bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case series of children with adenovirus pneumonia: three-year experiences in a tertiary PICU
Authors: Shi Jingyi , Zhou Yiping , Wang Fei , Wang Chunxia , Miao Huijie , Sun Ting , Shan Yijun , Cui Yun , Zhang Yucai 
Published: August 2020

Abstract
Background
Describe the outcome of adenovirus pneumonia in a pediatric intensive care unit (PICU) over a 3-year period, to identify the risk factors that may be associated with worse outcome.

Methods
A retrospective observational study was performed in the PICU of children’s hospital in Shanghai from July 2016 to June 2019. Sixty-seven children over 29 days to 14 years old with adenovirus pneumonia who were admitted to PICU with acute hypoxemic respiratory failure were included in this study. The primary outcome was hospital mortality, and secondary outcomes were hospital and PICU length of stay (LOS), and risk factors of worse outcome.

Results
Of 67 children with severe adenovirus pneumonia, the hospital mortality was 16.42% (11/67) and 28-day mortality was 14.93% (10/67). Median Pediatric Risk of Mortality III (PRISM III) score at admission was 13 (interquartile range [IQR], 10–15). Median PICU LOS stay was 11 days (8-18d) and hospital LOS was 22 days (16-31d). Among children with extracorporeal membrane oxygenation (n = 9), 6 cases survived and 3 cases died. The patients who need renal replacement therapy, neuromuscular blockade, parenteral nutrition, and packed red blood cell perfusion had higher hospital mortality (p < 0.001, p = 0.041, p = < 0.001, p = 0.012, respectively). Multivariate logistic analysis indicated that liver dysfunction and nosocomial infection were associated with high risk of mortality.

Conclusions
The hospital mortality of adenovirus pneumonia in our PICU was 16.42%. Patients complicated liver dysfunction and co-infection & nosocomial infection were associated with poor outcome.
Intra- and inter-rater reliability of thoracic spine mobility and posture assessments in subjects with thoracic spine pain
Authors: Takatalo Jani , Ylinen Jari , Pienimäki Tuomo , Häkkinen Arja 
Published: August 2020

AbstractBackgroundThe thoracic spine (TS) has been neglected in the study of the spine despite its essential role in the stability and posture of the entire spinal complex. Therefore, there is an inevitable need to investigate the reproducibility of different thoracic spinal posture measures used in subjects with TS pain.MethodsThirty-two subjects (16 females and 16 males, mean age 39 years) were evaluated by two physiotherapists on the same day to gauge inter-rater reliability and on two consecutive days to gauge intra-rater reliability. TS posture was assessed by observation, and thoracic spine mobility was measured by manual assessment of segmental flexion and extension mobility in a seated position. Additionally, posterior-to-anterior accessory mobility in a prone position was assessed manually. Moreover, cervicothoracic flexion in a seated position, thoracic posture, and thoracic flexion and extension mobility in a standing position were assessed with a tape measure, and flexion and extension mobility in a seated position and TS posture in seated and standing positions were measured with an inclinometer. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), mean difference (MD), Bland-Altman (B&A) plot features and coefficient of repeatability (CR) were calculated.ResultsThe mean and standard deviation (SD) of the duration of TS pain was 22 (SD 45) months, with the intensity of pain being rated at 27 (SD 21) mm on a visual analogue scale (VAS). Intra-rater reliability was very strong (ICC ≥ 0.80) for the evaluation of seated and standing upper TS posture, standing whole TS posture and seated lower TS posture with an inclinometer. Moreover, TS posture evaluation with a measuring tape, posture inspection in a seated position, and manual assessment of segmental extension were found to have very strong intra-rater reliability. Inter-rater reliability was very strong for inclinometer measurements of standing and seated upper TS posture as well as standing whole TS posture.ConclusionIntra-rater reliability was higher than inter-rater reliability in most of the evaluated measurements. Overall, posture measurements with an inclinometer were more reliable than mobility measurements with the same instrument. The manual assessments can be used reliably when same evaluator performs the examination.Trial registrationClinical Trials, NCT01884818. Registered 24 June 2013,https://clinicaltrials.gov/ct2/show/NCT01884818?cond=thoracic+spine&cntry=FI&rank=1
Increased risk of knee osteoarthritis in patients using oral N-acetylcysteine: a nationwide cohort study
Authors: Yeh Ying-Ting , Liang Chung-Chao , Chang Chia-Ling , Hsu Chung-Y. , Li Pei-Chen 
Published: August 2020

