitis is supported by randomized placebo-controlled trials demonstrating both clinical efficacy and safety. Comparative data with conventional treatments such as topical glucocorticosteroids were found only for Sinupret and suggested comparable efficacy in a small study.
For other herbal products, the overall level of evidence was low. The search retrieved two small-scale placebo-controlled randomized studies with CE nasal spray. The two trials were not powered to draw conclusions about the safety and efficacy of CE nasal spray and reported a lack of efficacy with CE on symptom reduction. Only one randomized placebo-controlled trial was identified for GeloMyrtol and cineole. These suggested an improvement in acute rhinosinusitis symptoms with both products, but the results warrant replication in larger trials.
Studies directly comparing herbal products are scarce; one randomized trial has compared cineole with Sinupret, but the results need confirmation in further studies.
Studies with N-acetylcysteine are limited to small-scale clinical trials, while MFNS is supported by a strength of evidence comparable to Sinupret in this indication.

Conclusion
State-of-the-art studies demonstrating the efficacy and safety of herbal products for the management of acute rhinosinusitis are available. Given that the evidence for Sinupret is the strongest and comparable to that of a widely available topical corticosteroid, MFNS, Sinupret may be considered for the management of acute uncomplicated rhinosinusitis.
Removal of a missing intrauterine contraceptive device after location through an ultrasound: a case report within a rural setting and review of literature
Authors: Argaw Mesele Damte , Abawollo Hailemariam Segni , Desta Binyam Fekadu , Tsegaye Zergu Taffesse , Belete Dejene Mengistu , Abebe Melkamu Getu 
Published: December 2020

AbstractBackgroundIn the last decade, (2000–2019), the modern contraceptive prevalence among married women of reproductive age (14–49 years), has increased by only 2.1%. The slow progress was due to limited access to services and myths surrounding methods held by both users and providers. This case report was identified, diagnosed and managed by a midwife working in rural health center in low resource setting. However, literature is scare on the management of missing Intra-Uterine Contraceptive Device (IUCD) thread removal services of confirmed diagnosis using Vscan or limited ultrasound services in rural health centers. The aim of reporting this case report was developed to enhance easy access to intra-uterine contraceptive method removals, which may address myths associated with difficulties of undergoing the services in rural set-up.A 26 year-old married woman, Gravida 1 and Para 1, attended Mekoy Health Center for IUCD removal service after 7 years of protection and internally referred to limited obstetric ultrasound service room due to non- visualization of IUCD thread with Vaginal Speculum examination. An ultrasonography scan however, showed a centrally located copper-T 380A IUCD in the endometrial cavity. As a result, after dilatation of the cervix, a successful removal of the Copper-T 308A was conducted. The client received followed up care for 2 hours post-procedure and was then discharged.ConclusionsThis case highlights the importance of availing diagnostic and removal services in rural set ups to mitigate myths in the community. The availability of limited obstetric ultrasound scanning services can improve the diagnoses and management of conditions in clients. The reported case shows that although, the basic infrastructure was limited, ultrasound scanning and Long Acting Reversible Contraception (LARC) trained midwives can ensure the provision of safe IUCD removal services in rural areas.
Determinants of unintended pregnancies among currently married women in Uganda
Authors: Wasswa Ronald , Kabagenyi Allen , Atuhaire Leonard 
Published: December 2020

Abstract
Background
Unintended pregnancies are no longer bound to teenagers or school-going children, married women in Uganda, as well do experience such pregnancies though little has been investigated on them. This study examines the determinants of unintended pregnancies among currently married women in Uganda.

Methods
In this study, we used data from the 2016 Uganda Demographic and Health Survey (UDHS) which comprised of 10,958 married women aged 15–49 years who have ever been pregnant. The analysis was done using descriptive analysis, logistic regression, and the generalized structural equation model.

Results
The study showed that 37% of pregnancies among married women were unintended. Young women, living in poor households, staying in rural areas, women in the Eastern and Northern region, Muslim women, lack of knowledge on ovulation period, discontinuation of contraceptives, non-use of and intention for contraceptives, high age at sexual debut, high age at first birth, and high parity were directly associated with a higher risk of unintended pregnancies. Relatedly, discontinuation of contraceptives regardless of the place of residence, region, woman’s age, education, household wealth, access to family planning messages were associated with higher odds of unintended pregnancies. Older women and those in rural areas who had more children were also at a higher risk of similar pregnancies. However, having more children while using contraceptives, being educated, living in a wealthier household, and having access to family planning messages significantly lowered the risk of unintended pregnancies.

