bluuebunny/crossref_metadata_2025_split huggingface dataset:
Veno-venous extracorporeal membrane oxygenation successfully treated a case of severe pulmonary hemorrhage caused by leptospirosis
Authors: Wang H. J. , Chen G. Z. , Zhou C. J. , FU Y. , YAO L. N. 
Published: October 2020

Abstract
Background
Pulmonary hemorrhage is an important complication of leptospirosis. Once acute respiratory distress syndrome (ARDS) occurs as a secondary condition, treatment is extremely difficult and the mortality rate is very high.

Case presentation
The patient was a 49-year-old. He was admitted to the hospital because he had experienced a fever and cough for 4 days. Hemorrhage, respiratory failure, ARDS and other symptoms appeared soon after admission. Due to severe pulmonary hemorrhage secondary to ARDS, mechanical ventilation was performed through tracheal intubation. During intubation, the patient suffered cardiac arrest, and the patient’s condition worsened. He was confirmed to have leptospirosis through second-generation sequencing of the alveolar lavage fluid. Finally, we successfully treated the patient with penicillin as an anti-infective medication and venous-venous extracorporeal membrane oxygenation (v-vECMO). To the best of our knowledge, this report is the first to describe the successful application of ECMO in mainland China.

Conclusions
Leptospirosis can induce serious but transient ARDS with a better prognosis than other causes of ARDS. Our patient was successfully treated with V-vECMO.
Who fails to return within 30 days after being tested positive for HIV/STI in a free testing centre?
Authors: Rolland Camille , de La Rochebrochard Elise , Piron Prescillia , Shelly Marc , Segouin Christophe , Troude Pénélope 
Published: October 2020

Abstract
Background
Some patients who test positive for sexually transmitted infections (STIs) fail to return for results and treatment. To target improvement actions, we need to find out who these patients are. This study aimed to explore factors associated with failure to return within 30 days (FTR30) after testing among patients with positive results in a free STI testing centre in Paris.

Methods
All patients with at least one positive result between October 2016 and May 2017 and who completed a self-administered questionnaire were included in this cross-sectional study (n = 214). The questionnaire included sociodemographic factors, sexual behaviour and history of testing. Factors associated with FTR30 were assessed using logistic regression models.

Results
More than two-thirds of patients were men (72%), and the median age of patients was 27 years. Most patients were born in metropolitan France (56%) or in sub-Saharan Africa (22%). Men who had sex with men represented 36% of the study population. The FTR30 rate was 14% (95% CI [10–19%]). In multivariate analysis, previous HIV testing in younger persons (aOR: 3.36, 95% CI [1.27–8.84]), being accompanied by another person at the pretest consultation (aOR: 3.45, 95% CI [1.36–8.91]), and lower self-perceived risk of HIV infection (aOR: 2.79, 95% CI [1.07–7.30]) were associated with a higher FTR30. Testing for chlamydia/gonorrhoea without presumptive treatment was associated with a lower FTR30 (aOR: 0.21, 95% CI [0.07–0.59]).

Conclusions
These factors that affect failure to return are related to the patient’s representations and involvement in the STI screening process. Increasing health literacy and patient empowerment could help to decrease failure to return after being tested positive for HIV/STI.

Trial registration
Not applicable.
Evaluating sensitivity and specificity of handheld point-of-care ultrasound testing for gynecologic pathology: a pilot study for use in low resource settings
Authors: Toscano Marika , Szlachetka Kam , Whaley Natalie , Thornburg Loralei L. 
Published: October 2020

Abstract
Background
Point-of-care ultrasound (POC-US) is a diagnostic test conducted at the site of patient care with direct interpretation by the clinician, providing immediate results. POC-US for gynecologic application is not well characterized by current literature yet has the potential to increase access in limited resource settings. We compared the diagnostics of three POC-US devices for gynecologic (GYN) pathology and then performed evaluation of sensitivity and specificity of a single best POC-US device for intended use in a low resource setting.

