bluuebunny/crossref_metadata_2025_split huggingface dataset:
3-7EFFECTIVENESS OF DEMONSTRATION COUNSELING METHOD ON KNOWLEDGE LEVEL REGARDING COMPLIANCE WITH DIET ON HYPERTENSION PATIENTS IN PUSKESMAS SUNGAI KAKAP, KUBU RAYA REGENCY, WEST KALIMANTAN
Authors: Islami Aditya , Nasution Bakrie Bayquni , Mustika Angnes Dera , Sonia Gatria , Purba Nur Harini 
Published: July 2020

Background:
Hypertension is still a high cause of death and illness. The results of the 2018 Riskesdas study showed that there was an increase in the number of hypertension that remained permanently from 2013 to 2018. Hypertension was still ranked first in the highest number of non-communicable diseases in Sungai Kakap. The most common conventional education patterns used in Primary Health Care Facilities in the form of lecture methods are still seen to be ineffective in influencing the level of public knowledge of salt needs and other nutritional content as well as eating patterns suitable for hypertensive patients.

Methods:
This research is a quasi-experimental research design of One Group Pretest Posttest, the results of which will be analyzed descriptively and analytically. Samples were taken by purposive sampling totaling 32 people divided into two groups: the test group was given a conventional counseling material lecture method, and the test group was given counseling material with a demonstration method. Primary data were obtained from pretest and posttest using a questionnaire in hypertensive patients in the working area of Puskesmas Sungai Kakap. Data were analyzed using the unpaired T-test.

Result:
The mean post-test results in the conventional lecture method group were 69.37 ± 16.11 and there were no significant differences in the comparison between pre-test and post-test scores. The mean post-test results in the group with the demonstration method treatment were worth 85.00 ± 14.60 and there was a significant difference in the comparison between the pre-test and post-test scores in the group with the counseling treatment demonstration method where the post-test value was higher than the post-test. The mean post-test score of the group using the demonstration method was of higher significance statistically when compared to the group with the lecture method (Sig <0.05, 95% confidence level) with a value difference of 15.62.

Summary:
Hypertension Diet Counseling with Demonstration Method is more effective compared to Conventional Counseling Lecture Method
3-9SYSTOLIC BLOOD PRESSURE, MEAN ARTERIAL BLOOD PRESSURE RELATED TO CLINICAL OUTCOMES IN HEMORRHAGIC STROKE WITH EMERGENCY HYPERTENSION
Authors: Djohar Yuzar Thesariva , Gamayani Uni , Juli Cep 
Published: July 2020

Introduction:
Stroke is a leading cause of mortality and disability in Indonesia. According to classification, 15–20% are hemorrhagic stroke, and 80% are due to hypertension. Many of them with emergency hypertension. Several studies have demonstrated a strong association between an increased level of blood pressure (BP) with poor outcomes. Comprehensive management of emergency hypertension could decrease mortality and disability.

Objective:
To study about the relationship of initial systolic blood pressure (SBP) and initial mean arterial pressure (MAP) with outcome in the patient having a hemorrhagic stroke and emergency hypertension.

Method:
This is an analytic observational study using medical records.The study investigated the association between SBP and MAP with clinical outcome based on The National Institutes of Health Stroke Scale (NIHSS) in living patients and deceased

Result:
We collected 60 subjects. Mean SBP initial 191.22 mmHg, MAP initial 134.26. We found a decrease in BP. Mean SBP at discharge 140.56 mmHg and MAP at discharge 103.0 mmHg. We observed decreasing in NIHSS from 12.89 at initial to 9.5 at discharge. Statistical analysis using Pearson's for delta SBP and MAP with NIHSS initial and discharge was not significant. The average of SBP and MAP of the patient who died is higher than the survived patient; however, it was not statistically significant.

Conclusion:
We could not find the relationship between initial systolic blood pressure, initial mean arterial pressure, and NIHSS in survived and deceased patients.
4-8CENTRAL AORTIC SYSTOLIC PRESSURE MEASUREMENT IN PATIENTS WITH REFRACTORY HYPERTENSION
Authors: Vamsi Varahabhatla , Prkacin Ingrid , Misri Z.K. , Kulkarni Vaman , Kamath Padmanabh , Achappa Basavaprabhu 
Published: July 2020

Background:
Aortic systolic pressure is regarded more reliable due to elastic properties of the central arterial walls, than the peripheral blood pressure (BP) brachial arteries being more muscular. The arterial distensibilty is an important factor in determining the vascular age and predicting future acute aortic events. The non-invasive central blood pressure can aid in early detection and harmonising treatment in patients with Refractory hypertension (RH).