Conclusion
Increased access to family planning messages, empowering women as well as having improved household incomes are key preventive measures of unintended pregnancies. There is a need to provide quality contraceptive counseling through outreaches so that women are informed about the different contraceptive methods and the possible side effects. Having a variety of contraceptive methods to choose from and making them accessible and affordable will also encourage women to make informed choices and reduce contraceptive discontinuation. All these coupled together will help women have their desired family sizes, increase the uptake of contraceptives and significantly reduce unintended pregnancies.
Prevalence, associated factors, and disclosure of intimate partner violence among mothers in rural Bangladesh
Authors: Stake Stephen , Ahmed Saifuddin , Tol Wietse , Ahmed Salahuddin , Begum Nazma , Khanam Rasheda , Harrison Meagan , Baqui Abdullah H. 
Published: December 2020

Abstract
Background
The purpose of this study is to assess the prevalence and associated factors of physical and sexual intimate partner violence (IPV) among married women of reproductive age in a rural population in northeast Bangladesh. In addition, we examined women’s sharing and disclosure of violence experience with others.

Methods
This cross-sectional study uses data from a household survey of 3966 women conducted in 2014 in the Sylhet District of Bangladesh. Interviews were completed in respondent’s homes by trained local female interviewers.

Results
Twenty-nine percent (28.8%, 95% CI 27.4–30.3%) of the women reported ever experiencing physical or sexual IPV by their spouse; 13.2% (95% CI 12.1–14.3%) reported physical or sexual IPV in the past year. Of the 13.2%, 10.1% (95% CI 9.2–11.1%) reported experiencing physical IPV and 4.6% (95% CI 4.0–5.3%) reported sexual IPV. In a combined model, the adjusted odds of having experienced physical or sexual IPV in the past year were higher for women who were raised in households with history of IPV (AOR = 4.35, 95% CI 3.26–5.80); women with no formal education (AOR = 1.76, 95% CI 1.30–2.37); women whose husbands had no formal education (AOR = 1.63, 95% CI 1.22–2.17); Muslim (AOR = 1.63, 95% CI 1.03–2.57); women younger than age 30 (AOR = 1.53, 95% CI 1.11–2.12); and women who were members of an NGO or microcredit financial organization (AOR = 1.38, 95% CI 1.04–1.82). Wealth, parity, number of household members, and pregnancy status (pregnant, postpartum, neither pregnant nor postpartum) were not associated with physical or sexual IPV after adjusting for other factors. Data on disclosure was available for women who reported experiencing physical violence in the last year; only 31.8% of victims told someone about the violence they had experienced and 1% reported to police, clerics, health workers, or a counselor altogether.

Conclusions
In rural northeast Bangladesh, a high proportion of women of reproductive age experience physical or sexual IPV. Women do not often speak of these experiences, especially to anyone outside of family. Interventions aimed at preventing future IPV and addressing current IPV should focus on women who witnessed IPV in childhood, as well as younger women and less educated couples.

Trial registration
This study was registered as a Clinical Trial (Identifier: NCT01702402). https://clinicaltrials.gov/ct2/show/NCT01702402
Prevalence and predictors of alcohol use among adult males in Ethiopia: multilevel analysis of Ethiopian Demographic and Health Survey 2016
Authors: Tessema Zemenu Tadesse , Zeleke Tadele Amare 
Published: December 2020

Abstract
Background
Alcohol is a psychoactive substance that is widely consumed in the world. Alcohol use is one of the world’s leading risk factors for disease and disability. It affects individuals’ physical, mental, economic, and social issues. To our knowledge, there is limited study on alcohol consumption and associated factors. Therefore, this study aimed to determine the prevalence and predictors of alcohol use in Ethiopia by using the 2016 Ethiopian Demographic and Health Survey.

Methods
This study was based on the most recent Ethiopian Demographic and Health Survey 2016. A total of 12,594 men at the age of 15 to 59 were included in this study. Considering the hierarchical nature of EDHS data, a multilevel logistic regression model was applied. The ICC, MOR, and the LR test were done to assess the presence of a significant clustering effect. Besides, deviance was used for model comparison since the models were nested models. Variables with a p value ≤ 0.2 in the bivariable analysis were considered for the multivariable analysis. In the multilevel logistic regression, the adjusted odds ratio (AOR) with 95% confidence interval (CI) was reported to declare the strength and significance of the association between the dependent variable and independent variables.

Results
The prevalence of alcohol drinking in this study was 46.64% with a 95% CI of 45.00 to 47.00%. Age groups 30–44 (AOR = 1.30, 95% CI 1.08, 1.56) and 45–59 (AOR = 1.38, 95% CI 1.10, 1.74), Orthodox religion follower (AOR = 0.36, 95% CI 0.24, 0.55), media exposure (AOR = 1.67, 95% CI 1.41, 2.20), khat chewing (AOR = 3.08, 95% CI 2.54, 3.74), smoking (AOR = 2.18, 95% CI 1.71, 2.79), having no occupation (AOR = 0.34, 95% CI 0.22, 0.51), and region were the predictors of alcohol use in Ethiopia.

