bluuebunny/crossref_metadata_2025_split huggingface dataset:
The cost‑effectiveness of hypertonic saline inhalations for infant bronchiolitis.
Authors: buendia jefferson , Acuña-Cordero Ranniery 
Published: October 2020

Abstract
BackgroundPharmacological treatment for bronchiolitis is primarily supportive because bronchodilators, steroids, and antibiotics, show little benefit. Clinical studies have suggested that nebulized 3% hypertonic solution is useful for infants with bronchiolitis. This study aims to evaluate the cost-effectiveness of the HS inhalations in infant bronchiolitis in a tropical country Methods Decision tree analysis was used to calculate the expected costs and QALYs. All cost and use of resources were collected directly from medical invoices of 193 patient hospitalized with diagnosis of bronchiolitis in tertiary centers, of Rionegro, Colombia. The utility values applied to QALYs calculations were collected from the literature. The economic analysis was carried out from a societal perspective.ResultsThe model showed that nebulized 3% hypertonic solution, was associated with lower total cost than controls (US $200vs US $240 average cost per patient), and higher QALYs ( 0.92 vs 0.91 average per patient); showing dominance. A position of dominance negates the need to calculate an incremental cost-effectiveness ratio.Conclusion The nebulized 3% hypertonic solution was cost-effective in the inpatient treatment of infant bronchiolitis. Our study provides evidence that should be used by decision-makers to improve clinical practice guidelines and should be replicated to validate their results in other tropical countries.
Evaluating the Implementation of the SWITCH® School Wellness Intervention and Capacity-Building Process through Multiple Methods
Authors: McLoughlin Gabriella M , Candal Priscila , Vazou Spyridoula , Lee Joey A. , Dzewaltowski David A. , Rosenkranz Richard R. , Lanningham-Foster Lorraine , Gentile Douglas A. , Liechty Laura , Chen Senlin , Welk Gregory J 
Published: October 2020

Abstract
Background: School wellness programming is important for promoting healthy lifestyles and academic achievement in youth; however, research is needed on methods that can help schools implement and sustain such programs on their own. The purpose of this study was to investigate factors within and outside the school environment that influenced school capacity for implementation and potential sustainability of wellness programming. Methods: As part of the School Wellness Integration Targeting Child Health (SWITCH®) intervention, elementary school wellness teams (N = 30) were guided through a capacity-building process focused on promoting the adoption of healthy lifestyle behaviors in students. Data on implementation were collected through three standardized surveys and interviews (pre-mid-post) and a post-implementation interview. Indicators of organizational capacity were assessed using the School Wellness Readiness Assessment (SWRA). Paired t-tests were run to assess changes in implementation (classroom, physical education, and lunchroom settings), capacity, and stakeholder engagement over time. One-way analysis of variance (ANOVA) tests were run to examine how implementation of best practices (low, moderate, high) explained differences in capacity gains. Qualitative data were analyzed through inductive and deductive analysis, following the Consolidated Framework for Implementation Research (CFIR). Results: Paired t-tests showed non-significant increases in school and setting-specific capacity and implementation of SWITCH best practices over time, in addition to a consistent level of engagement from key stakeholders. ANOVA results revealed positive, non-significant variances between implementation group and gains in school capacity (F[2,24] = 1.63; p = .21), class capacity (F[2,24]=0.20 p=.82), lunchroom capacity (F[2,24]=0.29; p=.78), and physical education (F[2,24]=1.45; p=.25). Qualitative data demonstrated that factors within the outer setting (i.e., engaging community partners) facilitated programming. Inner-setting factors (i.e., relationships with administration and staff) influenced implementation. Implementation process themes (e.g., planning, adaptation of resources to meet school capacity/needs, and engaging students as leaders) were cited as key facilitators. Schools discussed factors affecting sustainability, such as school culture and knowledge of school wellness policy. Conclusions: Findings suggest a potential relationship between implementation and capacity change, which is the primary goal of SWITCH. The results document the importance of allowing schools to adapt programming to meet their local needs.
Systematic review and bibliometric analysis of African anesthesia and critical care medicine research Part II: A scientometric analysis of the 116 most cited articles
Authors: Kanmounye Ulrick Sidney , Tochie Joel Noutakdie , Mbonda Aime , Solam Cynthia Wafo , Daya Leonid , Atem Thompson Hope , Nyalundja Arsène Daniel , Eyaman Daniel Cheryl 
Published: October 2020