Abstract
Background
Knee osteoarthritis (OA) is known to be a progressive degenerative disorder; however, recent evidence suggests that inflammatory mediators contribute to cartilage degradation. Studies have reported that N-acetylcysteine (NAC) had a promising effect on the reduction of the synthesis of proinflammatory and structural mediators by synovial cells. Given the lack of relevant clinical trials, we conducted this study to determine the relationship between NAC use and risk of knee OA.

Methods
We designed a retrospective cohort study from 2000 to 2013. Patients who received oral NAC over 28 days within 1 year after the first prescription were defined as the case group, whereas those without NAC use were considered as candidates of the control group. We adopted 1:4 propensity-score matching by age, sex, index year, and comorbidities to obtain the control group. The primary outcome was a new diagnosis of knee OA during the follow-up period.

Results
Our study sample comprised 12,928 people who used NAC and 51,715 NAC nonusers. NAC users had a significantly higher incidence of osteoarthritis (adjusted hazard ratio: 1.42, P < .001) than did NAC nonusers. Also, in analyses stratified by age group and sex, all subgroups exhibited a significantly higher incidence of knee osteoarthritis (P < .0001) among NAC users than among NAC nonusers. The use of oral NAC was associated with nearly four-fold increased the risk of knee OA in the young age group.

Conclusions
Long-term use of oral NAC is associated with a higher risk of knee OA.
Elevated non-high-density lipoprotein cholesterol corresponds to a high risk of nephrolithiasis in children
Authors: Chen Meiyuan , Xiao Jing , Du Yuan , Wang Miaomiao , Ruan Jimeng , Tian Ye 
Published: August 2020

Abstract
Background
Dyslipidemia contributes to the development of nephrolithiasis in adults; however its relationship to urolithiasis in children remains debatable, and will be clarified in the present work.

Methods
A case–control study was performed involving 58 pediatric patients diagnosed with upper urinary tract stones as well as 351 controls. Age, gender, body mass index (BMI), serum calcium, serum uric acid, blood glucose, blood lipids, and compositions of stones were compared.

Results
According to the univariate analysis, uric acid was higher (P < 0.01) but serum calcium lower in the stone group than the control (P < 0.05). As for the blood lipids, non-high-density lipoprotein cholesterol (non-HDL-c) was significantly higher in the stone group as compared to the control (P < 0.01), while total cholesterol, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol did not show statistical difference between the two groups. In the multivariate analysis, only non-HDL-c and serum uric acid were increased in the stone group (P = 0.003 and P = 0.008). In the stone compositions’ analysis, serum uric acid and non-HDL-c were associated with percentage of uric acid and pure calcium oxalate stones, respectively.

Conclusion
Non-high-density lipoprotein cholesterol may act as a lipid risk factor for urolithiasis in children.
Study of hospitalization and mortality in Korean diabetic patients using the diabetes complications severity index
Authors: Yoo Hyunju , Choo Eunjung , Lee Sukhyang 
Published: August 2020

Abstract
Background
The prevalence of type 2 diabetes mellitus (T2DM) is expected to increase from 7.7% in 2017 to 8.4% in 2045 worldwide. Diabetes complications contribute to morbidity and mortality. To evaluate whether the diabetes complications severity index (DCSI) was associated with increased risks of mortality and hospitalization.

Methods
A retrospective cohort study was conducted using the National Health Insurance Database (NHID) sample cohort of 1,102,047 patients (2002–2015) in Korea. Diabetes complications were evaluated at 2 years after the initial diagnosis and during the subsequent follow-up period (mean duration 6.56 ± 2.81 years). The type and severity of complications were evaluated on the basis of the International Classification of Disease Ninth (ICD-9) codes used in DCSI with 7 categories and 55 subcategories of complications. The Cox proportional hazard and Poisson regression models were used to evaluate the mortality and hospitalization rates. The incidence and relative risk of diabetes complications as well as the risk of mortality and hospitalization were the main outcome measures.

