bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validating a Chief Compliant List for Low Resource Settings: A Methodologic Case Study
Authors: Hansoti Bhakti , Hahn Elizabeth , Rao Aditi , Harris Jordan , Jenson Alexander , Markadakis Nicholas , Moonat Sachin , Ousula Valerie , Pousson Amelia 
Published: December 2020

Abstract
Background:The chief or presenting complaint is the reason for seeking health care, often in the patient’s own words. In limited resource settings, a diagnosis-based approach to quantifying burden of disease is not possible, partly due to limited availability of an established lexicon or coding system. Collaboration with World Health Organization colleagues resulted in the creation of a pilot symptom list representing an attempt to standardize undifferentiated chief complaints in emergency and acute care settings. A validated universal chief complaint list would profoundly benefit clinicians, researchers, and policymakers world-wide by allowing the communication and development of system-level priorities based around the signs and symptoms most often experienced by the patients being served.Methods: This study was incorporated as a part of a larger prospective observational study on human immunodeficiency virus testing in Emergency Departments in South Africa. The pilot symptom list was used for chief complaint coding in three Emergency Departments. Data was collected on 3,357 patients using paper case report forms. Chief complaint terms were reviewed by two study team members to determine the frequency of concordance between the coded chief complaint term and the selected symptom(s) from the pilot symptom list.Results:Overall, 3,537 patients’ chief complaints were reviewed, of which 640 were identified as ‘potential mis-matches’. When considering the 191 confirmed mis-matches (29.8%), the Delphi process identified 6 (3.1%) false mismatches and 185 (96.9%) true mismatches. Significant chief-complaint clustering was identified with 9 sets of complaints frequently selected together for the same patient. “Pain” was used 2,076 times for 58.7% of all patients. Testing for validity and functionality of the initial draft dataset via user feedback and expert-panel modified Delphi analysis resulted in several substantial changes to the pilot symptom list.Conclusions:This study found that the pilot symptom list with aforementioned modifications could be applied to a low resource emergency system. Recommendations for additions, modifications, and/or deletions from the draft chief complaint list will improve validity and functionality of the list in low resource environments. Selecting a patient’s chief complaint from a validated list offers a vital tool to help triage patients, streamline emergency care delivery, and improve patient outcomes.
Prophylactic Application of Lavandula Angustifolia Mill. Oil and Its Active Component Linalyl Acetate Alleviate Comorbidity and Exacerbation Risk in Rats With Collagen-Induced Arthritis Accompanied by Chronic Nicotine-Induced Hypertension.
Authors: Seo Eunhye , Hsieh Yu Shan , Lee Jeong-Min , Shin You Kyoung , Seol Geun Hee 
Published: December 2020

Abstract
Background: Hypertension (HTN) in rheumatoid arthritis (RA) is more common in smokers than in non-smokers, increasing the risks of cardiovascular and skeletal muscle related comorbidities, but studies on pharmacological protection strategies are insufficient. Lavandula angustifolia Mill. (lavender) oil has traditionally been used for RA and HTN via its anti-inflammatory properties. This study aimed to investigate the effects of lavender oil and its main component linalyl acetate on cardiovascular and skeletal muscle protection in a rat model of RA with chronic nicotine-induced HTN. Methods: Collagen-induced arthritis (CIA), with or without chronic nicotine-induced HTN, were induced in Sprague-Dawley rats. Lavender or linalyl acetate (10 or 100 mg/kg/day) were administrated intraperitoneally to CIA plus chronic nicotine-induced HTN (H-CIA) rats. The effects of lavender and linalyl acetate was evaluated by measurement of hind paw thickness, body weight, blood pressure (BP), serum concentrations of interleukin-6 (IL-6) and insulin-like growth factor-1 (IGF-1). In addition to above, histological analysis of thoracic aorta and gastrocnemius muscle were used. Results: BP was significantly higher, vascular endothelium more deteriorated and paw edema more severe in H-CIA than in CIA. Both groups showed clear signs of skeletal muscle atrophy and inflammation, but gastrocnemius muscle weight was lower and muscle inflammatory status worse in H-CIA than in CIA. Reduced mitochondrial function was observed only in H-CIA. Prophylactic application of 100 mg/kg lavender oil or linalyl acetate kept IL-6 levels to the normal range and reduced hind paw edema and systolic BP. Linalyl acetate 100 mg/kg was the only treatment that maintained diastolic BP and IGF-1 in their normal ranges and prevented vascular endothelial damage. These treatments also reduced inflammation of the gastrocnemius muscle and inhibited mitochondrial dysfunction while tending to increase muscle mass. Conclusions: Chronic nicotine exposure induces defects that increase the risks of cardiovascular disease and muscle weakness, and application of lavender and linalyl acetate reduced the risks, especially, linalyl acetated alleviated vascular endothelial damage along with maintained IGF-1 level. Current results encourage smokers at high risk for RA to quit smoking, and further suggest that linalyl acetate is a useful agent to prevent cardiovascular and skeletal muscle related comorbidities.
Estimation of Intracranial Pressure by Ultrasound of the Optic Nerve Sheath in an Animal Model of Intracranial Hypertension
Authors: Jeng Brasil Chian , Andrade Almir Ferreira de , Brasil Sérgio , Bor-Seng-Shu Edson , Belon Alessandro Rodrigo , Robertis Maira , de-Lima-Oliveira Marcelo , Rubiano Andrés Mariano , Godoy Daniel Agustín , Teixeira Manoel Jacobsen , Paiva Wellingson Silva 
Published: December 2020