Abstract
BackgroundScientometrics is used to assess the impact of research in several health fields, including Anesthesia and Critical Care Medicine. The purpose of this study was to define the landscape and key players of Anesthesia and Critical Care Medicine research in Africa.MethodsThe authors searched Web of Science from inception to May 4, 2020, for articles on and about Anesthesia and Critical Care Medicine in Africa with ≥ 2 citations. Quantitative (H-index) and qualitative (descriptive analysis of yearly publications and interpretation of document, co-authorship, author country, and keyword) bibliometric analyses were done.ResultsThe search strategy returned 116 articles that had a median of 5 (IQR: 3-12) citations on Web of Science. The most frequent journals were Anesthesia and Analgesia (18, 15.5%), World Journal of Surgery (13, 11.2%), and South African Medical Journal (8, 6.9%). Most (74, 63.8%) articles were published on or after 2013, and seven authors had more than 1 article in the top 116 articles: Epiu I (3, 2.6%), Elobu AE (2, 1.7%), Fenton PM (2, 1.7%), Kibwana S (2, 1.7%), Rukewe A (2, 1.7%), Sama HD (2, 1.7%), and Zoumenou E (2, 1.7%). The bibliometric coupling analysis of documents highlighted 10 clusters with the most significant nodes being Biccard BM, 2018; Baker T, 2013; Llewellyn RL, 2009; Nigussie S, 2014; and Aziato L, 2015. Dubowitz G (5) and Ozgediz D (4) had the highest H-indices among the authors referenced by the most-cited African Anesthesia and Critical Care Medicine articles. The U.S.A. had the largest global node, while South Africa and Uganda had the largest African nodes. The most prominent keywords were anesthesia, mortality, and surgery. ConclusionThis study highlighted a decline in the number of top-cited African articles and the roles of the U.S.A, Southern African, and East African countries in scholarly output. Future studies should focus on understanding the time trends of the publications.
The sniffing bead system, an olfactory dysfunction screening tool for geriatric subjects: A cross-sectional study
Authors: Min Hyun Jin , Kim Sun Mi , Han Doug Hyun , Kim Kyung Soo 
Published: October 2020

