bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fiber-Needle Swept-Source Optical Coherence Tomography for the Real-Time Visualization of the Transversus Abdominis Plane Block Procedure in a Swine Model
Authors: Teng Wei-Nung , Kao Meng-Chun , Ting Chien-Kun , Kuo Wen-Chuan 
Published: December 2020

BACKGROUND:
Fascia blocks (eg, the transversus abdominis plane [TAP] block) target the intermuscular fascia layers. Ultrasound techniques have allowed peripheral blocks to be performed with accuracy and safety, however, with limitations. Optical coherence tomography (OCT) is based on low-coherence interferometry. In this study, we examined the ability of OCT to identify the TAP.

METHODS:
A swept-source OCT probe was placed in a 17-gauge needle to obtain imaging. The needle was inserted within 2 different angle ranges (0°–30° and 30°–60°) on a slice of pork belly to assess imaging characteristics. A series of real-time OCT imaging of the muscle, fascia, and interfascial space was obtained. The tissue location of the needle tip was identified using near-infrared (NIR) imaging. In vivo OCT imaging was further done on 3 female 6-month-old native Chinese Landrance Duroc pigs. Real-time images of tissue layers were obtained with needle insertion. Ultrasound imaging of the OCT needle probe was also performed at the same time for needle trajectory guidance. After imaging, the OCT probe was removed, and 5 mL of normal saline was injected via the needle to confirm correct fascia plane identification.

RESULTS:
In and ex vivo studies showed clear visual distinction of muscle, fascia, and interfascial layer with OCT, with limitations. Independent validation of OCT criteria for the muscle/fascia differentiation by 20 OCT readers for the in vivo data demonstrated the sensitivity = 0.91, specificity = 0.90, and accuracy = 0.89. Although the angle of needle entry affected the depth of OCT penetration in the muscle, the attenuation coefficient values of the fascia and muscle tissue were statistically different (P < .001) and with high area under the receiver operating characteristics (ROC) curve (AUC) (AUC = 0.93 in 0°–30° and AUC = 1 in 30°–60°) for fascia identification.

CONCLUSIONS:
This study introduced a novel needle imaging probe method to identify the transversus abdominis fascia plane in real-time. Quantitative calculation of the attenuation coefficients can further aid objective identification by providing direct confirmation of the tip position, increasing the first-pass success rate, and decreasing the need for needle repositioning. Combining OCT and ultrasound may improve the accuracy of anesthetics placement.
A Bayesian Comparison of Frailty Instruments in Noncardiac Surgery: A Cohort Study
Authors: McIsaac Daniel I. , Aucoin Sylvie D. , van Walraven Carl 
Published: December 2020

BACKGROUND:
Frailty—a multidimensional syndrome related to age- and disease-related deficits—is a key risk factor for older surgical patients. However, it is unknown which frailty instrument most accurately predicts postoperative outcomes. Our objectives were to quantify the probability of association and relative predictive performance of 2 frailty instruments (ie, the risk analysis index-administrative [RAI-A] and 5-item modified frailty index [mFI-5]) with postoperative outcomes in National Surgical Quality Improvement Program (NSQIP) data.

METHODS:
Retrospective cohort study using Bayesian analysis of NSQIP hospitals. Adults having inpatient small or large bowel surgery 2010–2015 (derivation cohort) or intermediate to high risk mixed noncardiac surgery in 2016 (validation cohort) had preoperative frailty assigned using 2 unique approaches (RAI-A and mFI-5). Probabilities of association were calculated based on posterior distributions and relative predictive performance using posterior predictive distributions and Bayes factors for 30-day mortality (primary outcome) and serious complications (secondary outcome).

RESULTS:
Of 50,630 participants, 7630 (14.0%) died and 19,545 (38.6%) had a serious complication. Without adjustment, the RAI-A and mFI-5 had >99% probability being associated with mortality with a ≥2.0 odds ratio (ie, large effect size). After adjustment for NSQIP risk calculator variables, only the RAI-A had ≥95% probability of a nonzero association with mortality. Similar results arose when predicting postoperative complications. The RAI-A provided better predictive accuracy for mortality than the mFI-5 (minimum Bayes factor 3.25 × 1014), and only the RAI-A improved predictive accuracy beyond that of the NSQIP risk calculator (minimum Bayes factor = 4.27 × 1013). Results were consistent in leave-one-out cross-validation.