Aim:
To assess the Central aortic systolic pressure (CASP) in RH patients.

Methods and materials:
We identified 111 patients with refractory hypertension (uncontrolled BP despite use of 3 or more anti-hypertensives) at the outpatient clinic of Kasturba Medical College Hospital, Mangalore in the period of July-August 2018. The non-invasive CASP, Average systolic, diastolic and pulse (AvgS, AvgD, AvgP) measured with A-PULSE CASPal® Monitoring Device. Statistical analysis using SPSS software and parameters like Independent t-test, descriptive statistics (mean, standard deviation) were calculated.

Results:
The average age of the patients was 58 ± 14.95; 39 (35.1%) were females(F) and 72 (64.9%) were males (M). There was a significant difference in the CASP in F 146.6 ± 29.34 and 139.6 ± 21.8 in M; AvgS in F and M was 157.9 ± 28 and 152.4 ± 21.8 respectively. AvgD and AvgP in F and M were 92.9 ± 17.1, 92.5 ± 13.3 and 83.87 ± 13.9, 79.2 ± 13.6 respectively. Conditions age and CASP p = 0.324; age and AvgS p = 0.338; CASP and AvgS p = 0.919 were significant at p < 0.01.

Conclusions:
In patients with refractory hypertension, chrono-modulation with centrally acting anti-hypertensive drugs and synchronous CASP monitoring non-invasively can predict early target organ damage and helps improve the quality of life.
Where Are We in Bridging the Gender Leadership Gap in Academic Medicine?
Authors: Valantine Hannah A. 
Published: July 2020

In nearly all walks of life, leadership sets the tone for what gets done, who does it, and how it is achieved. In 2020, the top ranks of academic medicine have not yet attained gender parity—an aspirational goal set 7 years ago in this journal as “50:50 by 2020,” and a vital aim for the United States’ productivity and innovation as a leader in biomedical research. Parity in academic leadership for women and other groups underrepresented in science and medicine will seed the culture change necessary for inclusive excellence: environments in which individuals from all backgrounds thrive in their pursuit of new knowledge to benefit human health.
In this Invited Commentary, the author describes the National Institutes of Health’s (NIH’s) current system-wide framework and tools for creating cultures of inclusive excellence through a set of guiding principles and integrated strategies. Successful efforts will recognize that individually focused solutions are necessary but not sufficient for institutional culture change. In keeping with a systems approach are implementing accountability and transparency; establishing clear metrics of inclusion, diversity, and equity; tracking and evaluating such metrics; as well as tying these metrics to institutional reward systems. These essential steps to institutional culture transformation require strong partnerships between NIH and the academic community. The author argues that with committed vision, focus, and energy, success is attainable, and soon.
Direct Anterior Approach to Total Hip Arthroplasty for Femoral Neck Fractures
Authors: Greenstein Alexander S. , Soles Gillian 
Published: July 2020

Summary:
Femoral neck fractures are a common injury pattern, especially within the elderly. Replacement with either hemiarthroplasty or total hip arthroplasty allows for immediate weight-bearing. This video demonstrates the direct anterior approach to total hip arthroplasty for management of displaced femoral neck fractures.
Total Elbow Arthroplasty for Distal Humerus Fractures
Authors: Page Brian Joseph , Lee Brennan Michael 
Published: July 2020

Summary:
Distal humerus fractures in elderly patients are challenging due to poor bone quality and may threaten the independence of elderly patients due to loss of functional range of motion. Total elbow arthroplasty has gained popularity in the treatment of these injuries. This video demonstrates total elbow arthroplasty in an elderly patient with a comminuted distal humerus fracture.
Distally Based Peroneus Brevis Rotation Flap
Authors: Neiman Rafael , Finkemeier Christopher G. , Swentik Andrew G. 
Published: July 2020

