bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Aggressive Diuresis in Acute Heart Failure with Reduced and Preserved Ejection Fraction
Authors: Liu Chen , He Xin , Dong Bin , Xue Ruicong , Zhao Jingjing , Wu Zexuan , Wu Yuzhong , Zhou Yuanyuan , Wu Dexi , Dong Yugang , He Jiangui 
Published: December 2020

Abstract
Background: HFrEF and HFpEF had distinct hemodynamic characteristics in the setting of acute heart failure (AHF). The objective of our study is to evaluate the differential response to aggressive diuresis in Heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Methods: Patients in DOSE trial with left ventricular ejection fraction (LVEF) measurement were included (n=300), and classified into HFrEF (n=193) and HFpEF (n=107). Effect of high-dose versus low-dose furosemide strategy was compared separately in HFrEF and HFpEF. Results: High-dose strategy significantly increased change in creatinine and cystatin C at 72 hours in HFpEF (treatment difference: 0.16; 95% confidence interval [CI]: 0.02-0.30 mg/dl; P=0.03 for creatinine, and treatment difference: 0.26; 95% CI: 0.09-0.43 mg/dl; P=0.003 for cystatin C) but not in HFrEF (treatment difference: -0.05, 95% CI: -0.14-0.03 mg/dl; P=0.24 for creatinine, and treatment difference: -0.06, 95% CI: -0.15-0.02 mg/dl; P=0.15 for cystatin C) (P for interaction<0.01 for both). There were significantly more net fluid loss, weight loss, and congestion-free patients at 72 hours in high-dose group in HFrEF, but not in HFpEF. Compared with low-dose group, high-dose group had a significantly lower risk of composite clinical outcome of death, total hospitalizations and unscheduled visits due to heart failure (hazard ratio [HR]: 0.50, 95% CI: 0.27-0.93; P=0.03) in HFrEF, but a comparable risk (HR: 0.99, 95% CI: 0.48-0.23; P=0.98) in HFpEF.Conclusions: AHF on the basis of HFrEF and HFpEF responded differently to aggressive diuresis. Future trials should be designed separately for HFrEF and HFpEF.
Listening to Pedestrian; What are the Influential Factors on Bridge use?
Authors: Saadati Mohammad , Dorosti Abbasali , Dahim Mahin , Hemmati Elnaz , Edalatzadeh Monireheh , Hosseinpor Tina , Naglisar Tahereh , Moradi Hassan , Biparva Akbar Javan 
Published: December 2020

Abstract
The authors have requested that this preprint be removed from Research Square.
Determinants of Women’s Empowerment in Pakistan: Evidence from Demographic and Health Surveys, 2012–13 and 2017–18
Authors: Abbas Safdar , Isaac Noman , Zia Munir , Zakar Rubeena , Fischer Florian 
Published: December 2020

Abstract
Background: Women’s empowerment has always remained a contested issue in the complex socio-demographic and cultural milieu of Pakistani society. Women are ranked lower than men on all vital human development indicators. Therefore, studying various determinants of women’s empowerment is urgently needed in the Pakistani context.Methods: The present study empirically operationalized the concept of women’s empowerment and investigated its determinants through representative secondary data taken from the Pakistan Demographic and Health Surveys, 2012–13 and 2017–18. The study used simple binary logistic and multivariable regression analysis. Results: The results of the binary logistic regression highlighted that almost all of the selected demographic, economic, social, and access to information variables were significantly associated with women’s empowerment (p<0.05) in both PDHS datasets. In the multivariable regression analysis, the adjusted odds ratios highlighted that reproductive-age women in higher age groups, having children, with a higher level of education and wealth index, involved in skilled work, who were the head of household, and had access to information were reported to be more empowered. Conclusions: Women’s empowerment is determined by a number of social, economic, demographic, and other factors. The study proposes some evidence-based policy options to improve the status of women in Pakistan.
Two giant connected retroperitoneal schwannomas: A rare case report
Authors: Yang Tao , Cao Lanqing , Li Wei , Zhang Kai , Zhu Yuecheng , Liu Tongjun , Li Jiannan 
Published: December 2020