Abstract
Background: This study aimed to develop a simple and one-off olfactory screening test, the sniffing bead system, for general clinical use in older adults. Methods: In this cross-sectional study, geriatric subjects (aged > 50 years) who underwent neurocognitive and olfactory function tests were included. Overall, 137 subjects were enrolled, and the study was conducted at Chung-Ang University, Seoul, Korea. Olfactory function was measured by obtaining the scores of the sniffing bead system using 2-phenylethyl alcohol, n-butanol, and the YSK olfactory function test. Time taken for each olfactory function test was also measured. Results: The score of the 2-phenylethyl alcohol sniffing bead test was 2.58 ± 1.52, which was significantly associated with the YSK_threshold (2.41 ± 1.79) (p < 0.001, Pearson's correlation coefficient = 0.429), YSK_identification (8.93 ± 3.25) (p = 0.014, Pearson's correlation coefficient = 0.208) and YSK_threshold-discrimination-identification (17.46 ± 5.49) (p < 0.001, Pearson's correlation coefficient = 0.316) test scores. In the normal cognitive function group, YSK_threshold ( p < 0.001, Pearson's correlation coefficient = 0.479 ) , YSK_identification ( p = 0.003, Pearson's correlation coefficient = 0.316 ), and YSK_threshold-discrimination-identification (p < 0.001, Pearson's correlation coefficient = 0.429) were significantly correlated with the scores of the 2-phenylethyl alcohol sniffing bead system. In the impaired cognitive function group, the YSK_threshold (p = 0.002, Pearson's correlation coefficient = 0.415 ) and YSK_ threshold-discrimination-identification (p = 0.004, Pearson's correlation coefficient = 0.385 ) were significantly correlated with the scores of the 2-phenylethyl alcohol sniffing bead system. Time taken for the 2-phenylethyl alcohol sniffing bead system was 5.00 ± 1.51 min, which was significantly lower than that for the YSK_threshold-discrimination-identification (20.43 ± 5.29 min) (p < 0.001). The scores of the 2-phenylethyl alcohol sniffing bead system were significantly correlated with those of the n-butanol sniffing bead system (3.50 ± 1.21) (p < 0.001, Pearson's correlation coefficient = 0.315). Conclusions: This sniffing bead system was specifically designed for screening olfactory function in older adults, and it may allow for the rapid and accurate assessment of olfactory dysfunction.
Multiple gene targeting siRNAs for down regulation of Immediate Early-2 (Ie2) and DNA polymerase genes mediated inhibition of novel rat Cytomegalovirus (strain All-03)
Authors: Balakrishnan Krishnan Nair , Abdullah Ashwaq Ahmed , Bala Jamilu Abubakar , Jesse Faez Firdaus Abdullah , Abdullah Che Azurahanim Che , Noordin Mustapha Mohamed , Azmi Mohd Lila Mohd 
Published: October 2020

Abstract
Background: Cytomegalovirus (CMV) is an opportunistic pathogen that causes severe complications in congenitally infected newborns and non-immunocompetent individuals. Developing an effective vaccine is a major public health priority and current drugs are fronting resistance and side effects on recipients. In the present study, with the aim of exploring new strategies to counteract CMV replication, several anti-CMV siRNAs targeting IE2 and DNA polymerase gene regions were characterized and used as in combinations for antiviral therapy. Methods: The rat embryo fibroblast (REF) cells were transfected with multi siRNA before infecting with CMV strain ALL-03. Viral growth inhibition was measured by tissue culture infectious dose (TCID50), cytopathic effect (CPE) and droplet digital PCR (ddPCR) while IE2 and DNA polymerase gene knockdown was determined by real-time PCR. Ganciclovir was deployed as a control to benchmark the efficacy of antiviral activities of respective individual siRNAs.Results: There was no significant cytotoxicity encountered for all the combinations of siRNAs on REF cells analyzed by MTT colorimetric assay (P>0.05). Cytopathic effects (CPE) in cells infected by RCMV ALL-03 had developed significantly less and at much slower rate compared to control group. The expression of targeted genes was downregulated successfully resulted in significant reduction (P<0.05) of viral mRNA and DNA copies (dpb+dpc: 79%, 68%; dpb+ie2b: 68%, 60%; dpb+dpc+ie2b: 48%, 42%). Flow cytometry analysis showed a greater percentage of viable and early apoptosis of combined siRNAs-treated cells compared to control group. Notably, the siRNAs targeting gene regions were sequenced and mutations were not encountered, thereby avoiding the formation of mutant with potential resistant viruses. Conclusions: In conclusion. The study demonstrated a tremendous promise of innovative approach with the deployment of combined siRNAs targeting at several genes simultaneously with the aim to control CMV replication in host cells.
RNA sequencing identifies transcriptional changes in the rabbit larynx in response to low humidity challenge
Authors: Bailey Taylor W , Santos Andrea Pires dos , Nascimento Naila Cannes do , Xie Shaojun , Thimmapuram Jyothi , Sivasankar M. Preeti , Cox Abigail 
Published: October 2020