CONCLUSIONS:
Translation of frailty-related findings from research and quality improvement studies to clinical care and surgical planning will be aided by a consistent approach to measuring frailty with a multidimensional instrument like RAI-A, which appears to be superior to the mFI-5 when predicting outcomes for inpatient noncardiac surgery.
Do Elderly Patients With Diastolic Dysfunction Require Higher Doses of Norepinephrine During General Anesthesia for Noncardiac Surgeries? A Prospective Observational Study
Authors: Kahl Ursula , Vens Maren , Pollok Franziska , Menke Maja , Duckstein Christoph , Gruetzmacher Janna , Schirren Leah , Yu Yuanyuan , Fischer Marlene , Zöllner Christian , Goepfert Matthias S. , Roeher Katharina 
Published: December 2020

BACKGROUND:
Diastolic dysfunction is a risk factor for postoperative major cardiovascular events. During anesthesia, patients with diastolic dysfunction might experience impaired hemodynamic function and worsening of diastolic function, which in turn, might be associated with a higher incidence of postoperative complications.
We aimed to investigate whether patients with diastolic dysfunction require higher doses of norepinephrine during general anesthesia. Furthermore, we aimed to examine the association between the grade of diastolic dysfunction and the E/e’ ratio during anesthesia. A high E/e’ ratio corresponds to elevated filling pressures and is an important measure of impaired diastolic function.

METHODS:
We conducted a prospective observational cohort study at a German university hospital from February 2017 to September 2018. Patients aged ≥60 years and undergoing general anesthesia (ie, propofol and sevoflurane) for elective noncardiac surgery were enrolled. Exclusion: mitral valve disease, atrial fibrillation, and implanted mechanical device.
The primary outcome parameter was the administered dose of norepinephrine within 30 minutes after anesthesia induction (μg·kg−1 30 min−1). The secondary outcome parameter was the change of Doppler echocardiographic E/e’ from ECHO1 (baseline) to ECHO2 (anesthesia). Linear models and linear mixed models were used for statistical evaluation.

RESULTS:
A total of 247 patients were enrolled, and 200 patients (75 female) were included in the final analysis. Diastolic dysfunction at baseline was not associated with a higher dose of norepinephrine during anesthesia (P = .6953). The grade of diastolic dysfunction at baseline was associated with a decrease of the E/e’ ratio during anesthesia (P < .001).

CONCLUSIONS:
We did not find evidence for an association between diastolic dysfunction and impaired hemodynamic function, as expressed by high vasopressor support during anesthesia. Additionally, our findings suggest that diastolic function, as expressed by the E/e’ ratio, does not worsen during anesthesia.
Ultrasound in Trauma and Other Acute Conditions in Sports, Part II
Authors: Ray Jeremiah W. , Gende Alecia M. , Hall Mederic M. , Coe Ian , Situ-LaCasse Elaine , Waterbrook Anna 
Published: December 2020

AbstractThe utility of ultrasound in sports medicine is improving the sports medicine physician's ability to rapidly diagnose and treat a multitude of sports related pathologies. In this article, we clearly outline the current status of the evidence in support of using sports ultrasound in the setting of acute ocular injury, evaluation of elevated intracranial pressures, deep venous thrombosis, and soft tissue complaints.
E-Learning amid the COVID-19 Lockdown: Standpoint of Medical and Dental Undergraduates
Authors: Anwar Aiza , Mansoor Hajra , Faisal Danyal , Khan Huma Saeed 
Published: December 2020

