bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of sodium thiosulfate neutralizing effect on micro-hardness of dentin treated with sodium hypochlorite
Authors: Sahebi Safoora , Sobhnamayan Fereshteh , Moazami Fariborz , Naseri Mohammadhasan 
Published: November 2020

Abstract
Background
This study aims to evaluate the ability of sodium thiosulfate (STS) to neutralize the adverse effect of sodium hypochlorite (NaOCl) on dentin micro-hardness.

Methods
Fifty single-rooted teeth were longitudinally sectioned. The samples divided into a control and four sample groups (n = 20). All the samples were immersed in different solutions as follows, Control: Normal saline for 15 min, G1and G2: 2.5% NaOCl for 15 min, G3: 2.5% NaOCl for 15 min, followed by 5% STS for 10 min, G4: Normal saline for 15 min followed by 5% STS for 10 min. All groups except G1 incubated for one week before the test. The micro-hardness of samples was measured. Data were analyzed using the Kruskal–Wallis test for pairwise comparisons. A p value < 0.05 was considered significant.

Results
All groups showed a significant decrease in the micro-hardness value compared with the control group. NaOCl for one week (G2) reduced the micro-hardness of dentine compared with samples, tested immediately after immersion in NaOCl (G1) (p < 0.05). NaOCl alone (G2) or treated with STS (G3) resulted in a significant decrease in micro-hardness compared with the STS group (G4) (p < 0.05).

Conclusions
STS as a neutralizing agent could not prevent the dentin micro-hardness downturn caused by NaOCl.
‘It benefits patient care’: the value of practice-based IPE in healthcare curriculums
Authors: O’Leary Noreen , Salmon Nancy , Clifford Amanda M. 
Published: November 2020

Abstract
Background
Practice-based interprofessional education (IPE) is essential to prepare students for collaborative working. Pockets of practice-based IPE are integrated into healthcare curriculums in some regions. Yet practice-based IPE is not globally valued as a key element of healthcare curriculums. As students and clinical educators are key stakeholders, this study presents a case example of their experiences in a country where practice-based IPE is at an emergent stage. Their experiential knowledge generated important insights into how practice-based IPE is perceived. This learning can be applied, both locally and further afield, by those seeking to embed practice-based IPE in their placement curriculums.

Methods
A qualitative case study was conducted at a school of allied health and partner placement sites in Ireland. Data collection comprised two participant observations, 13 interviews and 12 document analyses. Inductive thematic analysis and deductive framework analysis, underpinned by activity theory and Hofstede’s cultural dimensions, informed data analysis and interpretations.

Results
Participants are grappling to establish the value of practice-based IPE, illustrated in three themes: clarifying the concept of practice-based IPE, mapping IPE activities and diversifying interprofessionalism. First, ambiguous conceptualisation of why and how to implement practice-based IPE was identified. Highlighting how practice-based IPE improved patient care and safety created a clear rationale for implementation. It was also helpful to demonstrate how adaptations to existing practice education models, rather than entirely new models, could achieve high-quality practice-based IPE. Second, the positioning of practice-base IPE in the placement curriculum was unclear. Overt mapping of practice-based IPE activities onto learning outcomes within assessment tools enhanced its value within practice education. Third, varying levels of professional engagement were noted, perpetuating stereotypes. Creating diverse educator networks and embedding practice-based IPE in organisational strategy may incentivise engagement across a greater range of professions.

Conclusions
Implementing these recommendations could enhance the value of practice-based IPE and optimise student preparation for collaborative working. Practice-based IPE remains a complex model and the trajectory of embedding in healthcare curriculums will differ globally.
An exploration of health workers risks of contracting tuberculosis in the workplace: a qualitative study
Authors: Mwenya Shadreck , Stapley Salley 
Published: November 2020

Abstract
Background
To explore the perceptions of health workers on the risks of contracting tuberculosis at Namwala District Hospital. Tuberculosis literature indicates that health workers are at risk of contracting tuberculosis while conducting their daily duties in the workplace. This is mainly attributed to low tuberculosis awareness. It is with this empirical evidence that this study was conducted to further explore health workers risky behavior, attitude and practices that expose them to tuberculosis infection when on duty and eventually generate effective health promotion and public health interventions.