Methods
This is prospective, pilot descriptive study of 60 subjects. In part 1, comparison of three POC-US devices was performed. Twenty subjects underwent POC-US with three test units [GE Vscan (Vscan), Sonosite Iviz (Iviz), Philips Lumify (Lumify)] followed by diagnostic ultrasound (Dx-US) for reference imaging. Image quality and correlation for devices was scored by blinded reviewers and quantitative measurements of GYN pathology were compared. In part 2, forty subjects underwent POC-US validation with the highest scoring device (Lumify) and Dx-US for reference imaging. Concordance of POC-US operator-interpreted diagnosis with reference imaging interpretation were assessed by Cohen’s unweighted kappa coefficient. Accuracy and agreement of POC-US were assessed by linear regression and Bland–Altman plot analysis. Sensitivity and specificity of POC-US for gynecologic pathologies were calculated.

Results
In aggregate qualitative measurements, Lumify and Iviz units performed superiorly to Vscan. There was no statistically significant difference in quantitative measurements between devices, but a trend towards lower mean error was seen for Lumify and Iviz as compared to Vscan. Lumify device had highest overall scoring and was selected for further testing. In validation comparison of Lumify to Dx-US, no statistically significant differences were found for measurements of endometrium, uterus, ovaries, adnexal pathology, or leiomyomata, (P < 0.02) with excellent agreement in operator-interpreted diagnosis (Kappa > 0.7). Sensitivity and specificity of detecting pathology was 80–100% with PPV and NPV 76–100%.

Conclusion
Among three POC-US devices, Lumify and Iviz devices show highest potential for successful application to clinical gynecologic ultrasound. Clinician-performed POC-US has high diagnostic accuracy, sensitivity, and specificity for basic GYN anatomy and pathology. POC-US is an acceptable and feasible diagnostic tool with potential for future application in a low resource setting to increase access to ultrasound.
The COVID-19 nephrology compendium: AKI, CKD, ESKD and transplantation
Authors: Kant Sam , Menez Steven P. , Hanouneh Mohamed , Fine Derek M. , Crews Deidra C. , Brennan Daniel C. , Sperati C. John , Jaar Bernard G. 
Published: October 2020

AbstractThe pandemic of coronavirus disease 2019 (CoVID-19) has been an unprecedented period. The disease afflicts multiple organ systems, with acute kidney injury (AKI) a major complication in seriously ill patients. The incidence of AKI in patients with CoVID-19 is variable across numerous international studies, but the high incidence of AKI and its associated worse outcomes in the critical care setting are a consistent finding. A multitude of patterns and mechanisms of AKI have been elucidated, and novel strategies to address shortage of renal replacement therapy equipment have been implemented. The disease also has had consequences on longitudinal management of patients with chronic kidney disease and end stage kidney disease. Kidney transplant recipients may be especially susceptible to CoVID-19 as a result of immunosuppression, with preliminary studies demonstrating high mortality rates. Increased surveillance of disease with low threshold for testing and adjustment of immunosuppression regimen during acute periods of illness have been recommended.
Influence of dialysate temperature on creatinine peritoneal clearance in peritoneal dialysis patients: a randomized trial
Authors: Fontana Francesco , Torelli Chiara , Giovanella Silvia , Ligabue Giulia , Alfano Gaetano , Gerritsen Karin , Selgas Rafael , Cappelli Gianni 
Published: October 2020

Abstract
Background
Patients on continuous ambulatory peritoneal dialysis (PD) are encouraged to warm dialysate to 37 °C before peritoneal infusion; main international PD guidelines do not provide specific recommendation, and patients generally warm dialysate batches partially or do not warm them at all. Warming of dialysate is a time-consuming procedure, not free from potential risks (i.e. degradation of glucose), and should be justified by a clear clinical benefit.

Methods
We designed a single blind randomized controlled trial where 18 stable PD patients were randomized to receive a peritoneal equilibration test either with dialysate at a controlled temperature of 37 °C (intervention group) or with dialysate warmed with conventional methods (control group). Primary end-point was a higher peritoneal creatinine clearance in patients in the intervention group.