Background and Objective: The corona-virus (COVID-19) pandemic has had devastating impacts on not only the health and socio-economic conditions but also on the education sector in various countries. Consequently, the world of education entered a new era of E-learning. This descriptive study, thus, aims to evaluate the standpoint of medical and dental undergraduates regarding E-learning amid the Covid-19 lockdown.
Methods: A descriptive online questionnaire was used to gather responses via Google forms. The questionnaire consisted of questions categorized as technology access, online skills and relationships, students’ views, and student’s perception of possible advantages of E-learning. Two hundred and eighty three medical and dental students of CMH Lahore Medical College participated in the study.
Results: One hundred and seventy nine female and 104 male students responded to the questionnaire. The results of the study showed students encouraging the accommodation of E-learning into current teaching practices. Students agreed online study material not only provides flexibility in the learning process (p=0.003) but also saves time (p = 0.012). Female participants showed a more positive readiness response towards e learning than males (p =0.001). Results also showed students have easier access to online teaching resources. Regarding online lectures, the students believe that online lectures were more organized (p= 0.001) and stimulated student interest (p=0.026). Students believe that frequent participation in the learning process is important for success in online education (p=0.002).
Conclusion: Undergraduate medical and dental students from the said private medical college are well equipped and ready to shift towards online education.
doi: https://doi.org/10.12669/pjms.37.1.3124
How to cite this:Anwar A, Mansoor H, Faisal D, Khan HS. E-Learning amid the COVID-19 Lockdown: Standpoint of Medical and Dental Undergraduates. Pak J Med Sci. 2021;37(1):217-222. doi: https://doi.org/10.12669/pjms.37.1.3124
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Comparison of efficacy of combination therapy of an Intravitreal injection of bevacizumab and photocoagulation versus Pan Retinal Photocoagulation alone in High risk Proliferative Diabetic Retinopathy
Authors: Rajar Rebecca Murtaza , Shaikh Fahad Feroz , Jatoi Shafi Muhammad 
Published: December 2020

Objective: To compare efficacy of intravitreal bevacizumab augmented with Panretinal photocoagulation versus Panretinal photocoagulation alone in high risk proliferative diabetic retinopathy.
Methods: This is Randomized clinical control trial study conducted at ISRA University Hospital, Hyderabad from July 2018 to December 2018. A total of 76 eyes were randomized into two groups, 38 eyes undergone PRP plus intravitreal bevacizumab, while 38 eyes had PRP alone. Status of neovessels was assessed before and after treatment with the help of fundus fluorescein angiography. Neovessels at disc (NVD’s) and neovessels elsewhere (NVE’s) were assessed with the disc surface diameter.
Results: Seventy-six eyes were enrolled in this randomized clinical trial into two groups consecutively, that all completed the six months follow-up. In the PRP group mean BCVA (logMAR) worsened significantly from mean 0.30±0.07 to mean 0.40±0.04 at a 30th day and mean 0.40±0.04 at day 90. While BCVA become improved from 0.30±0.05 to 0.1±0.03 at week four and 0.1±0.02 at week 12 in PRP-Plus group. There was significant change in regression of NVES in PRP only group at week 4 is 2.25±0.75 (p=0.00004) and at 12 weeks 2.00±0.50 (p=0.00002), while in PRP + intravitreal bevacizumab group at 4th week was 1±0.5 (p =0.0001) and at 12th week was 0.75±0.25 (p=0.0001).
Conclusion: Intravitreal Bevacizumab augmented with PRP is more effective in early regression of neovessels in high risk PDR patients.
doi: https://doi.org/10.12669/pjms.37.1.3141
How to cite this:Rebecca, Shaikh FF, Jatoi SM. Comparison of efficacy of combination therapy of an Intravitreal injection of bevacizumab and photocoagulation versus Pan Retinal Photocoagulation alone in High risk Proliferative Diabetic Retinopathy. Pak J Med Sci. 2021;37(1):157-161. doi: https://doi.org/10.12669/pjms.37.1.3141
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Clinical characteristics and predictors of the duration of hospital stay in COVID-19 patients in Jordan
Authors: Alqassieh Rami S. , Bsisu Isam K. , Al-Sabbagh Mohammed Qussay , El-Hammuri Naser M. , Yousef Moh’d A. , El Jarbeh Mohammad A. , Sharqawi Ahmed A. , Smadi Heba Z. , Abu-Halaweh Sami A. , Abufaraj Mohammad M. 
Published: December 2020