Abstract
Background: Invasive monitoring of intracranial pressure (ICP) is currently the gold standard method for the safe diagnosis and treatment of intracranial hypertension (ICHy), but it is subject to hemorrhage, infection and malfunction. Ultrasound of the optic nerve sheath diameter (ONSD) has been applied as a non-invasive alternative that is cost effective and available at the bedside. However, ONSD time-lapse behavior in a set of ICHy and its relief by means of whether saline infusion or surgery is still unknown. The objective of this study was to correlate intracranial pressure and ultrasonography of the optic nerve sheath in an experimental animal model of ICHy, and the interval needed to ONSD to return to its baseline levels.Methods: An experimental study was conducted on 30 male and female pigs weighing about 20 kg. The diameter of the optic nerve sheath was evaluated by ultrasound at different measures of ICP given by intraventricular catheter and intracranial balloon inflation, saline infusion and balloon deflation. Laboratory and hemodynamic data were collected from the animals. ICP and ONSD values were correlated at each time point of the study.Results: All the variables obtained by ONSD ultrasonography as left optic nerve, right optic nerve and average of optic nerve sheath (AON) diameter were statistically significant to estimate ICP value. ONSD values changed immediately at balloon inflation, with a delay of 30 minutes average to return to baseline levels after balloon deflation (p = 0.016). No statistical significance was observed in ICP and ONSD values with hypertonic saline infusion. Correlation between ICP and ONSD was linear and can be estimated using the formula: -80.5 + 238.2 x AON, in this swine model. Conclusion: In the present study, ultrasound of optic nerve sheath diameter disclosed linear correlation with ICP, although a short delay in returning to its baseline levels may be observed in the case of sudden intracranial hypertension relief.
Gold nanoclusters augment a fluoroquinolone lethality against biofilm associated persister cells
Authors: Bekale Laurent , Maria Peter L. Santa , Cao Zhixin , Chen Xiaohua , Xia Anping , Bacacao Brian , Tran Jessica , Chen Jing 
Published: December 2020

Abstract
Persister cells are an important medical concern, leading to the overuse of antibiotics and ultimately contributing to antimicrobial resistance. The use of an adjuvant that augments the antibiotic efficacy has yet to be explored for combating persister cells within biofilm infections. Here we demonstrate a paradigm shift in targeting bacteria in chronic infections by coadministration of a conventional antibiotic with a novel engineered gold nanocluster (AuNC@CPP). AuNC@CPP was found to reduce the minimum biofilm eradication concentration (MBEC) of ofloxacin up to 300-fold (from > 3000 μg/mL to 10 μg/mL). Compared to ofloxacin alone (FLOXIN®Otic), coadministration of ofloxacin with AuNC@CPP induces up to a 10,000-fold reduction in bacterial burden in a validated mouse model of chronic P. aeruginosa of ear infection mimicking chronic suppurative otitis media. The biocompatibility of AuNC@CPP encourages efforts for development as an antibiotic adjunct for combating bacterial biofilm infections.
The Prognostic Value of High-risk Human Papillomavirus Infection Status in Surgically Treated Stage IB1-IIA2&nbsp;Cervical Squamous Cell Carcinoma
Authors: Zeng Jia , Zuo Jing , Li Ning , Yao HongWen , Wang TianTian , Li Jian , Xiu Lin , Yu Jing , Liang LeiLei , Zhao YuXi , Wu LingYing 
Published: December 2020

