bluuebunny/crossref_metadata_2025_split huggingface dataset:
Credentialing of emergency medicine trainees in point‐of‐care ultrasound: An effective, efficient and enjoyable model
Authors: Toffoli Andrew , Hartnett Leanne , Mattick Anthony , Goudie Adrian 
Published: October 2020

AbstractObjectiveThe Australasian College for Emergency Medicine Curriculum Framework contains numerous mentions of point‐of‐care ultrasound (PoCUS). However, obtaining formal PoCUS credentials is often problematic. The Fiona Stanley Hospital ED PoCUS training programme was devised to assist emergency medicine trainees to meet the credentialing requirements of the Australasian College for Emergency Medicine and the Australasian Society for Ultrasound in Medicine.MethodsSix emergency medicine registrars are selected for each 6‐month semester. Successful applicants nominate two modules of Australasian Society for Ultrasound in Medicine's Certificate in Clinician Performed Ultrasound and receive dedicated non‐clinical time. For 3 h a week, an emergency physician holding formal PoCUS credentials supervises a pair of trainees while they perform scans on ED patients. During these sessions, trainee logbooks can be reviewed and assessments occur as required by the module.ResultsOver an 18‐month period, 18 emergency registrars were involved, averaging eight 3‐h sessions each. All selected the Extended Focused Abdominal Scan for Trauma module, 14 chose Abdominal Aortic Aneurysm and eight chose Basic Echo in Life Support. Overall, 30 (75%) of 40 modules were completed within the trainees' 6‐month semester. Just under half of logged scans were obtained during the supervised sessions. Overall, the average number of scans performed exceeded each module's logbook requirements. Trainees perceived that involvement in the programme benefited their ability to manage patients. There was overwhelming support for the structure of the programme.ConclusionsThe Fiona Stanley Hospital ED model is effective in assisting emergency medicine trainees to gain formal PoCUS credentials. As it requires relatively little organisation, time and staffing, it could be adopted in many EDs around Australia and New Zealand.
The effects of seed priming with sodium hydrosulphide on drought tolerance of sunflower (Helianthus annuus L.) in germination and early growth
Authors: Ocvirk Dijana , Špoljarević Marija , Kristić Marija , Hancock John T. , Teklić Tihana , Lisjak Miroslav 
Published: October 2020

AbstractSunflower seeds (hybrid Luka) were primed with water (hydropriming) or sodium hydrosulphide (NaHS) solutions (0.1, 0.5, 1.0 and 1.5 mM NaHS) and subsequently dried to initial moisture content. Unprimed (control) and primed seeds were germinated in a growth chamber on paper towels moistened with water or polyethylene glycol (PEG) 6000 solutions (2.5, 5.0 and 10%), mimicking different drought stress levels. To evaluate the response of the primed seeds to drought in the germination stage, the germination energy (GE), germination rate (SG), seedling fresh mass (SW), hydrogen peroxide and free proline content (PRO), as well as lipid peroxidation rate (malondialdehyde; MDA) were established. The results show strong effects of the imposed drought stress and the metabolic response to oxidative stress through lower germinability and proline accumulation in seedlings. NaHS priming showed some positive effects on seed germination depending on stress level and the concentration of NaHS. Sunflower seeds were also germinated in pots filled with soil, at optimal (70% of field water capacity [FWC 70%]) and drought conditions (FWC 30%), in natural outdoors conditions. When plantlets developed the first pair of leaves, the number of plants (emergence rate [ER]), shoot mass (SM) and leaves mass (LM) were determined, as well as the total activities of catalase (CAT), ascorbate peroxidase (APX), glutathione reductase (GR) and dehydroascorbate reductase (DHAR). There was a significant influence of an interaction between drought stress and priming, whereas drought stress inhibited plant emergence and early growth (SW and LW), and strong antioxidative enzymatic response to drought stress was clearly established in the leaves. Although seed priming showed some influence on enzyme activities, it was mostly related to seed hydropriming effects, while NaHS seed priming was less effective, influencing only DHAR. Altogether, the results imply that sunflower seed priming with NaHS may not have a prolonged impact on the antioxidative defence mechanism based on CAT and ascorbate/glutathione cycle during sunflower early growth in drought conditions.
Semen quality and waiting time to pregnancy explored using association mining
Authors: Romero Herrera Jose Alejandro , Bang Anne Kirstine , Priskorn Lærke , Izarzugaza Jose M. G. , Brunak Søren , Jørgensen Niels 
Published: October 2020