Methods
Semi-structured interviews lasting between 35 to 45 min were conducted to all the participants. A purposive sampling technique was used to recruit ten participants for this study. All the ten interviews were audio recorded in order to enhance consistency during data analysis process. Interview materials were transcribed verbatim, coded and themes generated to form thematic networks. Data analysis was conducted using thematic analysis strategy.

Results
Four themes were identified; 1. Health workers personal safety: participants reported wearing uniforms and gloves but they were not putting-on face masks hence, exposing themselves to tuberculosis infection. 2. Tuberculosis infection prevention practices: hand washing was described by many participants as a universal method of protecting health staff from the risks of contracting tuberculosis at the hospital however, few health workers frequently washed their hands after attending to tuberculosis patients. 3. Health workers working environment: the working environment at the hospital was not conducive for both health workers and patients due to poor ventilation, unhygienic conditions, overcrowding and the lack of an isolation ward. 4. Health promotion: awareness on tuberculosis was reported to be low with no refresher training being conducted for health workers at the hospital.

Conclusion
The risks of contracting tuberculosis by health workers at Namwala District Hospital did exist hence, a need of advocating for tuberculosis awareness for health workers through appropriate health promotion interventions. Health policy should focus on continuous health promotion activities on prevention and control of tuberculosis in health facilities and communities.
Assessing hospital performance indicators. What dimensions? Evidence from an umbrella review
Authors: Carini Elettra , Gabutti Irene , Frisicale Emanuela Maria , Di Pilla Andrea , Pezzullo Angelo Maria , de Waure Chiara , Cicchetti Americo , Boccia Stefania , Specchia Maria Lucia 
Published: November 2020

Abstract
Background
Patients’ increasing needs and expectations require an overall assessment of hospital performance. Several international agencies have defined performance indicators sets but there exists no unanimous classification. The Impact HTA Horizon2020 Project wants to address this aspect, developing a toolkit of key indicators to measure hospital performance. The aim of this review is to identify and classify the dimensions of hospital performance indicators in order to develop a common language and identify a shared evidence-based way to frame and address performance assessment.

Methods
Following the PRISMA statement, PubMed, Cochrane Library and Web of Science databases were queried to perform an umbrella review. Reviews focusing on hospital settings, published January 2000–June 2019 were considered. The quality of the studies selected was assessed using the AMSTAR2 tool.

Results
Six reviews ranging 2002–2014 were included. The following dimensions were described in at least half of the studies: 6 studies classified efficiency (55 indicators analyzed); 5 studies classified effectiveness (13 indicators), patient centeredness (10 indicators) and safety (8 indicators); 3 studies responsive governance (2 indicators), staff orientation (10 indicators) and timeliness (4 indicators). Three reviews did not specify the indicators related to the dimensions listed, and one article gave a complete definition of the meaning of each dimension and of the related indicators.

Conclusions
The research shows emphasis of the importance of patient centeredness, effectiveness, efficiency, and safety dimensions. Especially, greater attention is given to the dimensions of effectiveness and efficiency. Assessing the overall quality of clinical pathways is key in guaranteeing a truly effective and efficient system but, to date, there still exists a lack of awareness and proactivity in terms of measuring performance of nodes within networks. The effort of classifying and systematizing performance measurement techniques across hospitals is essential at the organizational, regional/national and possibly international levels to deliver top quality care to patients.
Prognostic irrelevance of plaque vulnerability following plaque sealing in high-risk patients with type 2 diabetes: an optical coherence tomography study
Authors: Dettori Rosalia , Milzi Andrea , Burgmaier Kathrin , Almalla Mohammad , Hellmich Martin , Marx Nikolaus , Reith Sebastian , Burgmaier Mathias 
Published: November 2020