Results
Patients in the intervention group did not show a significantly higher peritoneal creatinine clearance when compared to the control group (6.38 ± 0.52 ml/min vs 5.65 ± 0.37 ml/min, p = 0.2682). Similar results were obtained for urea peritoneal clearance, mass transfer area coefficient of creatinine and urea. There were no significant differences in total abdominal discomfort questionnaire score, blood pressure and body temperature between the two groups.

Conclusions
Using peritoneal dialysate at different temperatures without causing significant side effects to patients appears feasible. We report a lack of benefit of warming peritoneal dialysate to 37 °C on peritoneal clearances; future PD guidelines should not reinforce this recommendation.

Trial registration
NCT04302649, ClinicalTrials.gov; date of registration 10/3/2020 (retrospectively registered).
An integrated autophagy-related gene signature predicts prognosis in human endometrial Cancer
Authors: Zhang Jun , Wang Ziwei , Zhao Rong , An Lanfen , Zhou Xing , Zhao Yingchao , Wang Hongbo 
Published: October 2020

AbstractBackgroundGlobally, endometrial cancer is the fourth most common malignant tumor in women and the number of women being diagnosed is increasing. Tumor progression is strongly related to the cell survival-promoting functions of autophagy. We explored the relationship between endometrial cancer prognoses and the expression of autophagy genes using human autophagy databases.MethodsThe Cancer Genome Atlas was used to identify autophagy related genes (ARGs) that were differentially expressed in endometrial cancer tissue compared to healthy endometrial tissue. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes were referenced to identify important biological functions and signaling pathways related to these differentially expressed ARGs. A prognostic model for endometrial cancer was constructed using univariate and multivariate Cox, and Least Absolute Shrinkage and Selection Operator regression analysis. Endometrial cancer patients were divided into high- and low-risk groups according to risk scores. Survival and receiver operating characteristic (ROC) curves were plotted for these patients to assess the accuracy of the prognostic model. Using immunohistochemistry the protein levels of the genes associated with risk were assessed.ResultsWe determined 37 ARGs were differentially expressed between endometrial cancer and healthy tissues. These genes were enriched in the biological processes and signaling pathways related to autophagy. Four ARGs (CDKN2A, PTK6, ERBB2 and BIRC5) were selected to establish a prognostic model of endometrial cancer. Kaplan–Meier survival analysis suggested that high-risk groups have significantly shorter survival times than low-risk groups. The area under the ROC curve indicated that the prognostic model for survival prediction was relatively accurate. Immunohistochemistry suggested that among the four ARGs the protein levels of CDKN2A, PTK6, ERBB2, and BIRC5 were higher in endometrial cancer than healthy endometrial tissue.ConclusionsOur prognostic model assessing four ARGs (CDKN2A, PTK6, ERBB2, and BIRC5) suggested their potential as independent predictive biomarkers and therapeutic targets for endometrial cancer.
Interventions on cognitions and perceptions that influence work participation of employees with chronic health problems: a scoping review
Authors: De Wit Mariska , Horreh Bedra , Daams Joost G. , Hulshof Carel T. J. , Wind Haije , de Boer Angela G. E. M. 
Published: October 2020

Abstract
Background
Cognitions and perceptions, such as motivation and return to work (RTW) expectations, can influence work participation of employees with chronic health problems. This makes these cognitions and perceptions important factors for occupational health professionals to intervene upon in order to increase work participation. There is, however, no overview of interventions that influence these factors and are aimed at increasing work participation. Therefore, the purpose of this scoping review is to explore available interventions that are focused on cognitions and perceptions of employees with chronic health problems and aimed at increasing work participation.

Methods
A scoping review was carried out following the framework of Arksey and O’Malley. Ovid MEDLINE and PsycINFO were searched for original papers published between January 2013 and June 2020. We included studies that describe interventions that focus on at least one of ten cognitions and perceptions and on work participation. The risk of bias of the studies included was assessed using quality assessment tools from the Joanna Briggs Institute.