Abstract
Background: High-risk HPV(hr-HPV) infection is important for the development of invasive cervical cancer. As a developing country with the largest population in the world, China has a great burden of cervical cancer. The cervical cancer screening strategies consisted of cytology and virology, which has been studied by HPV-typing test and HPV-DNA quantitative test since decades ago. The cervical cancer incidence rate has been declined due to the early treatment of precancerous lesions, but postoperative HPV infection is still an issue for cervical cancer patients. This study aims to investigate the association between HPV infection status and recurrence of early-stage cervical cancer through a novel PCR-based HPV test, which could do both HPV typing-test and DNA quantitative-test. Methods: Patients diagnosed with cervical cancer staged IB1- IIA2, who were treated by radical hysterectomy and lymphadenectomy at Cancer Hospital Chinese Academy of Medical Sciences(CAMS) between January 2014 and December 2016 were accrued. The clinicopathological factors, pre- and post-operative HPV infection status, and the prognosis were investigated. Cox regression was used to identify factors associated with LRFS, MFS and OS. Results: A total of 312 patients were enrolled in this study, who were treated by radical resection and accepted pre- and post-operative HPV tests, with a median follow-up time of 60 months(range 14~79 months). The 5-year LRFS rate, MFS rate, and OS rate were 97.8%, 98.4%, and 98.7%. The pre-operative HPV infection rate was 85.3%(266/312), 74 patients had a high level of HPV-DNA(>5x106 copy number/104 cells). Twenty-nine patients had a postoperative persistent high level of HPV-DNA(9.3%). Postoperative persistent high level of HPV-DNA within 12 months(p=0.013), postoperative persistence of HPV-16/18 within 24 months(p=0.004), and deep stromal invasion(>2/3)(p=0.007) were associated with a poor LRFS.Conclusion: Pre-operative HPV-16/18 infection and high level of HPV-DNA were not associated with local recurrence of cervical cancer. Most initial HPV-positive patients had HPV cleared within 24 months postoperatively. Postoperative HPV-16/18 persistence within 24 months, postoperative persistence of high HPV-DNA level within 24 months, and deep stromal invasion(>2/3) were independent risk factors for local recurrence of cervical cancer.
A Rare Case of Stage IV Adrenocortical Carcinoma with Acute Adrenocortical Dysfunction After Trans-Catheter Arterial Chemo-Embolization (TACE)
Authors: Wang Zhilong , Sun Xin , Zhang Fengli , Wang Ting , Li Ping 
Published: December 2020

Abstract
Background: Adrenocortical carcinoma(ACC) is a rare and highly invasive endocrine malignant tumor with poor prognosis and insensitivity tochemotherapy, which don't have effective treatment. Although Surgical resection is considered to be the main treatment for ACC, postoperative recurrence and metastasis have become the most important factors of death. Therefore, local treatments such as trans-catheter arterial chemo-embolization, radiofrequency ablation become be new treatment for ACC. Trans-catheter arterial chemo-embolization therapy for ACC patients with liver metastasis has good efficacy and can effectively reduce the tumor burden of patients, which is considered to be safe and easy for patients. Case presentation: We report a 47-year-old female patient diagnosed with stage Ⅳ ACC with liver metastases, who developed symptoms of acute adrenocortical dysfunctions after hepatic arterial catheter chemo-embolization.Conclusion: Trans-catheter arterial chemo-embolization therapy for ACC patients with liver metastasis is not completely safe, and there is a certain probability that it will lead to secondary adrenal dysfunction. Hydrocortisone supplementation can effectively alleviate the symptoms.
Correlation Between CCND1 Gene Polymorphism and Genetic Susceptibility to Gastric Cancer in Chinese Population
Authors: Pan Huiwen , Gu Xuyu , Zou Chen , Chen Keping , Fan Yu 
Published: December 2020

Abstract
Objective: The relationship between Cyclin D1 gene (CCND1) rs9344 polymorphism and susceptibility to gastric cancer (GC) is investigated.Methods: In a case-control study, we selected 577 cases of GC from The People's Hospital Affiliated to Jiangsu University in China along with 678 normal controls. Blood DNA was extracted and PCR amplified, gene polymorphism was determined using Snapshot method.Results: Analysis reveals significant difference in smoking between GC and control groups (P=0.006), however, not on polymorphism (P＞0.05). Conclusion: Smoking is associated with gastric cancer, whereas CCND1 rs9344 polymorphism does not implicate susceptibility of gastric cancer.
Psychometric Properties of the EORTC&nbsp;QLQ-C30 in a Ugandan Context
Authors: Mayanja Allen Naamala , Eriksson Lars E. , Orem Jackson , Nalwadda Gorrette Kayondo , Kabir Zarina Nahar , Wettergren Lena 
Published: December 2020