Abstract
Background：There are few reports of large retroperitoneal schwannomas and few guidelines for the diagnosis and surgical treatment.Case presentation：A 40-year-old female came to our department due to abdominal pain for 1 day and there are no other specific symptoms. There were no abnormalities in the patient's tumor markers. Plain computer tomography (CT) scan of the whole abdomen revealed two mass soft tissue density shadows behind the peritoneum, with uneven internal density, cystic low-density shadows and patchy calcification shadows. The larger mass was about 12.0 cm × 12.3 cm in size. Then tumors were completely excised by a reasonable surgical approach while the surrounding organs closely related to the tumor were preserved. Postoperative pathology confirmed that the tumor was benign schwannoma. In the 18-month follow-up, the patient had no recurrences and was asymptomatic.Conclusion：We summarize the diagnosis and treatment of a rare giant retroperitoneal schwannoma. Laparotomy for the management of retroperitoneal giant schwannomas may be a safe and effective method.
Effectiveness and Safety of Non-Vitamin K Antagonist Oral Anticoagulants Compared to Vitamin K Antagonists for the Treatment of Ventricular Thrombus: A Systematic Review and Meta-analysis of Observational Studies
Authors: Yang Qing , He Liyun , Liang Yan 
Published: December 2020

Abstract
Background To compare the effectiveness and safety of non-vitamin K antagonist oral anticoagulants (NOACs) and vitamin K antagonists (VKAs) on the rate of thrombus resolution and clinical outcomes.Method MEDLINE, PUBMED, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure Database and Wanfang Database, were searched up to August 16, 2020. Observational studies of patients with ventricular thrombus which compared the effect of two agents on the primary outcome were included. The primary outcome was rate of thrombus resolution, and the secondary outcomes were systemic embolism, bleeding and all-cause death. Odds ratio (OR) and 95% confidential intervals (CI) were utilized for the pooled results.Result Eight studies with 905 participants were finally included. Among these cases, 66.6% of patients received VKAs and 33.4% of patients received NOACs. Rivaroxaban (71.9%) was the most commonly used NOACs. There were no significant differences between NOACs and VKAs groups in thrombus resolution (OR 1.18, 95% CI 0.73-1.91), systemic embolism (OR 0.83, 95% CI 0.34-2.05), bleeding (OR 0.65, 95% CI 0.35-1.19) and all-cause death (OR 0.95, 95% CI 0.53-1.71). In studies with rivaroxaban predominantly or only rivaroxaban in the NOACs groups, NOACs group showed high thrombus resolution rate (OR 2.31, 95% CI 1.31-4.07) and lower systemic embolism rate (OR 0.32, 95% CI 0.11-0.96) than VKAs group, but no differences in bleeding.Conclusion Our findings showed that NOACs had a comparative complete resolution of thrombus compared with VKAs, as well as systemic embolism, bleeding events and all-cause death. In subgroups with rivaroxaban predominantly or only rivaroxaban in the NOACs group, NOACs showed better efficacy and safety profiles than VKAs, indicating that rivaroxaban might have favorable effectiveness over VKAs, though the sample size of NOACs in ventricular thrombus is small and the studies are most non-randomized. Further randomized controlled trials are urgently required to assess the effectiveness and safety of NOACs in patients with ventricular thrombus.
Implementation and sustainability factors of two early-stage breast cancer conversation aids in diverse practices
Authors: Schubbe Danielle , Yen Renata W. , Saunders Catherine H. , Elwyn Glyn , Forcino Rachel C. , O'Malley A. James , Politi Mary C. , Margenthaler Julie , Volk Robert J. , Sepucha Karen , Ozanne Elissa , Percac-Lima Sanja , Bradley Ann , Goodwin Courtney , Muijsenbergh Maria van den , Aarts Johanna WM , Scalia Peter , Durand Marie-Anne 
Published: December 2020