Background: On March 11th, 2020, the World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) as a global pandemic. Healthcare systems in low- and middle-income countries may face serious limitations during a pandemic, for which understanding the predictors of prolonged hospital stay are crucial in decreasing the mortality rate. The aim of this study was to investigate the predictors of increased length of hospitalization among COVID-19 patients. Methods: In this prospective study, we investigated the effect of presenting symptoms and laboratory investigations on the duration of hospitalization of 131 COVID-19 patients at a tertiary hospital in Jordan from March 17th to April 9th, 2020. Results: Patients median age was 24 years [interquartile range (IQR): 8-39], of which 67 (51.15%) were males and 64 (48.85%) were females. Smokers had shorter in-hospital stay (OR: -3.52; 95% CI: -6.73 to -0.32; P=0.03). Taste loss (OR: 5.1; 95% CI: 1.95 to 8.25; P<0.01) and chills or rigors (OR: 4.08; 95% CI: 0.73 to 7.43; P=0.02) were the symptoms significantly associated with increased in-hospital stay, while those who had malaise (OR: -4.98; 95% CI: -8.42 to -1.59; P<0.01) and high white blood cell (WBC) count (OR: -0.74; 95% CI: -1.31 to -0.17; P=0.01) had faster recovery. Conclusions: Our study found that the most common presenting symptoms of COVID-19 are cough, malaise, and headache. Smoking, presenting with malaise or elevated WBCs were associated with shorter hospital stay, while loss of taste and chills or rigors at presentation were associated with a longer in-hospital stay.
Mapping virtual platforms to estimate the population size of men who have sex with men (MSM) who use internet to find sexual partners: implications to enhance HIV prevention among MSM in Kenya
Authors: Emmanuel Faran , Kioko Japheth , Musyoki Helgar , Kaosa Shem , Ongaro Martin Kyana , Kuria Samuel , Olango Kennedy , Musimbi Janet , Walimbwa Jeffrey , Blanchard James , Isac Shajy , Bhattacharjee Parinita 
Published: December 2020

Introduction: Men who have sex with men (MSM) in Kenya face a disproportionate HIV disease burden. Over the last few years, the use of virtual platforms and internet sites to seek male sexual partners has increased manyfold in Kenya. New approaches are required to map, estimate and profile MSM who operate through virtual platforms to design interventions for them. Methods: This study was conducted in three counties in Kenya: Kiambu, Kisumu and Mombasa with MSM who use virtual platforms such as geosocial networking (GSN) and social networking applications to find and connect with male sex partners. The platforms were profiled through a multi-stage approach and the number of MSM associated with these platforms were estimated. In the final stage, 435 respondents randomly selected from the virtual platforms were interviewed in a secure location after informed consent. Data analysis focused on calculating an estimate of MSM for each virtual platform in each site, adjusting for duplicate profiles and multiple registrations. Results: We identified 24 GSN apps, 18 Facebook accounts/pages and 18 WhatsApp groups across the three counties, with Facebook being the preferred platform. Kiambu had the highest number of estimated MSM at 3,635 (95%CI = 3,335 to 3,990) followed by Kisumu at 1,567 (95%CI = 1,480 to 1,665) and Mombasa at 1,469 (95%CI = 1,335 to 1,604) who used virtual platforms to find other male sexual partners. On average, each MSM had 3.7 profiles on multiple platforms, with an average of 2.1 profiles used in the past month. Conclusions: The use of conventional population size estimation approaches that focus on physical sites alone may underestimate the total number of MSM in a geography. Virtual mapping should be used in conjunction with conventional hot spot based size estimation methodologies to estimate numbers of MSM to set programmatic targets.
Seasonality and immunity to laboratory-confirmed seasonal coronaviruses (HCoV-NL63, HCoV-OC43, and HCoV-229E): results from the Flu Watch cohort study
Authors: Aldridge Robert W. , Lewer Dan , Beale Sarah , Johnson Anne M. , Zambon Maria , Hayward Andrew C. , Fragaszy Ellen B. ,   Flu Watch Group
Published: December 2020

