bluuebunny/crossref_metadata_2025_split huggingface dataset:
Severe Perineal Trauma in a Brazilian Southeastern Tertiary Hospital: A Retrospective Cohort Study
Authors: Nóbrega Marina Augusto , Pereira Gláucia Miranda Varella , Brito Luiz Gustavo Oliveira , Luz Adriana Gomes , Lajos Giuliane Jesus 
Published: June 2020

Objective
This study aimed to investigate the prevalence of severe perineal trauma (obstetric and anal sphincter injury [OASIS]) in a tertiary high-risk pregnancy facility and the associated factors.

Methods
A retrospective electronic chart review on perineal lacerations was performed from the period of April 2017 to February 2019. Obstetric and anal sphincter injury was diagnosed by a rectal examination. Primary outcome was the prevalence of OASIS (third- and fourth-degree perineal tear). Independent variables were maternal, intrapartum, and neonatal characteristics. Univariate and multivariate analyses with logistic regression models were performed. A P value lower than 0.05 was considered significant.

Results
The prevalence of OASIS (third/fourth-degree laceration) was 1.51% (43/2846) in our population. Our population was mostly white (66.3%) and mostly primiparous (52.1%). By comparison, the prevalence of first/second-degree laceration was 43% (1223/2846). Selective episiotomy occurred in 18.73% (517/2761) of patients, and it was not associated with OASIS (P = 0.211). Advanced maternal age (P = 0.196), higher number of vaginal examinations (P = 0.169), fetal presentation (P = 0.533), and duration of second stage (P = 0.757) were not associated with OASIS. Univariate analysis has found that forceps delivery (odds ratio [OR], 3.68 [1.74–7.79]; P = 0.001), neonatal macrossomy (OR, 3.42 [1.02–11.43]; P = 0.045), and larger head circumference (OR, 1.15 [1.02–1.32]; P = 0.026) were risk factors for OASIS, whereas higher gravidity reduced the risk (OR, 0.61 [0.42–0.91] for OASIS. However, after multivariate analysis, only head circumference (OR, 1.86 [1.10–3.14]; P = 0.020) remained as a risk factor.

Conclusions
Larger neonatal head circumference increased in 86% the risk for severe perineal trauma in this cohort of women.
Role of Whole Body CT (WBCT) in Trauma Patients “Life Saver or Needless Radiation Exposure?”
Authors: Alkandari Latifa , Abass Mahdy A , Masoomi Michael , Kannan Shreeram , Ashebu Samuel D , Abdulla Hagrassy 
Published: June 2020

ABSTRACTBackgroundWhole-body computed tomography (WBCT) is used indiscriminately in trauma cases, just on the suspicion of them being polytrauma cases. A good clinical examination done pre-emptively could prevent the need for this investigation and its undesired radiation effects. The use of WBCT was assessed in our busy hospital to determine whether there has been an overuse of the WBCT and also to estimate the true incident of clinical injuries.MethodsRetrospective database analysis of 546 WBCT polytrauma cases for the period of April to October 2018 was performed. All the trauma patients were initially managed and proceed for WBCT according to the American College of Radiology (Major Trauma). We recorded age, gender, mechanism of injury, clinical requests, WBCT findings in regions of the cervical spine, thoracolumbar spine, chest, abdomen and pelvis skeleton injuries (as per our institutional reporting protocol), as well as DLP for each patient scanned. We compared pre-test clinical requests stating the mechanism of injury and clinical query with WBCT findings and categorized the radiological findings, initially into negative and positive findings. The positive findings were further classified into the major and minor injuries. The total numbers in each radiological finding were calculated and inferences discussed.ResultsOn analysis of data, we found that 462 patients had been referred due to RTA (84.6%), 47 patients due to FFH (8.6%), ten patients due to blunt trauma (1.8%), 8 patient due to assault (1.5%), while the 5 patients had stable wound (0.09%), five patients had injury due to the fall of a heavy object (0.09%), 3 patients had a buggy injury (0.05%), 3 patients had injury due to fallen on the back (0.05%) and 3 more patients had injury due to other traumas including blast injury, suicide and other injury. We noticed RTA with an 84.7 % score was the most common indication for WBCT referral. Out of 546 cases, 414 patients (75.8 %) were normal (negative finding), where 132 patients (24.2 %) had positive trauma related radiological finding of which 54 patients were found to have a major injury (9.9%). Fractures were scored the highest, 75.6% of all positive finding traumas.ConclusionsThis study re-emphasizes the significance of exercising a good clinical examination in the era of evidence based medicine, which would reduce the high number of unnecessary high dose WBCT, as 462 scans with no positive findings on radiological examinations were nearly normal and only 54 cases (9.9%) had major injuries.
KNOWLEDGE ABOUT SEXUALLY TRANSMITTED DISEASES AMONG THE STUDENTS OF SELECTED MADRASHAS OF DHAKA CITY
Authors: Mahmud Tareq 
Published: June 2020