Summary:
Soft tissue defects of the distal leg, ankle, and hindfoot pose challenges for orthopaedic surgeons. The distally based peroneus brevis muscle flap is a viable local muscle rotation flap to cover defects in these challenging circumstances, and can be learned and performed by most orthopaedic surgeons without the need for microvascular techniques. This video demonstrates the technique for a peroneus brevis rotation flap in a patient with a lateral ankle defect and exposed bone.
Dorsal Approach for Dorsal Impaction Distal Radius Fracture—Visualization, Reduction, and Fixation Made Simple
Authors: Via Garrhett G. , Roebke Austin J. , Julka Abhishek 
Published: July 2020

Summary:
Distal radius fractures with dorsal articular surface impaction comprise a difficult fracture pattern to operatively reduce using a standard volar approach. Distal radius open reduction internal fixation using a dorsal approach allows direct visualization and reduction. The surgical technique video presented demonstrates technical pearls for optimal visualization, reduction, and fixation.
Levosimendan Efficacy and Safety: 20 Years of SIMDAX in Clinical Use
Authors: Papp Zoltán , Agostoni Piergiuseppe , Alvarez Julian , Bettex Dominique , Bouchez Stefan , Brito Dulce , Černý Vladimir , Comin-Colet Josep , Crespo-Leiro Marisa G. , Delgado Juan F. , Édes István , Eremenko Alexander A. , Farmakis Dimitrios , Fedele Francesco , Fonseca Cândida , Fruhwald Sonja , Girardis Massimo , Guarracino Fabio , Harjola Veli-Pekka , Heringlake Matthias , Herpain Antoine , Heunks Leo M. A. , Husebye Tryggve , Ivancan Višnja , Karason Kristjan , Kaul Sundeep , Kivikko Matti , Kubica Janek , Masip Josep , Matskeplishvili Simon , Mebazaa Alexandre , Nieminen Markku S. , Oliva Fabrizio , Papp Julius G. , Parissis John , Parkhomenko Alexander , Põder Pentti , Pölzl Gerhard , Reinecke Alexander , Ricksten Sven-Erik , Riha Hynek , Rudiger Alain , Sarapohja Toni , Schwinger Robert H. G. , Toller Wolfgang , Tritapepe Luigi , Tschöpe Carsten , Wikström Gerhard , Lewinski Dirk von , Vrtovec Bojan , Pollesello Piero 
Published: July 2020

Abstract:
Levosimendan was first approved for clinical use in 2000, when authorization was granted by Swedish regulatory authorities for the hemodynamic stabilization of patients with acutely decompensated chronic heart failure (HF). In the ensuing 20 years, this distinctive inodilator, which enhances cardiac contractility through calcium sensitization and promotes vasodilatation through the opening of adenosine triphosphate–dependent potassium channels on vascular smooth muscle cells, has been approved in more than 60 jurisdictions, including most of the countries of the European Union and Latin America. Areas of clinical application have expanded considerably and now include cardiogenic shock, takotsubo cardiomyopathy, advanced HF, right ventricular failure, pulmonary hypertension, cardiac surgery, critical care, and emergency medicine. Levosimendan is currently in active clinical evaluation in the United States. Levosimendan in IV formulation is being used as a research tool in the exploration of a wide range of cardiac and noncardiac disease states. A levosimendan oral form is at present under evaluation in the management of amyotrophic lateral sclerosis. To mark the 20 years since the advent of levosimendan in clinical use, 51 experts from 23 European countries (Austria, Belgium, Croatia, Cyprus, Czech Republic, Estonia, Finland, France, Germany, Greece, Hungary, Italy, the Netherlands, Norway, Poland, Portugal, Russia, Slovenia, Spain, Sweden, Switzerland, the United Kingdom, and Ukraine) contributed to this essay, which evaluates one of the relatively few drugs to have been successfully introduced into the acute HF arena in recent times and charts a possible development trajectory for the next 20 years.
Consensus Recommendations on the Prehospital Care of the Injured Athlete With a Suspected Catastrophic Cervical Spine Injury
Authors: Mills Brianna M. , Conrick Kelsey M. , Anderson Scott , Bailes Julian , Boden Barry P. , Conway Darryl , Ellis James , Feld Francis , Grant Murphy , Hainline Brian , Henry Glenn , Herring Stanley A. , Hsu Wellington K. , Isakov Alex , Lindley Tory , McNamara Lance , Mihalik Jason P. , Neal Timothy L. , Putukian Margot , Rivara Frederick P. , Sills Allen K. , Swartz Erik E. , Vavilala Monica S. , Courson Ron 
Published: July 2020

Introduction:
Sports participation is among the leading causes of catastrophic cervical spine injury (CSI) in the United States. Appropriate prehospital care for athletes with suspected CSIs should be available at all levels of sport. The goal of this project was to develop a set of best-practice recommendations appropriate for athletic trainers, emergency responders, sports medicine and emergency physicians, and others engaged in caring for athletes with suspected CSIs.