AbstractBackgroundAssessment of semen quality is a key pillar in the evaluation of men from infertile couples. Usually, semen parameters are interpreted individually because the interactions between parameters are difficult to account for.ObjectivesTo determine how combinations of classical semen parameters and female partner age were associated with waiting time to pregnancy (TTP).Materials and methodsSemen results of 500 fertile men, information of TTP, and partner age were used for regressions and to detect breaking points. For a modified Association Rule Mining algorithm, semen parameters were categorized as High, Medium, and Low.ResultsMen ≤32.1 years and women ≤32.9 years had shorter TTP than older. Decreasing TTP was associated with increasing level of individual semen parameters up to threshold values: sperm concentration 46 mill/mL, total sperm count 179 mill, progressive motility 63%, and normal morphology 11.5%. Using association mining, approximately 100 combinations of semen parameters and partner age were associated with TTP. TTP ≤ 1 month often co‐occurred with high percentages of progressive motility (≥62%) and morphologically normal spermatozoa (≥10.5%). Furthermore, TTP ≤ 1 did not tend to appear with lower percentages of these two semen parameters or high partner age (≥32 years). However, high percentages of motile or normal spermatozoa could not compensate for sperm concentration ≤42 mill/mL or total sperm count ≤158 mill. The prolonging effect of high partner age could not be compensated for by the man's semen quality.Discussion and ConclusionUsing association mining, we observed that TTP was best predicted when combinations of semen parameters were accounted for. Sperm counts, motility, and morphology were all important, and no single semen parameter was inferior. Additionally, female age above 32 years had a negative impact on TTP that could not be compensated for by high semen parameters of the man.
Hemodynamic findings in normotensive women with small‐for‐gestational‐age and growth‐restricted fetuses
Authors: Di Pasquo Elvira , Ghi Tullio , Dall’Asta Andrea , Angeli Laura , Ciavarella Sara , Armano Giulia , Sesenna Veronica , Di Peri Antonio , Frusca Tiziana 
Published: October 2020

AbstractIntroductionFetal growth restriction (FGR) in most instances is a consequence of primary placental dysfunction due to inadequate trophoblastic invasion. Maternal cardiac maladaptation to pregnancy has been proposed as a possible determinant of placental insufficiency and impaired fetal growth. This study aimed to compare the maternal hemodynamic parameters between normotensive women with small‐for‐gestational‐age (SGA) and FGR fetuses and to evaluate their correlation with neonatal outcome.Material and methodsAn observational cohort study including singleton pregnancies referred to our tertiary care center due to fetal smallness. At the time of diagnosis, fetuses were classified as SGA or FGR according to the Delphi consensus criteria, and pregnant women underwent hemodynamic assessment using a cardiac output monitor. A group of women with singleton uncomplicated pregnancies ar ≥35 weeks of gestation were recruited as controls. Cardiac output, systemic vascular resistance, stroke volume, and heart rate were measured and compared among the three groups (controls vs FGR vs SGA). The correlation between antenatal findings and neonatal outcome was also evaluated by multivariate logistic regression analysis.ResultsA total of 51 women with fetal smallness were assessed at 34.8 ± 2.6 weeks. SGA and FGR were diagnosed in 22 and 29 cases, respectively. The control group included 61 women assessed at 36.5 ± 0.8 weeks of gestation. Women with FGR had a lower cardiac output Z‐score (respectively, −1.3 ± 1.2 vs −0.4 ± 0.8 vs −0.2 ± 1.0; P < .001) and a higher systemic vascular resistance Z‐score (respectively, 1.2 ± 1.2 vs 0.2 ± 1.1 vs −0.02 ± 1.2; P < .001) compared with both SGA and controls, whereas no difference in the hemodynamic parameters was found between women with SGA and controls. The incidence of neonatal intensive care unit admission did not differ between SGA and FGR fetuses (18.2% vs 41.4%; P = .13), but FGR fetuses had a longer hospitalization compared with SGA fetuses (14.2 ± 17.7 vs 4.5 ± 1.6 days; P = .02). Multivariate analysis showed that the cardiac output Z‐score at diagnosis (P = .012) and the birthweight Z‐score (P = .007) were independent predictors of the length of neonatal hospitalization.ConclusionsDifferent maternal hemodynamic profiles characterize women with SGA or FGR fetuses. Furthermore, a negative correlation was found between the maternal cardiac output and the length of neonatal hospitalization.
Hemoadsorption cartridge and coronavirus disease 2019 infections: A case report and brief literature review
Authors: Melegari Gabriele , Bertellini Elisabetta , Melegari Alessandra , Trenti Tommaso , Malaguti Silvio , Barbieri Alberto 
Published: October 2020