AbstractBackgroundSexually transmitted diseases have become a silent epidemic that devastates the life of both men and women. In Bangladesh, there has been no national prevalence data on Sexually transmitted diseases.Aims & objectivesThe objectives of the study were to find out the level of knowledge about sexually transmitted diseases among madrasha students.MethodsA cross-sectional study was conducted in four purposively selected madrashas in Dhaka city. A total randomly selected 390 students of class 9 and 10 were included in this study. A semi structured questionnaire was used to collect data and the responses of students were recorded after obtaining verbal consent.ResultsMean age of the respondents was 17 and 33.1% of them were from Science group. 54% respondents had average knowledge, 29.5% had good knowledge. Television/radio was the main source of information for majority (68.6%) of the students and around 40% was informed about STDs from their academic study. About 75% of the respondents mentioned that there was microorganism for all STDs as causative agents. More than 70% respondents mentioned that unprotected sexual intercourse and using same syringes with different persons were the mood of transmission of STDs. Condom as the main protector of STDs was seemed by the most. Type of madrasha and academic group were significantly related (P<0.00) with level of knowledge on STDs.ConclusionScience group respondents had more academic knowledge than the arts group respondents and respondents who belonged to late adolescent group had more knowledge than early adolescent group.
Development and Validation of Postoperative Venous Thromboembolism risk prediction model
Authors: Woo Sang H. , Rhoades Ruben , Ackermann Lily , Cowan Scott W. , Zavodnick Jillian , Marhefka Gregary D. 
Published: June 2020

AbstractBackgroundVTE is a serious postoperative complication after surgery with resultant higher morbidity and mortality. Despite years of experience with current risk models, rates continue to be high and more information is needed on individual patient risk in the prophylaxis era.Research QuestionsCan we assess the individualized risk of postoperative venous thromboembolism (VTE) for broad categories of surgery?MethodsThis study was performed using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Database. Patient data (n=2,875,190) from 2015-2017 were used for study analysis. Eight predictors were selected for the model: age, preoperative platelet count≥450 (×109/L), disseminated cancer, corticosteroid use, serum albumin ≤2.5 g/dL, preoperative sepsis, hospital length of stay and surgery type. The second model included 7 predictors without hospital length of stay. A predictive model was trained using ACS-NSQIP data from 2015-2016 (n=1,859,227) and tested using data from 2017 (n= 1,015,963). Primary outcomes are postoperative 30-day VTE, including deep vein thrombosis (DVT) and/or pulmonary embolism (PE).ResultsVTE occurred in 23,249 patients (0.81%) and 49.9% of VTE occurred after discharge from index hospitalization. The risk prediction model had high AUC (area under the receiver operating characteristic curve) for postoperative VTE of 0.78 (training cohort) and 0.78 (test cohort).InterpretationThis clinical prediction model is a validated, practical and easy-to-use tool to identify surgical patients at the highest risk of postoperative VTE and provide an individualized assessment of risk based on clinical factors and type of surgery. This prediction model may be used as a tool to assess individualized risk of postoperative VTE and promote broader discussion and awareness of the VTE risk during the perioperative period.
Estimation of Undetected Symptomatic and Asymptomatic cases of COVID-19 Infection and prediction of its spread in USA
Authors: Mahajan Ashutosh , Solanki Ravi , Sivadas Namitha 
Published: June 2020