Abstract
Background: Voice disorders are a worldwide problem impacting human health, particularly for occupational voice users. Avoidance of surface dehydration is commonly prescribed as a protective factor against the development of dysphonia. The available literature inconclusively supports this practice and a biological mechanism for how surface dehydration of the laryngeal tissue affects voice has not been described. In this study, we used an in vivo male New Zealand white rabbit model to elucidate biological changes based on gene expression within the vocal folds from surface dehydration. Surface dehydration was induced by exposure to low humidity air (18.6% + 4.3%) for 8 hours. Exposure to moderate humidity (43.0% + 4.3%) served as the control condition. Ilumina-based RNA sequencing was performed and used for transcriptome analysis with validation by RT-qPCR. Results: There were 103 statistically significant differentially expressed genes identified through Cuffdiff with 61 genes meeting significance by both false discovery rate and fold change. Functional annotation enrichment and predicted protein interaction mapping showed enrichment of various loci, including cellular stress and inflammatory response, ciliary function, and keratinocyte development. Eight genes were selected for RT-qPCR validation. Matrix metalloproteinase 12 (MMP12) and macrophage cationic peptide 1 (MCP1) were significantly upregulated and an epithelial chloride channel protein (ECCP) was significantly downregulated after surface dehydration by RNA-Seq and RT-qPCR. Suprabasin (SPBN) and zinc activated cationic channel (ZACN) were marginally, but non-significantly down- and upregulated as evidenced by RT-qPCR, respectively. Conclusions: The data together support the notion that surface dehydration induces physiological changes in the vocal folds and justifies targeted analysis to further explore the underlying biology of compensatory fluid/ion flux and inflammatory mediators in response to airway surface dehydration.
Pregnancy and childbirth during the COVID-19 pandemic in Poland: qualitative evidence from experts interviews.
Authors: Pustułka Paula , Buler Marta 
Published: October 2020

Abstract
Background: The COVID-19 outbreak has significantly altered the provisions and shape of medical services for expecting mothers worldwide. In Poland, the country where pregnancy and childbirth are subject to comparably greater medicalization, those shifts are particularly tangible. This study aimed at capturing how maternal health professionals tackle care over pregnant and birthing women during a pandemic, highlighting possible long-term implications for the expecting and new mothers, as well as the reproductive health sector.Methods: This is a qualitative and rapid-response study which addresses the themes around the emerging implications of the viral outbreak. Semi-structured expert interviews were conducted with 46 individuals, all highly-skilled, working in either medical or adjacent sectors connected with reproductive medicine, as well as varied antenatal and postpartum care services. In this analysis, 7 digital experts were excluded as observers rather than field practitioners. Among 38 interviews, 5 have been conducted with OB-GYNs, 13 with midwives, 6 with doulas, 14 broadly-conceived category of maternal support experts including psychologists and physiotherapists. The recorded data were input into thematic grids and meticulously transcribed prior to being subject to an inductive, thematic analysis.Results: The findings revealed that the context of the heightened medicalization of pregnancy and hospital care during birth in Poland, resulted in strong restrictions and immediate fall back to a clinical care model. The majority also claimed that the COVID-19 pandemic exacerbated the implications of the decades of Polish maternal health recommendations contradicting the WHO regulations. Professionals’ anxieties concern limited access to services assisting women during pregnancies. While those linked to hospitals pointed out physiological risks, other maternal support experts drew attention to the effects of stress and uncertainty on maternal mental health. Conclusions: Experts face various challenges when providing care to pregnant and birthing women in Poland. They underscore both the information chaos surrounding recommendations and procedures, and see the pandemic as a moment of reflection, mostly being vocal in their critiques of the over-medicalized Polish care model. The interviewed maternal health experts believe that the pandemic will have multifaceted consequences that are being exacerbated by both a sudden cessation of extensive degree of medicalization during pregnancy, and a fallback to alienation during intervention-focused hospital deliveries.
Too sweet: cheminformatics for deglycosylation in natural products
Authors: Schaub Jonas , Zielesny Achim , Steinbeck Christoph , Sorokina Maria 
Published: October 2020