AbstractThe cytokine storm has been frequently reported to occur in patients with severe coronavirus disease 2019 (COVID‐19). Data from the literature suggest that elevated levels of inflammatory mediators, such as interleukin (IL)‐6, IL‐8, and tumor necrosis factor, indicate a severe course or the fatality of the disease. Several therapeutic options have been employed to treat critically ill patients, including hemoadsorption of inflammatory mediators. We here present a case of severe acute respiratory syndrome caused by COVID‐19 and acute renal failure. The patient was admitted to our intensive care unit and treated with mechanical ventilation, renal replacement therapy, and hemoadsorption to reduce the cytokine release syndrome, which plays a fundamental role in the clinical presentation of COVID‐19 patients. We also discuss the potential advantages of reducing cytokine plasma levels using a hemoadsorption cartridge.
Does adherence to lipid‐lowering medications improve cancer survival? A nationwide study of breast and colorectal cancer, and melanoma
Authors: Feng Jia‐Li , Qin Xiwen 
Published: October 2020

AimsInconclusive findings of lipid‐lowering medications (LLMs) on cancer survival benefit require more evidence. We tested the hypothesis that adherence to this drug is associated with reduced cancer‐specific mortality in a homogeneous population who had used this drug before cancer diagnosis.MethodsThe Australian Cancer Database was linked to the Pharmaceutical Benefits Scheme database, and to the National Death Index (up to 2015). Medication adherence was calculated by proportion of days covered. Cox regression models with time‐varying covariates were used to derive multivariable‐adjusted cause‐specific hazard ratio (HR) and 95% confidence interval (CI) for the associations between adherence to LLMs, statins, lipophilic, and hydrophilic statins and cancer‐specific mortality.ResultsFrom 2003 to 2013, 3 separate cohorts of 20 046, 11 719 and 6430 female patients with newly diagnosed breast, colorectal cancer, and melanoma respectively were identified. The 1‐year adherence was similar at 1‐year prediagnosis in the 3 cohorts, on average 82%. Each 10% increase in 1‐year adherence to LLMs was inversely associated with cancer‐specific mortality among women with breast cancer (fully adjusted HR = 0.92, 95% CI 0.91–0.93), colorectal cancer (fully adjusted HR = 0.92, 95% CI 0.91–0.93), or melanoma (fully adjusted HR = 0.97, 95% CI 0.94–1.00). The reductions in cancer‐specific mortality were more pronounced for women who adhered to lipophilic than hydrophilic statins in all 3 cancers albeit not statistically significant for melanoma.ConclusionAmong LLM users, adherence to this drug is associated with a decrease in cancer‐specific mortality. If confirmed, LLMs could be considered as an adjuvant cancer therapy to improve prognosis in cancer survivors.
Autonomy and social influence in predictive genetic testing decision‐making: A qualitative interview study
Authors: Zimmermann Bettina M. , Koné Insa , Shaw David , Elger Bernice 
Published: October 2020

AbstractBeauchamp and Childress’ definition of autonomous decision‐making includes the conditions of intentionality, understanding, and non‐control. In genetics, however, a relational conception of autonomy has been increasingly recognized. This article aims to empirically assess aspects of social influence in genetic testing decision‐making and to connect these with principlist and relational theories of autonomy. We interviewed 18 adult genetic counsellees without capacity issues considering predictive genetic testing for cancer predisposition for themselves and two counselling physicians in Switzerland. We conducted a qualitative analysis, building on a grounded theory study about predictive genetic testing decision‐making. We found that some participants agreed to predictive genetic testing predominantly because relatives wanted them to do it, with some even acting contrary to their own convictions. Others, in contrast, based their decision on purely individualistic reasons but expressed difficulties in explaining their decision to their social environment. Healthcare professionals had a critical influence on decision‐making in many cases without being manipulative, as perceived by counsellees. Still, cases of coercion and social pressure occurred within social relationships. In conclusion, predictive genetic testing decision‐making includes relational and individualistic aspects, and both are compatible with autonomous decision‐making. While the principlist and relational notions of autonomy compete on a theoretical level, they are two sides of the same coin when used as analytical lenses for genetic testing decision‐making. Social acceptance of refusal of testing should be improved to mitigate social pressure. Individuals should be encouraged to decide for themselves how much their social environment influences their decision regarding predictive genetic testing.
Three‐dimensional analysis of dimensional changes after alveolar ridge preservation with bone substitutes or plasma rich in growth factors: Randomized and controlled clinical trial
Authors: Stumbras Arturas , Galindo‐Moreno Pablo , Januzis Gintaras , Juodzbalys Gintaras 
Published: October 2020