AbstractThe reported COVID-19 cases in the USA have crossed over 2 million, and a large number of infected cases are undetected whose estimation can be done if country-wide antibody testing is performed. In this work, we estimate this undetected fraction of the population by modeling and simulation approach. We propose a new epidemic model SIPHERD in which three categories of infection carriers Symptomatic, Purely Asymptomatic, and Exposed are considered with different transmission rates that are taken dependent on the lockdown conditions, and the detection rate of the infected carriers is taken dependent on the tests done per day. The model is first validated for Germany and South Korea and then applied for prediction of total number of confirmed, active and death, and daily new positive cases in the United States. Our study also demonstrates the possibility of a second wave of the infection if social distancing regulations are relaxed to a large extent. We estimate that around 12.7 million people are already infected, and in the absence of any vaccine, 17.7 million (range: 16.3-19.2) people, or 5.3% (range: 4.9–5.8) of the population will be infected by when the disease spread ends in the USA. We find the Infection to Fatality Ratio to be 0.93% (range: 0.85-1.01).
Extension and implementation of a system modelling the COVID-19 pandemic in Chile
Authors: Vergara-Hermosilla Gastón , Navas Andrés 
Published: June 2020

AbstractWe modelling the dynamics of the COVID-19 epidemic taking into account the role of the unreported cases. In a first section we extend the model recently introduced/ implemented by Liu, Magal, Seydi and Webb, by considering different transmission rates for the infectious and unreported states, and we couple three new states related to hospitalized and fatalities. In addition, we introduce an operator that incorporates the effects of mitigation measures at the different rates considered in the system. Finally, we implemented the extended model in the Chilean context by considering variable the transmission rates and the fraction of unreported cases, the latter through an argument that uses mortality rates. We conclude with several conclusions and lines of future research.
Safety and efficacy of the portable steam sauna bath for fluid removal in maintenance haemodialysis patients: A pilot phase II clinical trial
Authors: Chandrashekaran Niranjini , Valson Anna T. , Priya Ankita , Subramani Sathya 
Published: June 2020

AbstractBackgroundDry heat, immersive, and Hammam sauna baths have been shown to aid fluid removal in haemodialysis patients but require high ambient temperatures, large volumes of water and sufficient space, all of which limit their widespread use in India. We aimed to study the safety and efficacy of a commercially available, inexpensive, portable steam sauna bath for this purpose.MethodsIn this pilot phase II clinical trial, six adult prevalent haemodialysis patients each underwent 6 sauna sessions lasting 30-60 minutes, on all non-dialysis days, for 2 weeks. Weight, blood pressure, serum urea, creatinine, electrolytes, haematocrit, core body temperature, thermal comfort, and thirst visual analogue scale were measured before and after each session. Karnofsky performance status (KPS) and Dialysis Symptoms Index (DSI) were measured at the beginning and end of the intervention period. The primary end points were per session weight loss and interdialytic weight gain (IDWG).ResultsPatients experienced a median weight loss of 0.35 kg, median fall in systolic and diastolic BP of 10 mm Hg and 2 mm Hg respectively (p < 0.001 for all) without significant change in IDWG (p = 0.46). Mean thermal comfort was 5.41 ± 0.56 out of 8, there was no significant increase in thirst (p = 0.06) and no significant change in KPS and DSI scores (p = 1.00 and 0.32 respectively). No adverse events were noted.ConclusionsThe portable steam sauna is safe, but modestly effective for fluid removal in haemodialysis patients, and may not influence IDWG.Details of each author’s contributions
Healthcare workers’ experiences of working on the frontline and views about support during COVID-19 and comparable pandemics: A rapid review and meta-synthesis
Authors: Billings Jo , Ching Brian Chi Fung , Gkofa Vasiliki , Greene Talya , Bloomfield Michael 
Published: June 2020

AbstractHealthcare workers across the world have risen to the demands of treating COVID-19 patients, potentially at significant cost to their own health and wellbeing. There has been increasing recognition of the potential mental health impact of COVID-19 on frontline healthcare workers and growing calls to provide psychosocial support for them. However, little attention has so far been paid to understanding the impact of working on a pandemic from healthcare workers’ own perspectives or what their views are about support. This rapid review identified 40 qualitative studies which have explored healthcare workers’ experiences and views from previous pandemics, including and comparable to COVID-19. Meta-synthesis of this qualitative data using thematic analysis derived eight key themes which transcended pandemics, time, and geographical boundaries. This pandemic is not unprecedented; the themes that arose from previous pandemics were remarkably resonant with what we are hearing about the impact of COVID-19 globally today. We have an opportunity to learn from the lessons of these previous pandemics, mitigate the negative mental health impact of COVID-19 and support the longer-term wellbeing of the healthcare workforce worldwide.
Clinical Presentation, Renal Histopathological Findings and Outcome in Patients with Monoclonal Gammopathy and Kidney Disease
Authors: Alfano Gaetano , Delrio Alice , Fontana Francesco , Mori Giacomo , Ferrari Annachiara , Perrone Rossella , Giovanella Silvia , Ligabue Giulia , Magistroni Riccardo , Cappelli Gianni 
Published: June 2020