Background: There is currently a pandemic caused by the novel coronavirus SARS-CoV-2. The intensity and duration of this first and second waves in the UK may be dependent on whether SARS-CoV-2 transmits more effectively in the winter than the summer and the UK Government response is partially built upon the assumption that those infected will develop immunity to reinfection in the short term. In this paper we examine evidence for seasonality and immunity to laboratory-confirmed seasonal coronavirus (HCoV) from a prospective cohort study in England. Methods: In this analysis of the Flu Watch cohort, we examine seasonal trends for PCR-confirmed coronavirus infections (HCoV-NL63, HCoV-OC43, and HCoV-229E) in all participants during winter seasons (2006-2007, 2007-2008, 2008-2009) and during the first wave of the 2009 H1N1 influenza pandemic (May-Sep 2009). We also included data from the pandemic and ‘post-pandemic’ winter seasons (2009-2010 and 2010-2011) to identify individuals with two confirmed HCoV infections and examine evidence for immunity against homologous reinfection. Results: We tested 1,104 swabs taken during respiratory illness and detected HCoV in 199 during the first four seasons. The rate of confirmed HCoV infection across all seasons was 390 (95% CI 338-448) per 100,000 person-weeks; highest in the Nov-Mar 2008/9 season at 674 (95%CI 537-835) per 100,000 person-weeks. The highest rate was in February at 759 (95% CI 580-975) per 100,000 person-weeks. Data collected during May-Sep 2009 showed there was small amounts of ongoing transmission, with four cases detected during this period. Eight participants had two confirmed infections, of which none had the same strain twice. Conclusion: Our results provide evidence that HCoV infection in England is most intense in winter, but that there is a small amount of ongoing transmission during summer periods. We found some evidence of immunity against homologous reinfection.
Enseñanza y filosofía. Una mirada desde la perspectiva del aprender
Authors: Espinel Oscar 
Published: December 2020

the inquiry into teaching in philosophy entails two different questions, namely: What does it mean to teach? And, what is understood by “philosophy”? The first of these questions constitutes the starting point of this article – product of the research project Balance of the Ways of Teaching Philosophy in Colombia –, specifically regarding the topics of teaching as an area, and the task of teaching. However, the methodological potential of studying the task of teaching from the perspective of learning arose while enquiring into the notions of translation, “plagiarism”, repetition, and creation. What kind of relation brings together teaching with learning and learning with teaching? In other words: How much does learning require from teaching? How much learning can we find in teaching? Can teaching and learning be thought of independently from one another? What happens in a philosophy classroom? In short, what does it mean to think about the relation between philosophy and teaching from the perspective of learning? In this way, as can be observed, positing the question of teaching on the axis of learning situates the discussion within the sphere of experience, and of the exercise and practices of the self. This is a different dimension of teaching from that determined by emulation, explanation, and monologue.
A atuação dos movimentos de doulas em Florianópolis (SC): conflitos pelo protagonismo feminino no parto
Authors: Espíndola Carla Klitzke , Zucco Luciana Patrícia 
Published: December 2020

Este artigo tem o objetivo de analisar a dinâmica interna do movimento de doulas em Florianópolis (SC), a partir de suas pautas políticas de promoção ao parto respeitoso e ao protagonismo feminino. A pesquisa é empírica, qualitativa e orientada pelas lentes da epistemologia feminista. Os resultados apontaram conflitos entre as doulas entrevistadas, explicitando disputas de projetos, posições políticas, compreensões sobre a doulagem e diferentes formas de ver e atender mulheres. Há doulas que defendem a doulagem como profissão, um nicho de mercado; outras, como ação transitória na política de saúde pública. Por fim, aquelas que problematizam o acesso à doulagem e a branquitude de quem atende e é atendida. A “gourmetização” do parto humanizado foi transversal às narrativas. Ademais, a pluralidade das narrativas nos levou a pensar em “movimentos de doulas”, devido às pautas identificadas. Apesar dos conflitos, elas convergem na compreensão da centralidade e respeito à mulher no parto. Palavras-Chave: movimentos de doulas; parto; saúde da mulher; feminismos; direitos reprodutivos.