AbstractBackgroundType 2 diabetes mellitus (T2DM) is associated with an increased cardiovascular risk related at least in part to a more vulnerable plaque phenotype. However, patients with T2DM exhibit also an increased risk following percutaneous coronary intervention (PCI). It is unknown if plaque vulnerability of a treated lesion influences cardiovascular outcomes in patients with T2DM. In this study, we aimed to assess the association of plaque morphology as determined by optical coherence tomography (OCT) with cardiovascular outcome following PCI in high-risk patients with T2DM.Methods81 patients with T2DM and OCT-guided PCI were recruited. Pre-interventional OCT and systematic follow-up of median 66.0 (IQR = 8.0) months were performed.ResultsDuring follow-up, 24 patients (29.6%) died. The clinical parameters age (HR 1.16 per year, 95% CI 1.07–1.26, p < 0.001), diabetic polyneuropathy (HR 3.58, 95% CI 1.44–8.93, p = 0.006) and insulin therapy (HR 3.25, 95% CI 1.21–8.70, p = 0.019) predicted mortality in T2DM patients independently. Among OCT parameters only calcium-volume-index (HR 1.71 per 1000°*mm, 95% CI 1.21–2.41, p = 0.002) and lesion length (HR 1.93 per 10 mm, 95% CI 1.02–3.67, p = 0.044) as parameters describing atherosclerosis extent were significant independent predictors of mortality. However, classical features of plaque vulnerability, such as thickness of the fibrous cap, the extent of the necrotic lipid core and the presence of macrophages had no significant predictive value (all p = ns).ConclusionClinical parameters including those describing diabetes severity as well as OCT-parameters characterizing atherosclerotic extent but not classical features of plaque vulnerability predict mortality in T2DM patients following PCI. These data suggest that PCI may provide effective plaque sealing resulting in limited importance of local target lesion vulnerability for future cardiovascular events in high-risk patients with T2DM.
Update on human exposure to glyphosate, with a complete review of exposure in children
Authors: Gillezeau Christina , Lieberman-Cribbin Wil , Taioli Emanuela 
Published: November 2020

Abstract
Background
Glyphosate, a commonly used pesticide, has been the topic of much debate. The effects of exposure to glyphosate remains a contentious topic. This paper provides an update to the existing literature regarding levels of glyphosate exposure in occupationally exposed individuals and focuses or reviewing all the available published literature regarding glyphosate exposure levels in children.

Methods
A literature review was conducted and any articles reporting quantifiable exposure levels in humans published since January 2019 (the last published review on glyphosate exposure) were reviewed and data extracted and standardized.

Results
A total of five new studies reporting exposure levels in humans were found including 578 subjects. Two of these studies focused on occupationally exposed individuals while three of them focused on glyphosate exposure levels in children. Given the sparse nature of the new data, previously identified studies on exposure to glyphosate in children were included in our analysis of children’s exposure. The lowest average level of glyphosate exposure reported was 0.28 μg/L and the highest average exposure levels reported was 4.04 μg/L.

Conclusion
The literature on glyphosate exposure levels, especially in children, remains limited. Without more data collected in a standardized way, parsing out the potential relationship between glyphosate exposure and disease will not be possible.
Lectin complement pathway initiators after subarachnoid hemorrhage — an observational study
Authors: Matzen Jeppe Sillesen , Krogh Charlotte Loumann , Forman Julie Lyng , Garred Peter , Møller Kirsten , Bache Søren 
Published: November 2020

Abstract

Background
This exploratory study investigated the time-course of lectin complement pathway (LCP) initiators in cerebrospinal fluid (CSF) and plasma in patients with subarachnoid hemorrhage (SAH), as well as their relationship to delayed cerebral ischemia (DCI) and functional outcome.

Methods
Concentrations of ficolin-1, ficolin-2, ficolin-3, and mannose-binding lectin (MBL) were analyzed in CSF and plasma from patients with SAH. Samples were collected daily from admission until day 9 (CSF; N_PATIENTS = 63, n_SAMPLES = 399) and day 8 (plasma; N_PATIENTS = 50, n_SAMPLES = 358), respectively. Twelve neurologically healthy patients undergoing spinal anesthesia and 12 healthy blood donors served as controls. The development of DCI during hospitalization and functional outcome at 3 months (modified Rankin Scale) were registered for patients.