Results
In total, 29 studies were identified that studied interventions aimed at changing at least one of ten cognitions and perceptions in order to change work participation. The interventions that were included mainly focused on changing recovery and RTW expectations, self-efficacy, feelings of control, perceived health, fear-avoidance beliefs, perceived work-relatedness of the health problem, coping strategies and catastrophizing. No interventions were found that focused on changing motivation or on optimism/pessimism. Four interventions were judged as effective in changing coping, self-efficacy, fear-avoidance beliefs, or perceived work-relatedness and work participation according to results of randomized controlled trials.

Conclusions
This review provides an overview of interventions that focus on changing cognitions and perceptions and work participation. Evidence was found for four effective interventions focused on changing these factors and increasing work participation. Occupational health professionals may use the overview of interventions to help employees with chronic health problems to increase their work participation.
Risk factors for incident delirium among urological patients: a systematic review and meta-analysis with GRADE summary of findings
Authors: Sanyaolu L. , Scholz A. F. M. , Mayo I. , Coode-Bate J. , Oldroyd C. , Carter B. , Quinn T. , Hewitt J. 
Published: October 2020

AbstractBackgroundPost-operative delirium is an important, yet under-researched complication of surgery. Patients undergoing urological surgery may be at especially high risk of POD, as they are often older, and interventions can be associated with conditions that trigger delirium. The main aim of this systematic review was to evaluate the available evidence for risk factors in this patient group.MethodsFive databases were searched (MEDLINE, Web of Science, EMBASE, CINAHL and PsychInfo) between January 1987 and June 2019. The Newcastle–Ottawa Scale was used to assess for risk of bias. Pooled odds ratio or mean difference (MD) for individual risk factors were estimated using the Mantel–Haenzel and inverse variance methods.ResultsSeven articles met the inclusion criteria, giving a total population of 1937. The incidence of POD ranged from 5 to 29%. Three studies were deemed low risk of bias and four at a high risk of bias. Nine risk factors were suitable for meta-analysis, with age (MD 4.314 95% CI 1.597, 7.032 p = 0.002) and the clock drawing test (MD − 2.443 95% CI − 3.029, − 1.857 p < 0.001) having a statistically significant association with POD in pooled analyses.ConclusionDelirium is common in urological patients. This review has identified a lack of studies in this surgical population, with wide heterogeneity and high risk of bias. It also highlights a number of potential risk factors for post-operative delirium, of which some are modifiable. However, the strength of evidence is weak at present and so future research should focus on assessing comparable risk factors in this patient group in order to inform future clinical practice.Review registrationThe review protocol was prospectively registered with the PROSPERO database (reference CRD42017054613)
Isoniazid-induced gynaecomastia: report of a paediatric case and review of literature
Authors: Poon Sarah Wing Yiu , Siu Ka Ka , Tsang Anita Man Ching 
Published: October 2020

Abstract
Background
Gynaecomastia is a fairly common condition in puberty but is rare in prepubertal boys. While it is necessary to exclude possible endocrinopathay in prepubertal gynaecomastia, medication is an important and potentially reversible cause to consider in new onset gynaecomastia. Isoniazid-induced gynaecomastia has been reported in adult males, but none was reported in the paediatric population and general paediatricians may not be aware of this uncommon side effect.

Case presentation
We hereby report a 11-year-old prepubertal boy who developed gynaecomastia while taking anti-tuberculosis drugs. Investigations excluded endocrinopathies. Gynaecomastia subsided 8 weeks after stopping isoniazid.