Results
A total of 27,871 patients were finally included and grouped by the number of complications present at 2 years. Four hundred ninety patients (5.37%) died without complications, 659 (7.31%) died with one complication and 1153 (11.85%) died with two or more complications. As DCSI at index date increased, the risk of additional new diabetes complications increased by 26% [relative risk (RR) 1.26, 95% CI 1.25–1.27]. The risks of mortality and hospitalization were linearly related to DCSI [hazard ratio 1.13 (95% CI 1.11–1.16), relative risk 1.04 (95% CI 1.03–1.06)].

Conclusions
Patients with higher incidence and severity of diabetes complications have increased risks of mortality and hospitalization.
Efficiency of tooth bleaching agent on staining and discoloration characteristics of nicotine stained dental enamel model
Authors: Lertsukprasert Nattha , Locharoenrat Kitsakorn 
Published: August 2020

Abstract
Background
Surface staining and deeper discoloration characteristics of peroxide-based bleaching agents in the nicotine stain in dental enamel model were evaluated in the present study.

Methods
Nicotine stained dental enamel fragments (n = 36) were prepared and were subjected to the bleaching ingredients for a fixed treatment time of 30 min. The bleaching agents were composed of limonene, coconut diethanolamide, and carbamide peroxide served as solvent, nonionic surfactant, and oxidizer, respectively. Optical analysis was carried out considering color stability via colorimeter and UV-Vis spectrometer.

Results
Degrees of color variations were significantly influenced by nicotine content and bleaching ingredient factors. They varied in the range of approximately 3.00 and 5.00 units for all tooth-bleaching agents. The most prominent degrees of color variation elevations were obtained in the tooth bleaching formulae set #2 (1.0% limonene + 20% coconut diethanolamide) in the stained tooth model in comparison to set #1 (0.5% limonene + 10% coconut diethanolamide) and set #3 (1.5% limonene + 30% coconut diethanolamide), partly due to the perceptible color changes. The lowest degree of color variation under a dose limitation was found in the tooth bleaching formulae set #2 + 10% carbamide peroxide formulation. Absorbance spectra were also evaluated after the interaction of bleaching treatment. They confirmed a relationship between nicotine content and discoloration characteristics of the tooth bleaching formulae set #2 + 10% carbamide peroxide.

Conclusions
Carbamide peroxide is considered as generator of free radicals. It converts the color of stains to clear by oxidizing the organic compounds in the stained dental enamel model, achieving whiteness enhancement.
The impact of a hands-on arthrocentesis workshop in undergraduate medical education
Authors: Ladurner Andreas , Nijman Thomas , Gill Tiffany K. , Smitham Peter J. 
Published: August 2020

AbstractBackgroundTo evaluate the impact of a training programme for arthrocentesis on procedural skills enhancement and self-confidence in medical students.MethodsParticipants were provided a structured workshop on injection models. A self-confidence questionnaire and medical knowledge assessment were performed. Retention of knowledge and skills were assessed at a later time point during a formal OSCE examination and compared to participants who had not attended a lecture and clinical attachments only.P-values, 95% confidence intervals about the mean, standard error of the mean, and standard deviations of the differences were calculated.ResultsAll participants gained self-confidence, and improvement of their skills was significant. The mean self-confidence with performing an arthrocentesis procedure increased from 1.3 pre- to 5.9 points post-workshop (10-point Likert scale). The knee was the joint students felt most confident with (1.3 to 6.5 points). Knowledge on the selection of corticosteroid preparations (1.2 to 5.8 points) gained substantially, as well as confidence in providing post-injection advice (1.9 to 6.6 points). Upon the OSCE examination, attendance to the workshop resulted in a significant higher total score (16.2 vs 14.8 points,p < 0.05).ConclusionsA workshop for arthrocentesis procedures, in conjunction with other learning activities, is well suited to increasing skills and self-confidence in fourth year medical students and allows for developing important baseline knowledge and practicing invasive techniques without risk to a patient.Trial registrationThis trial has been approved by the human research ethics committee of the University of Adelaide (Ethics approval No H-2019-134).
Evaluating stakeholder involvement in building a decision support tool for NHS health checks: co-producing the WorkHORSE study
Authors: Lloyd-Williams Ffion , Hyseni Lirije , Guzman-Castillo Maria , Kypridemos Chris , Collins Brendan , Capewell Simon , Schwaller Ellen , O’Flaherty Martin 
Published: August 2020