Abstract
Background Conversation aids can facilitate shared decision making and improve patient-centered outcomes. However, few examples exist of sustained use of conversation aids in routine care due to numerous barriers at clinical and organizational levels. We explored factors that will promote the sustained use of two early-stage breast cancer conversation aids. We examined differences in opinions between the two conversation aids and across socioeconomic strata. Methods We nested this study within a randomized controlled trial that demonstrated the effectiveness of two early-stage breast cancer surgery conversation aids, one text-based and one picture-based. These conversation aids improved shared decision making and the decision process, among other outcomes, across four health systems with socioeconomically diverse patient populations. We conducted semi-structured interviews with a purposive sample of patient participants across conversation aid assignment and socioeconomic status (SES), and collected observations and field-notes. We interviewed trial surgeons and other stakeholders. Two independent coders conducted framework analysis using the NOrmalization MeAsure Development through Normalization Process Theory. We also conducted an inductive analysis and additional sub-analyses based on conversation aid assignment and patient SES. Results We conducted 73 semi-structured interviews with 43 patients, 16 surgeons, and 14 stakeholders like nurses, cancer center directors, and electronic health record (EHR) experts. Patients and surgeons felt the conversation aids should be used in breast cancer care in the future and were open to various methods of giving and receiving the conversation aid (EHR, email, patient portal, before consultation). Patients of higher SES were more likely to note the conversation aids influenced their treatment discussion, while patients of lower SES noted more influence on their decision making. Intervention surgeons reported using the conversation aids did not lengthen their typical consultation time. Most intervention surgeons felt using the conversation aids was similar to their usual care after using it a few times, and most patients felt it appeared part of their normal routine. Conclusions Key factors that will guide the future sustained implementation of the conversation aids include adapting to existing clinical workflows, flexibility of use, patient characteristics and communication preferences.Trial registration ClinicalTrials.gov Identifier: NCT03136367, registered on May 2, 2017, https://clinicaltrials.gov/ct2/show/NCT03136367
Training Needs Assessment of Health Care Professionals in Reproductive, Maternal and Newborn Health in a Low-Income Setting in Tanzania
Authors: Mbekenga Columba , Pallangyo Eunice , Mwansisya Tumbwene , Isangula Kahabi , Mwasha Loveluck , Orwa James , Mugerwa Micheal , Mantel Michaela , Subi Leonard , Mrema Secilia , Siso David , Selestine Edna , Temmerman Marleen , Edwards Grace 
Published: December 2020

Abstract
BackgroundHealthcare delivery globally and particularly in low-income setting is challenged by multiple, complex and dynamic problems. The reproductive, maternal and newborn health (RMNH) care is among the most affected areas resulting into high maternal and neonatal mortality and morbidity across the Sub Saharan region and Tanzania in particular. However, under-investment in adequate education and training of health care providers (HCPs) is reported worldwide and contributes to the critical shortages, and lack of adequate knowledge and skills among HCPs. The aim of this study was to assess the training needs among HCPs of RMNH care in selected health facilities of Mwanza, Tanzania. MethodsA cross-sectional descriptive and analytic survey using a self- administered questionnaire was conducted in 36 out of 80 health care facilities included in the Government of Canada and Aga Khan Foundation Canada funded Improving Access to Reproductive, Maternal and Newborn Health in Mwanza, Tanzania (IMPACT) project within the 8 Councils of Mwanza region in Tanzania. The training needs assessment (TNA) tool adapted from the Hennessy-Hicks’ Training Needs Assessment Questionnaire (TNAQ) instrument was used for data collection. The HCPs provided ratings on the importance of their task and their current performance of the task. The differences in scores were calculated to identify the greatest training needs. ResultsOut of 153 HCPs who responded to the TNA questionnaire, majority were registered (n=62) and enrolled (n=43) nurses. Ninety percent (n= 137) were from government-owned health facilities, mostly from hospitals 68 (45%). Training needs were high in 16 areas (out of 49) including cervical cancer screening and care; accessing research resources; basic and comprehensive emergency obstetric and newborn care; and sexual and gender-based violence. The overall perceived importance of the training needs was significantly associated with perceived performance of tasks related to RMNH services (Pearson Correlation (r) = .256; p <001).ConclusionsThe study highlights 16 (out of 49) training gaps as perceived by HCPs working in RMNH in Tanzania. The utilization of findings from the TNA has great potential to facilitate designing of effective trainings for local RMNH services delivery hence improve the overall quality of care.
Systemic Inflammatory Score Predicts Overall Survival In Patients With Cervical Cancer
Authors: Xu Mu , Wu Qibin , Cai Liangzhi , Sun Xiaoqi , Xie Xiaoyan , Sun Pengming 
Published: December 2020