Results
On admission, CSF levels of all LCP initiators were increased in SAH patients compared with healthy controls. Levels declined gradually over days in patients; however, a biphasic course was observed for ficolin-1. Increased CSF levels of all LCP initiators were associated with a poor functional outcome in univariate analyses. This relationship persisted for ficolin-1 and MBL in multivariate analysis after adjustments for confounders (age, sex, clinical severity, distribution and amount of blood on CT-imaging) and multiple testing (1.87 ng/mL higher in average, 95% CI, 1.17 to 2.99 and 1.69 ng/mL higher in average, 95% CI, 1.09 to 2.63, respectively). In patients who developed DCI compared with those without DCI, CSF levels of ficolin-1 and MBL tended to increase slightly more over time (p_interaction = 0.021 and 0.033, respectively); however, no association was found after adjustments for confounders and multiple testing (p-adj_interaction = 0.086 and 0.098, respectively). Plasma ficolin-1 and ficolin-3 were lower in SAH patients compared with healthy controls on all days. DCI and functional outcome were not associated with LCP initiator levels in plasma.

Conclusion
Patients with SAH displayed elevated CSF levels of ficolin-1, ficolin-2, ficolin-3, and MBL. Increased CSF levels of ficolin-1 and MBL were associated with a poor functional outcome.

Trial registration
This study was a retrospective analysis of samples, which had been prospectively sampled and stored in a biobank. Registered at clinicaltrials.gov (NCT01791257, February 13, 2013, and NCT02320539, December 19, 2014).
Impact of age on CD4 recovery and viral suppression over time among adults living with HIV who initiated antiretroviral therapy in the African Cohort Study
Authors:   the AFRICOS Study Group, Bahemana Emmanuel , Esber Allahna , Dear Nicole , Ganesan Kavitha , Parikh Ajay , Reed Domonique , Maganga Lucas , Khamadi Samoel , Mizinduko Mucho , Lwilla Anange , Mkondoo Dorothy , Mwaisanga Gwamaka , Somi Nancy , Owouth John , Maswai Jonah , Kiweewa Francis , Iroezindu Michael , Ake Julie A. , Crowell Trevor A. , Valcour Victor G. , Polyak Christina S. 
Published: November 2020

Abstract
Introduction
With increased use of antiretroviral therapy (ART), HIV mortality rates are declining and people living with HIV (PLWH) are surviving longer. We characterized CD4 recovery and viral suppression among adults aged < 50 and ≥ 50 years living with HIV who initiated ART in the African Cohort Study (AFRICOS).

Methods
Beginning in January 2013, PLWH at twelve clinics in Kenya, Uganda, Tanzania and Nigeria underwent medical history review, CD4 and viral load testing as part of the ongoing African Cohort Study (AFRICOS). ART-naïve PLWH who initiated ART within 30 days of enrollment and had at least one year of follow-up were included in these analyses. To compare ART response in participants < 50 years and ≥ 50 years old, changes in CD4 count and viral load suppression after ART initiation were examined at different time points using linear and binomial regression with generalized estimating equations. Variables for time since ART initiation and the interaction between age group and time on ART were included in the model to evaluate longitudinal changes in CD4 recovery and viral suppression by age.

Results
Between January 2013 and September 2019, 2918 PLHV were enrolled in the cohort. Of these, 443 were ART naïve and initiated on ART within 30 days of enrollment, with 90% (n = 399) aged < 50 years old at ART initiation. At ART initiation, participants aged 50 and older had a higher median CD4 count compared to participants younger than 50 years of age although it did not reach statistical significance (306 cells/mm3, IQR:130–547 vs. 277cells/mm3, IQR: 132–437). In adjusted models examining CD4 recovery and viral suppression there were no significant differences by age group over time. By the end of follow-up viral suppression was high among both groups of adults (96% of adults ≥ 50 years old and 92% of adults < 50 years old).