Methods:
A consensus-driven approach (RAND/UCLA method) in combination with a systematic review of the available literature was used to identify key research questions and develop conclusions and recommendations on the prehospital care of the spine-injured athlete. A diverse panel of experts, including members of the National Athletic Trainers' Association, the National Collegiate Athletic Association, and the Sports Institute at UW Medicine participated in 4 Delphi rounds and a 2-day nominal group technique (NGT) meeting. The systematic review involved 2 independent reviewers and 4 rounds of blinded review.

Results:
The Delphi process identified 8 key questions to be answered by the systematic review. The systematic review comprised 1544 studies, 49 of which were included in the final full-text review. Using the results of the systematic review as a shared evidence base, the NGT meeting created and refined conclusions and recommendations until consensus was achieved.

Conclusions:
These conclusions and recommendations represent a pragmatic approach, balancing expert experiences and the available scientific evidence.
Congenital Benign Metastasizing Teratoma? A Case Report and Literature Review
Authors: Russell Daniel H. 
Published: July 2020

Abstract
A case is presented of a patient with completely resected congenital immature gastric teratoma containing yolk sac tumor, with locoregional recurrence and peritoneal seeding 25 months later as pure mature teratoma. To the knowledge of the author, this is the first case of its type to progress purely as mature teratoma.
Rectal Perivascular Epithelioid Cell Tumor With Partial CD117 Expression and Giant Cells
Authors: Maskoliūnaitė Vygantė , Jakubauskas Matas , Garnelytė Aušra , Jotautas Valdemaras , Stankevičienė Jolanta , Strupas Kestutis , Mickys Ugnius 
Published: July 2020

Abstract
Perivascular epithelioid cell tumor (PEComa) is a rare entity, characterized as a mesenchymal tumor with coexpression of melanocytic and smooth muscle markers. The involvement of the gastrointestinal tract is described in up to 100 cases in the English literature. Rectal PEComas are even more uncommon, with only 10 previously described cases. We present the case of a 62-year-old man with rectal PEComa with some unusual features, such as gastrointestinal stromal tumor–like CD117 positivity and HMB45 (human melanoma black-45)–positive multinucleated giant tumor cells. After 12 months' follow-up, the patient is alive with no radiologic, endoscopic, or histologic evidence of disease recurrence.
The Head and Neck Oncology Specimen: The Gross Examination as an Essential Component to Diagnosis and Optimal Patient Outcomes
Authors: Laklouk Israa , Sadow Peter M. 
Published: July 2020

Abstract
Achieving complete resection in head and neck oncologic cancer surgeries without leaving behind residual disease is the most significant factor to minimize the risk of locoregional recurrence and overall survival. Approaches regarding how to handle en bloc specimens for margin assessment also impact patients' long-term outcomes. Although sampling the tumor bed to evaluate for residual tumor at surgical margins (excision edges) is the most commonly practiced technique, some studies have shown that separately submitted tumor bed margins have lower sensitivity for tumor assessment compared with detection of those positive margins from direct sampling of the en bloc specimen. Close collaboration between the surgeon and pathologist is fundamental to optimize surgical margin assessment and reporting. Current American Joint Committee on Cancer (eighth edition) and National Comprehensive Cancer Network guidelines recommend the en bloc specimen sampling for intraoperative assessment of surgical margins. Cutoffs less than 5 mm between tumor and the surgical margin had been considered adequate in specific subsites in head and neck region. Emerging in situ imaging modalities and molecular testing may help to reduce inadequate surgical margins during tumor resections; however, further studies and validation are needed. This article presents a review of recent publications and guidelines of general grossing principles and recent updates to optimize cancer-free surgical margins and to emphasize the limitation issues encountered in routine practice.
Galectin-3 and Risk of Late Graft Failure in Kidney Transplant Recipients: A 10-year Prospective Cohort Study
Authors: Sotomayor Camilo G. , te Velde-Keyzer Charlotte A. , Diepstra Arjan , van Londen Marco , Pol Robert A. , Post Adrian , Gans Rijk O.B. , Nolte Ilja M. , Slart Riemer H.J.A. , de Borst Martin H. , Berger Stefan P. , Rodrigo Ramón , Navis Gerjan J. , de Boer Rudolf A. , Bakker Stephan J.L. 
Published: July 2020