AbstractMonoclonal gammopathies have been associated with kidney injury. Nephrotoxicity of the secreted monoclonal (M)-protein relies on a complex interplay between biological characteristics and serum concentration. Little is known about the epidemiology and clinical manifestations of the different types of monoclonal gammopathies in patients with kidney disease.We enrolled all patients with monoclonal gammopathy who underwent kidney biopsy between January 2000 and March 2017. Data about demographics, clinical manifestations and histological lesions were collected retrospectively.Monoclonal gammopathy was detected in 174 (13%) patients with a mean age of 66.4±13.1 years. M-protein was secreted by monoclonal gammopathy of undetermined significate (MGUS) (52,8%), myeloma multiple (MM) (25.2%), primary amyloidosis (AL) (9,1%), smoldering MM (7 %), non-Hodgkin lymphoma (NHL) (6.8%) and HL (1.7%). Monoclonal gammopathy of renal significance (MGRS) accounted for 6.5% in patients with MGUS and 14.2% in patients with smoldering MM. Evaluation of kidney biopsy revealed that M-protein was directed involved in causing kidney injury in MM (93.1%) and NHL (8,3%). MM was the only gammopathy significantly associated with an increased risk of kidney injury (odds ratio [OR]=47.5, CI95%, 13.7-164.9; P=<0.001). While there were no significant differences in the progression toward end-stage renal disease or dialysis (P=0.776), these disorders were associated with a different risk of death (P=0.047) at the end of the follow-up.Monoclonal gammopathy was a frequent finding in patients with kidney disease. Kidney biopsy had a key role in identifying the underlying monoclonal gammopathy and recognizing the causal relationship between M-protein and kidney injury.
Mental health and health behaviours before and during the initial phase of the COVID-19 lockdown: Longitudinal analyses of the UK Household Longitudinal Study
Authors: Niedzwiedz Claire L , Green Michael J , Benzeval Michaela , Campbell Desmond D , Craig Peter , Demou Evangelia , Leyland Alastair H , Pearce Anna , Thomson Rachel M , Whitley Elise , Katikireddi S Vittal 
Published: June 2020

AbstractBackgroundThere are concerns that COVID-19 mitigation measures, including the “lockdown”, may have unintended health consequences. We examined trends in mental health and health behaviours in the UK before and during the initial phase of the COVID-19 lockdown and differences across population subgroups.MethodsRepeated cross-sectional and longitudinal analysis of the UK Household Longitudinal Study, including representative samples of adults (aged 18+) interviewed in four survey waves between 2015 and 2020 (n=48,426). 9,748 adults had complete data for longitudinal analyses. Outcomes included psychological distress (General Health Questionnaire-12 (GHQ)), loneliness, current cigarette smoking, use of e-cigarettes and alcohol consumption. Cross-sectional prevalence estimates were calculated and multilevel Poisson regression assessed associations between time period and the outcomes of interest, as well as differential associations by age, gender, education level and ethnicity.ResultsPsychological distress increased one month into lockdown with the prevalence rising from 19.4% (95% CI 18.7%-20.0%) in 2017-19 to 30.3% (95% CI 29.1%-31.6%) in April 2020 (RR=1.3, 95% CI: 1.1,1.4). Groups most adversely affected included women, young adults, people from an Asian background and those who were degree educated. Loneliness remained stable overall (RR=0.9, 95% CI: 0.6,1.5). Smoking declined (RR=0.9, 95% CI=0.8,1.0) and the proportion of people drinking four or more times per week increased (RR=1.4, 95% CI: 1.3,1.5), as did binge drinking (RR=1.5, 95% CI: 1.3,1.7).ConclusionsPsychological distress increased one month into lockdown, particularly among women and young adults. Smoking declined, but adverse alcohol use generally increased. Effective measures are required to mitigate adverse impacts on health.What is already known on this topicCountries around the world have implemented radical COVID-19 lockdown measures, with concerns that these may have unintended consequences for a broad range of health outcomes.Evidence on the impact of lockdown measures on mental health and health-related behaviours remains limited.What this study addsIn the UK, psychological distress markedly increased during lockdown, with women particularly adversely affected.Cigarette smoking fell, but adverse drinking behaviour generally increased.
Design of a Companion Bioinformatic Tool to detect the emergence and geographical distribution of SARS-CoV-2 Spike protein genetic variants
Authors: Massacci Alice , Sperandio Eleonora , D’Ambrosio Lorenzo , Maffei Mariano , Palombo Fabio , Aurisicchio Luigi , Ciliberto Gennaro , Pallocca Matteo 
Published: June 2020