Abstract
Background
Stakeholder engagement is being increasingly recognised as an important way to achieving impact in public health. The WorkHORSE (Working Health Outcomes Research Simulation Environment) project was designed to continuously engage with stakeholders to inform the development of an open access modelling tool to enable commissioners to quantify the potential cost-effectiveness and equity of the NHS Health Check Programme.
An objective of the project was to evaluate the involvement of stakeholders in co-producing the WorkHORSE computer modelling tool and examine how they perceived their involvement in the model building process and ultimately contributed to the strengthening and relevance of the modelling tool.

Methods
We identified stakeholders using our extensive networks and snowballing techniques. Iterative development of the decision support modelling tool was informed through engaging with stakeholders during four workshops. We used detailed scripts facilitating open discussion and opportunities for stakeholders to provide additional feedback subsequently. At the end of each workshop, stakeholders and the research team completed questionnaires to explore their views and experiences throughout the process.

Results
30 stakeholders participated, of which 15 attended two or more workshops. They spanned local (NHS commissioners, GPs, local authorities and academics), third sector and national organisations including Public Health England.
Stakeholders felt valued, and commended the involvement of practitioners in the iterative process. Major reasons for attending included: being able to influence development, and having insight and understanding of what the tool could include, and how it would work in practice. Researchers saw the process as an opportunity for developing a common language and trust in the end product, and ensuring the support tool was transparent. The workshops acted as a reality check ensuring model scenarios and outputs were relevant and fit for purpose.

Conclusions
Computational modellers rarely consult with end users when developing tools to inform decision-making. The added value of co-production (continuing collaboration and iteration with stakeholders) enabled modellers to produce a “real-world” operational tool. Likewise, stakeholders had increased confidence in the decision support tool’s development and applicability in practice.
Patient-appraised beneficial moments during inpatient psychiatric treatment
Authors: Locher Cosima , Mansour Ramin , Koechlin Helen , Büchi Stefan 
Published: August 2020

AbstractBackgroundPsychiatric inpatients receive a multidisciplinary treatment approach, covering psychiatry, nursing, occupational therapy, and psychology. Research findings reveal that the effectiveness of any treatment is associated with three types of factors: specific (e.g., treatment techniques), common (e.g., clinician-patient relationship, patients’ expectations) and extra-therapeutic. However, there is little published research on the factors and events which inpatients themselves consider to be beneficial (‘beneficial moments’).MethodsInpatients (N = 107) of a psychiatric clinic completed a questionnaire to elicit their appraisal of beneficial moments. A qualitative content analysis was applied. The coding procedure was conducted independently by two authors.ResultsSelf-appraised beneficial moments were found in five areas: therapy-specific components (number of quotations,N = 204), positive relationships (N = 140), clinical setting and environment (N = 52), inpatients’ new insights (N = 36), and factors unrelated to either therapy or the clinic (N = 30). In total, 44% of the quotations were related to specific factors, 49% to common factors, and 7% to extra-therapeutic factors.ConclusionsInpatients judge both specific and common factors as crucial for the therapeutic benefit they gain during their stay at the clinic. Our results differ from meta-analytical findings, where the impact of specific factors on symptom improvement has shown to be much smaller (i.e., 17%) than appraised by patients in our study (i.e., 44%). Our study underlines the importance of a patient-centred care approach as well as shared decision making and patient-clinician communication. For clinical practice, knowledge of inpatients’ perspectives on beneficial moments is crucial in order to reinforce precisely these therapeutic components.
Impact of intermittent preventive treatment of malaria in pregnancy with dihydroartemisinin-piperaquine versus sulfadoxine-pyrimethamine on the incidence of malaria in infancy: a randomized controlled trial
Authors: Kakuru Abel , Jagannathan Prasanna , Kajubi Richard , Ochieng Teddy , Ochokoru Harriet , Nakalembe Miriam , Clark Tamara D. , Ruel Theodore , Staedke Sarah G. , Chandramohan Daniel , Havlir Diane V. , Kamya Moses R. , Dorsey Grant 
Published: August 2020

Abstract
Background
Intermittent preventive treatment of malaria during pregnancy (IPTp) with dihydroartemisinin-piperaquine (DP) significantly reduces the burden of malaria during pregnancy compared to sulfadoxine-pyrimethamine (SP), the current standard of care, but its impact on the incidence of malaria during infancy is unknown.