Abstract
Sugar units in natural products are pharmacokinetically important but often redundant and therefore obstructing the study of the structure and function of the aglycon. Therefore, it is recommended to remove the sugars before a theoretical or experimental study of a molecule. Deglycogenases, enzymes that specialized in sugar removal from small molecules, are often used in laboratories to perform this task. However, there is no standardized computational procedure to perform this task in silico . In this work, we present a systematic approach for in silico removal of ring and linear sugars from molecular structures. Particular attention is given to molecules of biological origin and to their structural specificities. This approach is made available in two forms, through a free and open web application and as standalone open-source software.
Incidence of Airway Complications Associated with Deep Extubation in Adults
Authors: Juang Jeremy , Cordoba Martha , Ciaramella Alex , Xiao Mark , Goldfarb Jeremy , Bayter Jorge Enrique , Macias Alvaro Andres 
Published: October 2020

Abstract
Background: Endotracheal extubation is the most crucial step during emergence from general anesthesia and is usually carried out when patients are awake with return of airway reflexes. Alternatively, extubations can also be accomplished while patients are deeply anesthetized, a technique known as “deep extubation”, in order to provide a “smooth” emergence from anesthesia. Deep extubation is seldomly performed in adults, even in appropriate circumstances, likely due to concerns for potential respiratory complications and limited research supporting its safety. It is in this context that we designed our prospective study to understand the factors that contribute to the success or failure of deep extubation in adults.Methods: In this prospective observational study, 300 patients, age ≥ 18, American Society of Anesthesiologists Physical Status (ASA PS) Classification I - III, who underwent head-and-neck and ocular surgeries. Patients’ demographic, comorbidity, airway assessment, O2 saturation, end tidal CO2 levels, time to exit OR, time to eye opening, and respiratory complications after deep extubation in the OR were analyzed. Results: Forty (13%) out of 300 patients had at least one complication in the OR, as defined by persistent coughing, desaturation SpO2 < 90% for longer than 10s, laryngospasm, stridor, bronchospasm and reintubation. When comparing the complication group to the no complication group, the patients in the complication group had significantly higher BMI (30 vs 26), lower O2 saturation pre and post extubation, and longer time from end of surgery to out of OR (p<0.05). Conclusions: The complication rate during deep extubation in adults was relatively low compared to published reports in the literature and all easily reversible. BMI is possibly an important determinant in the success of deep extubation.
Development of the Labor Pain Relief Attitude Questionnaire for Pregnant Women (LPRAQ-p)
Authors: Hulsbosch Lianne P , Nyklíček Ivan , Potharst Eva S , Boekhorst Myrthe GBM , Pop Victor JM 
Published: October 2020

Abstract
Background: Receiving epidural analgesia during labor can possibly have negative consequences for mother and child. Yet, the use of epidural analgesia rapidly increased in the Netherlands over the last decade. Since antenatal plans for labor pain relief have been related to epidural analgesia use during labor, the aim of the current study was to develop a Labor Pain Relief Attitude Questionnaire for pregnant women (LPRAQ-p).Methods: Three focus group interviews were conducted with pregnant women, new mothers and caregivers and 13 candidate items were derived. Psychometric properties were tested with explorative factor analysis in sample I (N = 429) and a subsequent confirmatory factor analysis in a different sample II (N = 432).Results: The explorative factor analysis suggested a two-factor seven-item solution: a ‘women’s perception’ and ‘social environment’ subscale. The confirmatory factor analysis confirmed an excellent six-item model fit with appropriate internal consistency. Higher scores on the six-item LPRAQ-p indicate greater willingness for request of pain relief medication during labor. Two-tailed t-tests showed that women with elevated levels of depression and pregnancy-specific distress symptoms, nulliparous women and multiparous women with complications during previous delivery had greater willingness for request of pain relief medication during labor. Linear regression showed that the most important association with higher scores on the LPRAQ-p were high pregnancy-specific distress symptoms.Conclusions: This study showed the LPRAQ-p to be a valid instrument to evaluate attitude towards labor pain relief in pregnant women. High scores on this questionnaire are associated with high levels of pregnancy-specific distress symptoms.