Conclusions
Nearly half of the Ethiopian population reported alcohol use at least once in their lifetime. Old age, Orthodox religion followers, media exposure, khat chewing, smoking, and having no occupation were predictors of alcohol use in Ethiopia. Therefore, health education about the risk of alcohol used is highly recommended. In addition, khat chewing and smoking control mechanisms should be designed and given special attention. Advertising alcohol through media is better to be controlled. Job opportunities should also be created for those who have no occupation to mitigate alcohol use in Ethiopia.
Plasma lipidome abnormalities in people with HIV initiating antiretroviral therapy
Authors:   the AIDS Clinical Trials Group A5248/A5249s Team, Bowman Emily R. , Kulkarni Manjusha , Gabriel Janelle , Mo Xiaokui , Klamer Brett , Belury Martha , Lake Jordan E. , Zidar David , Sieg Scott F. , Mehta Nehal N. , Playford Martin P. , Kuritzkes Daniel R. , Andrade Adriana , Schmidt Elizabeth Koss , Taylor Christopher , Overton Edgar T. , Willig Amanda L. , Lederman Michael M. , Funderburg Nicholas T. 
Published: December 2020

AbstractBackgroundDyslipidemia often accompanies human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART). Lipid abnormalities likely contribute to increased cardiometabolic disease among people with HIV (PWH). Here, we expand our previous findings on changes in the lipidome following ART initiation, and associations among lipid species, including ceramides (CER), diacylglycerols (DAG), and triacylglycerols (TAG), with immune activation.MethodsConcentrations and fatty acid composition of plasma lipids (~ 1300 species) were measured by differential mobility spectroscopy in samples from 35 treatment-naïve PWH pre- and post-initiation of ART (raltegravir (RAL)/tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC)); lipidomes were compared to those found in demographically similar HIV-uninfected individuals (n = 13).ResultsCompared to people without HIV, 37.1% of all lipid species measured were altered in PWH at baseline, and 31.8% of lipid species were altered following 48 weeks of ART. Concentrations of lipid classes were also altered in PWH; diacylglycerols (DAGs) and triacylglycerols (TAGs) were increased at baseline, and DAGs remained increased after 48 weeks of ART. Lipids previously linked to cardiovascular disease (CVD) and diabetes were enriched in PWH pre- and post ART, and were related to immune activation and insulin resistance scores. Polyunsaturated fatty acid (PUFA)-containing lipids were lower in PWH compared to levels in controls, and were inversely related to levels of inflammatory biomarkers.ConclusionsHIV infection and ART initiation both induce cardiometabolic changes to the composition of the plasma lipidome. These alterations are associated with inflammatory biomarkers, and may directly contribute to elevated CVD risk and diabetes.Trial registrationThis study is registered with Clinicaltrials.gov (NCT00660972). Registered April 16, 2008.
Growth performance of planted population of Pinus roxburghii in central Nepal
Authors: Tiwari Achyut , Thapa Nita , Aryal Sugam , Rana Prabina , Adhikari Shankar 
Published: December 2020

Abstract
Background
Climate change has altered the various ecosystem processes including forest ecosystem in Himalayan region. Although the high mountain natural forests including treelines in the Himalayan region are mainly reported to be temperature sensitive, the temperature-related water stress in an important growth-limiting factor for middle elevation mountains. And there are very few evidences on growth performance of planted forest in changing climate in the Himalayan region. A dendrochronological study was carried out to verify and record the impact of warming temperature tree growth by using the tree cores of Pinus roxburghii from Batase village of Dhulikhel in Central Nepal with sub-tropical climatic zone. For this total, 29 tree cores from 25 trees of P. roxburghii were measured and analyzed.

Result
A 44-year long tree ring width chronology was constructed from the cores. The result showed that the radial growth of P. roxburghii was positively correlated with pre-monsoon (April) rainfall, although the correlation was not significant and negatively correlated with summer rainfall. The strongest negative correlation was found between radial growth and rainfall of June followed by the rainfall of January. Also, the radial growth showed significant positive correlation with that previous year August mean temperature and maximum temperature, and significant negative correlation between radial growth and maximum temperature (Tmax) of May and of spring season (March-May), indicating moisture as the key factor for radial growth. Despite the overall positive trend in the basal area increment (BAI), we have found the abrupt decline between 1995 and 2005 AD.