Methods
We conducted a double-blind randomized trial to compare the incidence of malaria during infancy among infants born to HIV-uninfected pregnant women who were randomized to monthly IPTp with either DP or SP. Infants were followed for all their medical care in a dedicated study clinic, and routine assessments were conducted every 4 weeks. At all visits, infants with fever and a positive thick blood smear were diagnosed and treated for malaria. The primary outcome was malaria incidence during the first 12 months of life. All analyses were done by modified intention to treat.

Results
Of the 782 women enrolled, 687 were followed through delivery from December 9, 2016, to December 5, 2017, resulting in 678 live births: 339 born to mothers randomized to SP and 339 born to those randomized to DP. Of these, 581 infants (85.7%) were followed up to 12 months of age. Overall, the incidence of malaria was lower among infants born to mothers randomized to DP compared to SP, but the difference was not statistically significant (1.71 vs 1.98 episodes per person-year, incidence rate ratio (IRR) 0.87, 95% confidence interval (CI) 0.73–1.03, p = 0.11). Stratifying by infant sex, IPTp with DP was associated with a lower incidence of malaria among male infants (IRR 0.75, 95% CI 0.58–0.98, p = 0.03) but not female infants (IRR 0.99, 95% CI 0.79–1.24, p = 0.93).

Conclusion
Despite the superiority of DP for IPTp, there was no evidence of a difference in malaria incidence during infancy in infants born to mothers who received DP compared to those born to mothers who received SP. Only male infants appeared to benefit from IPTp-DP suggesting that IPTp-DP may provide additional benefits beyond birth. Further research is needed to further explore the benefits of DP versus SP for IPTp on the health outcomes of infants.

Trial registration
ClinicalTrials.gov, NCT02793622. Registered on June 8, 2016.
Evaluation of nutraceutical properties of Leucaena leucocephala leaf pellets fed to goat kids infected with Haemonchus contortus
Authors: Marie-Magdeleine Carine , Ceriac Steve , Barde Dingamgoto Jesse , Minatchy Nathalie , Periacarpin Fred , Pommier Frederic , Calif Brigitte , Philibert Lucien , Bambou Jean-Christophe , Archimède Harry 
Published: August 2020

Abstract
Background
Leucaena leucocephala, as a shrub legume rich in condensed tannins, is a candidate for the integrated control of gastrointestinal parasitic pathogen nematodes. Here, we investigated the anthelmintic potential of the nutraceutical L. leucocephala, transformed into pellets, against Haemonchus contortus.

Results
Creole goat kids were fed an iso-nitrogenous diet of Dichantium hay with alfalfa pellets or Leucaena pellets or an alfalfa–leucaena mixture in varying ratios. The artificial infection of kids with H. contortus led to infection levels comparable to those observed in the farm environment on the basis of egg excretion. The anthelmintic activity of Leucaena, compared to alfalfa, was demonstrated by its potential to reduce egg excretions (1524 vs. 3651 eggs/g) and the larval development of excreted eggs (3.5 vs. 24%). This anthelmintic potential was reported when the ratio of Leucaena incorporation in the diet was high (50% DM intake). The voluntary dry matter intake (79.3 vs. 77.0 g Large Weigth0.75), the total tract dry matter digestion (0.585 vs. 0.620), and the growth (57.1 vs. 71.3 g/d) of kids fed Leucaena compared to alfalfa indicate that Leucaena has a high feed value. The Leucaena, even at the highest intakes in the diets, has not shown any signs of poisoning in kids.

Conclusions
Leucaena fulfilled the conditions to be a good nutraceutical, and pelleting is a good method for its use.