Abstract
Background To evaluate the prognostic value of the systemic inflammatory score (SIS) in cervical cancer patients.Methods The optimal cutoff values for inflammatory biomarkers were calculated by X-tile software. The prognostic factors were investigated using univariate and multivariate Cox analyses. Time-dependent receiver operating characteristic (time-ROC) analysis and the concordance index (C-index) were used to compare the prognostic impact of factors. Results In total, 264 patients with cervical cancer were included in the study. The optimal cutoff value for lymphocyte-to-monocyte ratio (LMR) was 4.1. In multivariate analysis, FIGO stage, lymphovascular invasion, lymph node metastasis, preoperative serum albumin (Alb), and LMR were independent prognostic factors (P<0.05). Then, we combined preoperative Alb and LMR to establish the SIS. Multivariate analysis showed that the SIS was an independent factor that affected survival (P<0.05). When stratified by FIGO stage, significant differences in survival were also found for patients with different SISs (P<0.05). When the SIS and FIGO stage were combined, the time-ROC curve was superior to that of FIGO stage only. The C-index of the model combining the SIS and FIGO stage was 0.786 (95% CI 0.699-0.873), which was significantly higher than that of the model with FIGO stage only (0.676, 95% CI 0.570-0.782, P=0.0049).Conclusions The preoperative SIS is a simple and useful prognostic factor for postoperative survival in patients with cervical cancer. It might assist in the identification of high-risk patients among patients with the same FIGO stage.
Effect of Platelet Count on Prognostic Value in Patients with Chronic Heart Failure
Authors: Li Zhi , Jiao Zhenyu , Xie Yang , Li Yanbing 
Published: December 2020

Abstract
Background: The prognostic value of platelet count in chronic heart failure (CHF) is not clearly established. The present study aimed to assesse the independent prognostic value of platelet count in patients with CHF.Methods: From Januay 2016 to December 2019, 1162 patients with a discharge diagnosis of CHF were recorded in present study. The patients were divided into two groups according to the platelet count: low platelet count (LP, ≦140,000/μl) and high plate count (HP, >140,000/μl). The main outcomes were defined as all-cause death or cardiogenic rehospitalization within 3 years. Survival analysis and Cox proportional hazard models adjusted by an established risk score were performed. Results: During 3 years follow-up, the overall main outcomes including all-cause death (P=0.0475) and composite endpoint events of all-cause death or cardiogenic rehospitalization (P=0.0053) were higher in LP group than in those with HP group. After adjusting for other covariables, including gender, age, et al., low platelet count was related to increased the risk of main outcomes during 3 years follow-up (all-cause death, HR:1.151, 95%CI: 1.082-1.670, P=0.040; composite endpoint events, HR: 1.313, 95%CI: 1.152-1.964, P=0.016). Conclusions: Low platelet count was associated with risk for higher adverse outcome in patients with CHF.
An Oblique Cutting Based Mechanical Model For Insertion Torque of Dental Implant
Authors: Li Luli , Zhang Song , Li Quhao , Bian Cuirong , Zhang Airong 
Published: December 2020

Abstract
The insertion torque of a dental implant is an important indicator for the primary stability of dental implants. Thus, the preoperative prediction for the insertion torque is crucial to improve the success rate of implantation surgery. In this present research, an alternative method for prediction of implant torque was proposed. First, the mechanical model for the insertion torque was established based on oblique cutting process. In the proposed mechanical model, three factors, including bone quality, implant geometry and surgical methods were considered by defined bone-quality coefficients, chip load and insertion speeds, respectively. Then, the defined bone-quality coefficients for cancellous bone with the computed tomography (CT) value of 235~245, 345~355 and 415~425 Hu were obtained by a series of insertion experiments of IS and ITI implants. Finally, the insertion experiments of DIO implants were carried out to verify the accuracy of developed model. The predicted insertion torques calculated by the mechanical model were compared with that acquired by insertion experiments, which were agreed match with the relative error less than 15%. This method reduces the time consumption on establishing the fitting equations for different implants and enhance the predicted accuracy by considering the effects of implants’ geometries and surgical methods.
Chemical Composition and Larvicidal Activities of Essential Oils of Medicinal Plants, Artemisia Sieberi and Tanacetum Balsamita Against Malaria Vector, Anopheles Stephensi
Authors: Kazempour Samad , Shayeghi Mansoreh , Abai Mohammad Reza , Vatandoost Hassan , Pirmohammadi Masoumeh 
Published: December 2020