Conclusion
The results indicated that chir pine planted population was moisture sensitive, and the negative impact of higher temperature during early growth season (March-May) was clearly seen on the radial growth. We emphasize that the forest would experience further moisture stress if the trend of warming temperatures continues. The unusual decreasing BAI trend might be associated with forest management processes including resin collection and other disturbances. Our results showed that the planted pine forest stand is sub-healthy due to major human intervention at times. Further exploration of growth climate response from different climatic zones and management regimes is important to improve our understanding on the growth performance of mid-hill pine forests in Nepal.
SPLEnic salvage and complications after splenic artery EmbolizatioN for blunt abdomINal trauma: the SPLEEN-IN study
Authors: Clements Warren , Joseph Tim , Koukounaras Jim , Goh Gerard S. , Moriarty Heather K. , Mathew Joseph , Phan Tuan D. 
Published: December 2020

Abstract
Background
As an adjunct to non-operative management, splenic artery embolization (SAE) has been increasingly utilized throughout the world and is now the standard of care for hemodynamically stable patients. This study aimed to retrospectively assess the rate of splenic salvage and complications after SAE for blunt trauma at a level 1 trauma center using the 2018 update to the AAST criteria, and further sub-stratify the role of angiography in AAST grade III injuries with significant hemoperitoneum.
All patients between 1 January 2009 and 1 January 2019 who underwent blunt trauma and proceeded to embolization were included. Data was collected concerning initial injury grade, location of embolization, type of embolic material used, complications, and need for subsequent splenectomy. Technical success was defined as successful angiographic occlusion of the target artery at the conclusion of embolization. Clinical success was defined as splenic salvage at discharge. Vascular lesions were characterized including those with active bleeding, pseudoaneurysm, and arterio-venous fistula.

Results
Two hundred thirty-two patients were included in the study. Treatments were performed at a median of 0 days (range 0–28 days) and the median AAST grade was IV (range III-V). Technical success was achieved in all patients. There were 13 complications (5.6%) consisting of re-bleed (9, 3.9%), infarction (3, 1.3%), and access site haematoma (1, 0.43%). Clinical success was achieved in 97% of patients with 7 patients requiring splenectomy after SAE (3.0%) at a median time of 4 days (range 0–17 days). Angiography in patients with grade III injuries identified 18 occult vascular injuries not identified at initial CT (p < 0.0001).

Conclusions
The SPLEEN-IN study shows that treatment of intermediate-high grade blunt force traumatic splenic injuries using SAE resulted in a low rate of complication and splenic salvage in 97% of patients, providing a safe and effective treatment in stable patients. In addition, angiography of grade III injuries identified occult vascular lesions and may warrant treatment of select patients in this cohort.

Level of evidence
Level 3.
First report of cryptococcuria in a bitch from India: a case report
Authors: Singh Abhishek Dharm , Banerjee Abhiroop , Batabyal Kunal 
Published: December 2020

AbstractBackgroundCryptococcuria has not been reported in dogs although few cases have been described in humans and cats. Cryptococcuria is often seen as a manifestation of systemic or disseminated cryptococcosis. Early diagnosis and treatment is crucial as systemic infections are usually fatal. To the best of author’s knowledge, this is the first reported case of cryptococcuria in a bitch from India.Case presentationAn 8-month-old bitch was presented with anorexia, urinary incontinence and dysuria for the last 10 days. Urinalysis showed the presence of yeast cells, andCryptococcus neoformanswas confirmed by both fungal culture and gene sequencing. Antifungal susceptibility testing revealed resistance against ketoconazole, fluconazole and amphotericin B, while sensitivity towards itraconazole, voriconazole and terbinafine. Unfortunately, the bitch expired before the antifungal results were made available. Histopathological changes were observed in lungs which revealed several budding and encapsulatedC. neoformanscells.ConclusionThis report highlights the importance to conduct routine urine cultures for yeast infections along with antifungal susceptibility testing to identify and initiate proper antifungal therapy to improve clinical outcome.
Risk factors affect success rate of debridement, antibiotics and implant retention (DAIR) in periprosthetic joint infection
Authors: Xu Yihong , Wang Liping , Xu Weidong 
Published: December 2020

AbstractBackgroundPeriprosthetic joint infection (PJI) is the most devastating complication of joint replacement that seriously affects the quality of life and causes a heavy burden to the families and society. Due to shorter hospital stays, lower costs, improved joint function and less morbidity, a process of debridement, antibiotics and implant retention (DAIR) is recommended as the preferred treatment for acute periprosthetic joint infection. However, the factors that impact the success rate of DAIR remain controversial. This article evaluates the influential factors of DAIR and provides insights for orthopaedics surgeons to make optimal decisions to improve the success rate of DAIR.ConclusionThe poor general condition of patients, high preoperative C-reactive protein (CRP) level, repeated joint surgeries, and Methicillin-resistantStaphylococcus aureus(MRSA) infections may be associated with lower DAIR success rate. To the contrary, early surgery, radical debridement, exchange of removable components, washing with iodine and vacuum sealing drainage (VSD) may improve the success rate of DAIR. A sinus tract may not be absolutely contraindicated, but surgeons should treat it with caution. As there is no consensus on many issues, more high-quality research is required.