Background.
Galectin-3 may play a causal role in kidney inflammation and fibrosis, which may also be involved in the development of kidney graft failure. With novel galectin-3-targeted pharmacological therapies increasingly coming available, we aimed to investigate whether galectin-3 is associated with risk of late graft failure in kidney transplant recipients (KTR).

Methods.
We studied adult KTR who participated in TransplantLines Insulin Resistance and Inflammation Biobank and Cohort Study, recruited in a university setting (2001–2003). Follow-up was performed for a median of 9.5 (interquartile range, 6.2–10.2) years. Overall and stratified (P
interaction < 0.05) multivariable-adjusted Cox proportional-hazards regression analyses were performed to study the association of galectin-3 with risk of graft failure (restart of dialysis or retransplantation).

Results.
Among 561 KTR (age 52 ± 12 y; 54% males), baseline median galectin-3 was 21.1 (interquartile range, 17.0–27.2) ng/mL. During follow-up, 72 KTR developed graft failure (13, 18, and 44 events over increasing tertiles of galectin-3). Independent of adjustment for donor, recipient, and transplant characteristics, galectin-3-associated with increased risk of graft failure (hazard ratios [HR] per 1 SD change, 2.12; 95% confidence interval [CI], 1.63-2.75; P < 0.001), particularly among KTR with systolic blood pressure ≥140 mmHg (HR, 2.29; 95% CI, 1.80-2.92; P < 0.001; P
interaction = 0.01) or smoking history (HR, 2.56; 95% CI, 1.95-3.37; P < 0.001; P
interaction = 0.03). Similarly, patients in the highest tertile of galectin-3 were consistently at increased risk of graft failure.

Conclusions.
Serum galectin-3 levels are elevated in KTR, and independently associated with increased risk of late graft failure. Whether galectin-3-targeted therapies may represent novel opportunities to decrease the long-standing high burden of late graft failure in stable KTR warrants further studies.
Clinicopathologic Characteristics of JC Virus Nephropathy in Kidney Transplant Recipients
Authors: Wiegley Nasim , Walavalkar Vighnesh , Aujla Harleen , Chen Ling-Xin , Huang Yihung , Lee Brian K. , Jen Kuang-Yu 
Published: July 2020

Background.
The vast majority of polyomavirus nephropathy (PVN) is due to BK virus, but rare cases result from JC virus reactivation. To date, only a handful of biopsy-proven JC-PVN cases have been reported. Here, we describe the clinical and pathologic findings in 7 patients with biopsy-proven JC-PVN.

Methods.
Search of the pathology archives at 2 institutions found 7 cases of JC-PVN. Clinical data were extracted from the electronic medical records, and the biopsies were reviewed.

Results.
Four cases were diagnosed at 6 y posttransplant or later. The remaining 3 cases presented within approximately 2 y posttransplant, of which 2 showed subclinical JC-PVN on surveillance biopsy. Two early presenting patients were treated for acute rejection just before acquiring JC-PVN. Late presenting patients had higher chronicity, which correlated to worse outcome. All but 1 biopsy showed nonspecific inflammation within areas of interstitial fibrosis without significant inflammation in unscarred cortex. The earliest presenting patient was the exception and showed active inflammation with tubulitis. Viral cytopathic changes were detected in all cases with moderate or high-histologic viral load (pvl), showing preference for the distal tubules and medulla. The 2 cases with low pvl did not demonstrate cytopathic changes but were SV40 positive.

Conclusions.
JC-PVN can be insidious in presentation, which may cause delayed or missed diagnosis. Unlike BK-PVN, which typically occurs early in the posttransplant period, JC-PVN can occur both early and late following transplant. Overreliance on negative plasma and urine BK viral loads to exclude PVN can be a pitfall.