Abstract
Background: The country is suffering from malaria disease. There are several chemical control of mosquito. Due to resistant of vectors to different pesticides, this research was conducted to measure the chemical components and larvicidal activities of two native plants, Artemisia sieberi and Tanacetum balsamita against Anopheles stephensi.Materials and methods: Two species of medicinal plants were collected from different localities in in Iran. The plant samples were dried in shaded place and Essential Oils (EO) dried over anhydrous sodium sulfate. The EOs was maintained in the dark sealed vials until conduction larvicidal tests. The maximum storing of EOs was two days. The larvicidal tests were carried out based on the guideline of WHO. Results: The values of LC50 and LC90 of EOs were 47.9 and 178.8 ppm for Artemisia sieberi. The figure of 26.2and 52.4 ppm was observed for Tanacetum balsamita.The chemical constituents of Tanacetum balsamita and Artemisia sieberi which showed the highest efficacy for larviciding. A total of 39 constituents were isolated from Tanacetum balsamita .The main constituents were Thujone (52.37%) and Carvone (26.84%). Totally 57 constituents were detected in Artemisia sieberi and the main components were : camphor (23.6%) , 2-Ethyl-3- methyl maleic anhydride (15. 193%) and, Bombykal (10.32%) , Ethylbutenol (10.74%) .Conclusion: New formulations of plants should be prepared and then evaluated under semi-filed and filed conditions in a malrious areas.
Locally-developed External Fixators as Definitive Treatment of Open Tibia Diaphyseal Fractures: A Clinical Prospective Study Conducted in Ivory Coast
Authors: Kouassi Kouamé Jean-Eric , Akobé Jean Régis , Kouassi Aya Adélaïde Natacha , Founkoué Loïc , Detrembleur Christine , Kodo Michel , Cornu Olivier 
Published: December 2020

Abstract
Background: This study sought to evaluate the effectiveness of locally-developed external fixators (LDEF) as definitive treatment for open tibia diaphyseal fractures (OTDF) in Ivory Coast.Methods: Gustilo I, II and IIIA OTDFs of patients admitted within 24 hours of injury were prospectively included and treated with a locally-developed external fixator. The rates of union, mal-union, septic complications, as well as the functional results were assessed, in addition to the LDEF construct’s integrity. Predictive factors of failure or poor results were assessed.Results: Overall, 40 OTDF patients were admitted within 24 hours of injury. Gustilo I, II and IIIA fractures were observed in three, 13, and 24 patients, respectively. Uneventful fracture healing was obtained in 29 cases, with an average union time of 8.47 months. Mal-union and non-union were registered in three and four cases, respectively. Pin-track infection (PTI) was observed in 13 cases, and deep infection in seven. Infection resolved in all patients except four, who developed chronic osteomyelitis. None of the non-unions were associated with an infection. The overall functional result was satisfactory in 32 patients. PTI was the only predictive factor for chronic infection. Biplanar frames, when compared to monoplanar constructs, were associated with a significantly improved functional outcome.Conclusion: In comparison with the results obtained in the same environment without a locally-developed external fixator, the provision of such a device improved significantly the OTDF management, as it provided better stability and superior fracture healing rates. PTI remains an essential problem but with, hopefully, limited negative consequences. Trial registration: This study protocol was registered in Pan African Clinical Trial Registry under N°PACTR202009854874448. Date of registration 28 September 2020 ‘retrospectively registered’. www.pactr.org.