Conclusion
This study found no difference in long-term CD4 recovery or viral suppression by age at ART initiation. We found that particularly among younger adults participants had lower median CD4 counts at ART initiation, suggesting the importance of identifying and putting this population on treatment earlier in the disease course.
Non coding RNAs as the critical factors in chemo resistance of bladder tumor cells
Authors: Zangouei Amir Sadra , Rahimi Hamid Reza , Mojarrad Majid , Moghbeli Meysam 
Published: November 2020

Abstract

Background
Bladder cancer (BCa) is the ninth frequent and 13th leading cause of cancer related deaths in the world which is mainly observed among men. There is a declining mortality rates in developed countries. Although, the majority of BCa patients present Non-Muscle-Invasive Bladder Cancer (NMIBC) tumors, only 30% of patients suffer from muscle invasion and distant metastases. Radical cystoprostatectomy, radiation, and chemotherapy have proven to be efficient in metastatic tumors. However, tumor relapse is observed in a noticeable ratio of patients following the chemotherapeutic treatment. Non-coding RNAs (ncRNAs) are important factors during tumor progression and chemo resistance which can be used as diagnostic and prognostic biomarkers of BCa.

Main body
In present review we summarized all of the lncRNAs and miRNAs associated with chemotherapeutic resistance in bladder tumor cells.

Conclusions
This review paves the way of introducing a prognostic panel of ncRNAs for the BCa patients which can be useful to select a proper drug based on the lncRNA profiles of patients to reduce the cytotoxic effects of chemotherapy in such patients.
Naloxone administration by nonmedical providers- a descriptive study of County sheriff department training
Authors: Janssen Alan , Garove Brittany , LaBond Virginia 
Published: November 2020

Abstract
The study background
In 2015 a county sheriff department in Michigan began a training program for its deputies on administration of naloxone for non-medical providers.

Methods
A descriptive analysis was used to evaluate the effectiveness of the program. Data collected from the Sheriff’s department allowed the study to quantify the incidence of naloxone administration, describe characteristics related to the administration, and report on aggregate outcomes.

Results
Of the reported 184 incidents involving naloxone use the sheriff department had an overall successful administration rate of 94.6% in the cases from 2015 to 2017. It was also noted that the overall number of naloxone administrations showed an upward trend with a greater number of trained deputies.

Conclusion
The outcome of training non-medical first responders in naloxone administration has been shown to be successful with regard to resuscitation of patients with opioid overdose.
Hemostatic effect of tourniquet combined with tranexamic acid in total knee arthroplasty: a network meta-analysis
Authors: Zhang Yimin , Lang Bao , Zhao Guifeng , Wang Fengming 
Published: November 2020

Abstract
Background
There are various techniques to reduce blood loss in total knee arthroplasty (TKA), including the use of a tourniquet and tranexamic acid (TXA). In this study, we studied the combined effect of TXA with a tourniquet on blood loss in the setting of primary TKA.

Methods
Randomized controlled trials (RCTs) of nine treatment methods were included (placebo, intravenous [i.v.] TXA, topical TXA, i.v.-combined topical TXA, oral TXA, placebo + tourniquet, i.v. TXA +tourniquet, topical TXA + tourniquet, and i.v.-combined topical TXA + tourniquet). The patients were divided into eight groups according to the different treatment strategies, with 30 cases per group. The differences in the total blood volume, the number of patients transfused, the hemoglobin before and after the operation, and complications after the operation were compared.

Results
Totally 15 RCTs meeting our inclusion criteria were collected in this study. Compared with the placebo + tourniquet group, the i.v. TXA + tourniquet group displayed lower hemoglobin reduction value, pulmonary embolism (PE) incidence, total blood loss, and blood transfusion risk; the topical TXA + tourniquet group showed reduced PE incidence, total blood loss, and blood transfusion risk, and the i.v.-combined topical TXA and i.v.-combined topical TXA + tourniquet groups showed decreased total blood loss and lower blood transfusion risk. Retrospective clinical study results also demonstrated that the efficacy of i.v.-combined topical TXA was the best.

Conclusions
Our meta-analysis indicates that i.v.-combined topical TXA provides a low total blood loss without increasing the blood transfusion risk in patients undergoing total knee replacement surgery.