Conclusion
This case is the first paediatric case report describing the association of gynaecomastia with isoniazid use. It is important for general paediatricians to recognize this entity, as prompt diagnosis and cessation of the offending drug can lead to resolution of the problem.
Xanthine oxidase inhibitory activity of a new isocoumarin obtained from Marantodes pumilum var. pumila leaves
Authors: Aladdin Nor-Ashila , Husain Khairana , Jalil Juriyati , Sabandar Carla Wulandari , Jamal Jamia Azdina 
Published: October 2020

AbstractBackgroundIn traditional Malay medicine,Marantodes pumilum(Blume) Kuntze (family Primulaceae) is commonly used by women to treat parturition, flatulence, dysentery, dysmenorrhea, gonorrhea, and bone diseases. Preliminary screening of some Primulaceae species showed that they possess xanthine oxidase inhibitory activity. Thus, this study aimed to investigate the xanthine oxidase inhibitory activity of three varieties ofM. pumilumand their phytochemical compounds.MethodDichloromethane, methanol, and water extracts of the leaves and roots ofM. pumilumvar.alata,M. pumilumvar.pumila,andM. pumilumvar.lanceolatawere tested using an in vitro xanthine oxidase inhibitory assay. Bioassay-guided fractionation and isolation were carried out on the most active extract using chromatographic techniques. The structures of the isolated compounds were determined using spectroscopic techniques.ResultsThe most active dichloromethane extract ofM. pumilumvar.pumilaleaves (IC50 = 161.6 μg/mL) yielded one new compound, 3,7-dihydroxy-5-methoxy-4,8-dimethyl-isocoumarin (1), and five known compounds, viz. ardisiaquinone A (2), maesanin (3), stigmasterol (4), tetracosane (5), and margaric acid (6). The new compound was found to be the most active xanthine oxidase inhibitor with an IC50value of 0.66 ± 0.01 μg/mL, which was not significantly different (p > 0.05) from that of the positive control, allopurinol (IC50 = 0.24 ± 0.00 μg/mL).ConclusionThis study suggests that the new compound 3,7-dihydroxy-5-methoxy-4,8-dimethyl-isocoumarin (1), which was isolated from the dichloromethane extract ofM. pumilumvar.pumilaleaves, could be a potential xanthine oxidase inhibitor.
How does participation in a voluntary prize exam affect medical students’ knowledge and interest in ENT, plastic surgery, ophthalmology and dermatology?
Authors: Nour Razan , Jobling Kerry , Mayer Alasdair , Babikir Salma 
Published: October 2020

Abstract
Background
Otolaryngology (ENT), plastic surgery, ophthalmology and dermatology are medical specialties which tend to receive less coverage in UK medical school curricula compared to larger, generalist specialties. As a result, there are fewer opportunities for medical students to learn and to cultivate an interest. There are numerous papers that report concerns about junior doctors’ ability to manage conditions within these specialties, which may jeopardise patient safety. The aim of our pilot project was to increase medical students’ interest and knowledge of ENT, plastic surgery, ophthalmology and dermatology. In addition to describing our project, we present and discuss literature on UK undergraduate education in these specialties and its impact on preparedness of junior doctors and future career choices.

Methods
One hundred twelve final year medical students at Newcastle University were invited to take part in a voluntary two-part (written and clinical) exam, in which prizes could be won and all participants would receive a certificate of participation. We distributed two online surveys to the students, one administered before the exam and one afterwards. Data was collected regarding the students’ motivation for entering the prize exam and the students’ baseline interest and knowledge in these specialties before and after the prize exam. Free-text responses were collected about the students’ opinion of the project and whether participation was beneficial.

Results
Sixteen students participated in the exam. There was a statistically significant increase in the students’ knowledge in ENT (p < 0.000), plastic surgery (p < 0.000), ophthalmology (p < 0.028) and dermatology (p < 0.012) after participation in the exam, but not in their interest levels. ENT was the preferred specialty of our cohort. The students reported that they found participation beneficial to their learning, particularly receiving exam feedback and explanations to exam questions.

Conclusions
This pilot project was a useful intervention in increasing medical students’ knowledge in these specialties, but not in their levels of interest. It also demonstrates that medical students are willing to participate in voluntary initiatives (in their spare time) to gain more learning opportunities and that medical students value timely exam feedback to guide their revision.