AbstractBackgroundTracking the genetic variability of Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) is a crucial challenge. Mainly to identify target sequences in order to generate robust vaccines and neutralizing monoclonal antibodies, but also to track viral genetic temporal and geographic evolution and to mine for variants associated with reduced or increased disease severity. Several online tools and bioinformatic phylogenetic analyses have been released, but the main interest lies in the Spike protein, which is the pivotal element of current vaccine design, and in the Receptor Binding Domain, that accounts for most of the neutralizing the antibody activity.MethodsHere, we present an open-source bioinformatic protocol, and a web portal focused on SARS-CoV-2 single mutations and minimal consensus sequence building as a companion vaccine design tool. Furthermore, we provide immunogenomic analyses to understand the impact of the most frequent RBD variations.ResultsResults on the whole GISAID sequence dataset at the time of the writing (October 2020) reveals an emerging mutation, S477N, located on the central part of the Spike protein Receptor Binding Domain, the Receptor Binding Motif. Immunogenomic analyses revealed some variation in mutated epitope MHC compatibility, T-cell recognition, and B-cell epitope probability for most frequent human HLAs.ConclusionsThis work provides a framework able to track down SARS-CoV-2 genomic variability.
Individual Differences in the Connectivity of Left and Right Anterior Temporal Lobes Relate to Modality and Category Effects in Semantic Categorisation
Authors: Alam Tirso RJ Gonzalez , Krieger-Redwood Katya , Evans Megan , Rice Grace E , Smallwood Jonathan , Jefferies Elizabeth 
Published: June 2020

AbstractContemporary neuroscientific accounts suggest that ventral anterior temporal lobe (ATL) regions act as a bilateral heteromodal semantic hub. However, research also shows graded functional differences between the hemispheres relating to linguistic versus non-linguistic semantic tasks and to knowledge of objects versus people. Individual differences in connectivity from bilateral ATL and between left and right ATL might therefore give rise to differences in function within this system. We investigated whether the relative strength of intrinsic connectivity from left and right ATL would relate to differences in performance on semantic tasks. We examined resting-state fMRI in 74 individuals and, in a separate session, examined semantic categorisation, manipulating stimulus type (famous faces versus landmarks) and modality of presentation (visual versus verbal). We found that people with greater connectivity between left and right ATL were more efficient at categorising landmarks, especially when these were presented visually. In addition, participants who showed stronger connectivity from right than left ATL to medial occipital cortex showed more efficient semantic categorisation of landmarks regardless of modality of presentation. These findings show that individual differences in the intrinsic connectivity of left and right ATL are associated with effects of category and modality in semantic categorisation. The results can be interpreted in terms of graded differences in the strengths of inputs from ‘spoke’ regions, such as regions of visual cortex, to a bilateral yet partially segregated semantic ‘hub’, encompassing left and right ATL.
Dot1L interacts with Zc3h10 to activate UCP1 and other thermogenic genes
Authors: Yi Danielle , Nguyen Hai P. , Dinh Jennie , Viscarra Jose A. , Xie Ying , Dempersmier Jon M. , Wang Yuhui , Sul Hei Sook 
Published: June 2020

ABSTRACTBrown adipose tissue is a metabolically beneficial organ capable of dissipating chemical energy into heat, thereby increasing energy expenditure. Here, we identify Dot1L, the only known H3K79 methyltransferase, as an interacting partner of Zc3h10 that transcriptionally activates the UCP1 promoter and other BAT genes. Through a direct interaction, Dot1L is recruited by Zc3h10 to the promoter regions of thermogenic genes to function as a coactivator by methylating H3K79. We also show that Dot1L is induced during brown fat cell differentiation and by cold exposure and that Dot1L and its H3K79 methyltransferase activity is required for thermogenic gene program. Furthermore, we demonstrate that Dot1L ablation in mice using UCP1-Cre prevents activation of UCP1 and other target genes to reduce thermogenic capacity and energy expenditure, promoting adiposity. Hence, Dot1L plays a critical role in the thermogenic program and may present as a future target for obesity therapeutics.