AbstractObjectivesTo evaluate alveolar ridge dimensional changes of different alveolar ridge preservation techniques after 3 months of tooth extraction and to compare the efficacy of autologous plasma rich in growth factor (PRGF) to the bone substitutes in alveolar ridge preservation and sites left to heal spontaneously.Materials and MethodsForty patients requiring tooth extraction in the anterior maxilla were randomly allocated to the four following treatment modalities: spontaneous healing (control), natural bovine bone mineral covered with resorbable native collagen membrane (BBM/CM), freeze‐dried bone allograft covered with resorbable native collagen membrane (FDBA/CM) and PRGF alone. Cone beam computed tomography (CBCT) scans were taken after surgery and 3 months later. The measurements of height and width (at 1, 3, and 5 mm below the crest) were performed after superimposing the 2 consecutive CBCT scans.ResultsThe greatest horizontal alveolar bone resorption at 1 mm below bone crest was observed in the control group (−1.61 ± 1.76 mm, P = .037), whereas the least reduction in width was found in the BBM/CM group (−0.68 ± 0.67 mm, P = .037). The most pronounced alveolar height reduction was observed in the control group (−0.86 ± 0.43 mm), whereas alveolar ridge preservation with BBMC/CM (−0.26 ± 0.91 mm) and PRGF (−0.54 ± 0.86 mm) successfully reduced the alveolar height reduction as compared to the control group.ConclusionsAlveolar ridge preservation technique in the esthetic zone using BBM/CM or using PRGF is beneficial to reduce horizontal and vertical bone changes.
Increased occurrence of hand eczema in young children following the Danish hand hygiene recommendations during the COVID‐19 pandemic
Authors: Simonsen Anne B. , Ruge Iben F. , Quaade Anna S. , Johansen Jeanne D. , Thyssen Jacob P. , Zachariae Claus 
Published: October 2020

AbstractBackgroundDuring the first wave of the COVID‐19 pandemic of Spring 2020, Denmark was one of the first countries to introduce lockdown measures, including closing of all daycare centers. Following the reopening of daycare centers, Danish Health Authorities implemented a mandatory intensive hand hygiene regimen.ObjectivesTo examine the occurrence and point prevalence of hand eczema as a consequence of more intensive hand hygiene among Danish children attending daycare.MethodsThe heads of 1667 daycare centers in Denmark were contacted and asked to forward a link to a questionnaire to parents of the children attending the daycare center.ResultsAmong 6858 children, 12.1% had hand eczema before reopening of daycare centers, whereas 38.3% reported hand eczema after the children returned to daycare. Of the children who never had hand eczema, 28.6% developed hand eczema after returning to daycare. The risk of hand eczema was significantly associated with atopic dermatitis, female gender, higher age, and frequency of handwashing.ConclusionFollowing the implemented hygiene regimen, a high proportion of young children rapidly developed hand eczema. Well‐established prophylactic skin care might have spared a proportion of the children from developing hand eczema.
Foot ulcer recurrence, plantar pressure and footwear adherence in people with diabetes and Charcot midfoot deformity: A cohort analysis
Authors: Keukenkamp R. , Busch‐Westbroek T. E. , Barn R. , Woodburn J. , Bus S. A. 
Published: October 2020

AbstractAimsTo investigate people with Charcot midfoot deformity with regard to plantar pressure, footwear adherence and plantar foot ulcer recurrence.MethodsTwenty people with diabetes, Charcot midfoot deformity, plantar foot ulcer history and custom‐made footwear were assessed with regard to barefoot and in‐shoe plantar pressures during walking, footwear adherence (% of daily steps over 7‐day period) and plantar foot ulcer recurrence over 18 months. In a cohort design, they were compared to 118 people without Charcot foot (non‐Charcot foot group) with custom‐made footwear and similar ulcer risk factors.ResultsMedian (interquartile range) barefoot midfoot peak pressures were significantly higher in the Charcot foot group than in the non‐Charcot foot group [756 (260–1267) vs 146 (100–208) kPa;P<0.001]. In‐shoe midfoot peak pressures were not significantly higher in the Charcot foot group [median (interquartile range) 152 (104–201) vs 119 (94–160) kPa] and significantly lower for all other foot regions. Participants in the Charcot foot group were significantly more adherent, especially at home, than participants in the non‐Charcot foot group [median (interquartile range) 94.4 (85.4–95.0)% vs. 64.3 (25.4–85.7)%;P=0.001]. Ulcers recurred in 40% of the Charcot foot group and in 47% of the non‐Charcot foot group (P=0.63); midfoot ulcers recurred significantly more in the Charcot foot group (4/8) than in the non‐Charcot foot group (1/55;P=0.001).ConclusionsEffective offloading and very high footwear adherence were found in people with diabetes and Charcot midfoot deformity. While this may help protect against plantar foot ulcer recurrence, a large proportion of such people still experience ulcer recurrence. Further improvements in adherence and custom‐made footwear design may be required to improve clinical outcome.
Empagliflozin treatment effects across categories of baseline HbA1c, body weight and blood pressure as an add‐on to metformin in patients with type 2 diabetes
Authors: Inzucchi Silvio E. , Davies Melanie J. , Khunti Kamlesh , Trivedi Prabhav , George Jyothis T. , Zwiener Isabella , Johansen Odd Erik , Sattar Naveed 
Published: October 2020

AbstractAimTo investigate the association of different categories of baseline cardio‐metabolic risk factors on the treatment effects of empagliflozin 10 and 25 mg when added as second‐line therapy to metformin in patients with type 2 diabetes (T2D).Materials and MethodsPatients aged 18 years or older with HbA1c 7.0%‐10.0% were included. Analysis of covariance compared change from baseline to weeks 24 and 76 in HbA1c, body weight (BW) and systolic blood pressure (SBP) by respective baseline categories (HbA1c <8.5/≥8.5%; BW <80/80‐90/>90 kg, SBP <130/130‐140/>140 mmHg). Analyses were also conducted with a model using continuous covariates of cardio‐metabolic factors.ResultsIn total, 637 patients (56.7% males; mean [SD] age 55.7 [9.9] years, HbA1c 7.9% [0.9%], BW 81.2 [18.8] kg, SBP 129.4 [14.6] mmHg) received one or more dose of either empagliflozin 10 mg (n = 217) or 25 mg (n = 213), or placebo (n = 207). At both time points, empagliflozin 10/25 mg versus placebo significantly (P < .0001) reduced HbA1c and BW, with greater reductions in HbA1c at higher baseline HbA1c (P interaction week 24/76 categorical and continuous models: .0290/.1431 and .0004/.0042, respectively) and in BW (P interaction .1340/.0012 and .0202/<.0001, respectively). Both empagliflozin doses also significantly lowered SBP versus placebo at both time points, with similar efficacy by subgroups of baseline SBP. Adverse events were consistent with the established empagliflozin safety profile across treatment groups.ConclusionsEmpagliflozin, as add‐on to metformin, decreases HbA1c and BW, particularly in patients with higher HbA1c and BW baseline values, and effectively lowers SBP.
Evaluation of global and regional left ventricular myocardial work by echocardiography in patients with chronic kidney disease
Authors: Ke Qian‐qian , Xu Hai‐bo , Bai Jiao , Xiong Li , Li Meng‐mei 
Published: October 2020

AbstractObjectiveThis study aimed to quantitatively evaluate the left ventricular myocardial work of patients with chronic kidney disease (CKD) by echocardiographic pressure–strain loop (PSL) analysis.MethodsNinety‐three patients with CKD and forty‐two age‐ and sex‐matched controls were included in the study. CKD patients were divided into group 1 (stages 2–4) and group 2 (stage 5). Left ventricular blood pressure was estimated noninvasively according to echocardiographic valvular events and brachial artery systolic pressure. Left ventricular myocardial work parameters were acquired by echocardiographic PSL analysis.ResultsThe CKD groups had a significantly lower global work index (WI), global work efficiency (GWE), global constructive strain (GCW) and global longitudinal strain (GLS) and higher global waste work (GWW) than the control group. Segmental analysis showed that the myocardial WI, work efficiency (WE), and constructive work (CW) were lower in group 2 than the control group (P < .05), while the regional myocardial waste work (WW) was higher (P < .05). A Pearson correlation analysis revealed that GWE and GWW have good correlations with the LVEF and GLS. A multiple regression analysis showed that the systolic blood pressure (SBP), estimated glomerular filtration rate (eGFR), end‐diastolic volume (EDV), and GLS were associated with global work index (GWI) (b′ = 0.476, 0.252, −0.407, and −0.355, P < .05).ConclusionsLeft ventricular PSL analysis can be applied to assess global and regional myocardial work in CKD patients. This approach may serve as a noninvasive method for the detection of left ventricular systolic dysfunction at an early stage.