Abstract
Background Self-reported measures play a crucial role in research, clinical practice and health assessment. Instruments used to assess self-reported health-related quality of life (HRQoL) need validation to ensure that they measure what they are intended to, detect true changes over time and differentiate between subjects. A generic instrument measuring HRQoL adapted for use among people living with cancer in Uganda is lacking; therefore, this study aimed to evaluate the psychometric properties of the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 when used in a Ugandan context. Methods Adult patients with various types of cancer (N=385) cared for at the Uganda Cancer Institute answered the Luganda or English version of the EORTC QLQ-C30. The two language versions were evaluated with regard to data quality (floor and ceiling effects and missing responses), reliability (internal consistency) and validity (construct, known-group and criterion). Construct validity was examined through confirmatory factor analysis (CFA). Mean scores were compared between groups differing in disease stage to assess known-group validity. Criterion validity was examined according to associations between two QLQ-C30 subscales (Global quality of life and Physical function) and the Karnofsky Performance Scale (KPS).Results Floor and ceiling effects were observed for several scales in the Luganda and English versions. All EORTC scales with the exception of Cognitive function (Luganda α=0.66, English α=0.50) had acceptable Cronbach’s alpha values (0.79–0.96). The CFA yielded good fit indices for both versions (RMSEA=0.076–0.081, SRMR=0.048 and CFI=0.928–0.932). Known-group validity was demonstrated with statistically significant better HRQoL reported by patients with disease stages I–II compared to those in stages III–IV. The Global quality of life and the Physical function scales correlated positively to KPS (r=0.65 and r=0.75), indicating criterion validity. Conclusion The Luganda and English versions of the EORTC QLQ-C30 appear to be valid and reliable measures and can be recommended for use in clinical research to assess HRQoL in adult Ugandans with cancer. However, the cognitive scale did not reach acceptable internal consistency and needs further evaluation.
Analyzing the technical efficiency of health systems in Asian countries: What Myanmar can learn from Bangladesh and Sri Lanka.
Authors: Win Zin Mar , Löfgren Curt 
Published: December 2020

Abstract
Background: Advancements in medicine leads, among other things, to increasing life expectancy and quality of life. However, at the same time, health care costs are increasing, and this may not be sustainable in the future. Governments and health care organizations need to implement efficiency measures in order to maximize health outcomes within available resources. This study aims to compare the technical efficiency of health systems in middle-income Asian countries, and to identify “efficient peers” for each “inefficient country”: in particular for Myanmar. Methods: A data envelopment analysis (DEA) variable returns to scale output-oriented model was used to evaluate technical efficiency in middle-income Asian countries. The input variables were current health expenditure per capita, the density of doctors, and the density of nurses and midwifery personnel. The output variables were health adjusted life expectancy (HALE) and the infant mortality rate (IMR). Myanmar may learn how to improve efficiency of its health care system through studying its efficient peers from DEA results. A review of relevant English language literature was used as a basis for informing a comparative analysis of the health systems of Myanmar and its efficient peers: Bangladesh and Sri Lanka.Results: Among the twenty-eight middle-income Asian countries studied, 39.3% of countries were technically efficient. Myanmar is one of the inefficient countries, and it should look at the health systems of its efficient peers, Bangladesh and Sri Lanka, to make its health system technically more efficient.Conclusions: The results of this study suggested that countries with inefficient health systems can improve their health outcomes without increasing their health care resources. As DEA measures efficiency only, future studies should take into account equity to assess comprehensive health system performance.
Health care provided to recent asylum-seeking and non-asylum-seeking pediatric patients in 2016 and 2017 at a Swiss tertiary hospital - a retrospective study
Authors: Brandenberger Julia , Pohl Christian , Vogt Florian , Tylleskär Thorkild , Ritz Nicole 
Published: December 2020

Abstract
BackgroundAsylum-seeking children represent an increasing and vulnerable group of patients whose health needs are largely unmet. Data on the health care provision to asylum-seeking children in European contexts is scarce. In this study we compare the health care provided to recent asylum-seeking and non-asylum-seeking children at a Swiss tertiary hospital.MethodsWe performed a cross-sectional retrospective study in a pediatric tertiary care hospital in Basel, Switzerland. All patients and visits from January 2016 to December 2017 were identified, using administrative and medical electronic health records. The asylum-seeking status was systematically assessed and the patients were allocated accordingly in the two study groups.Results A total of 202,316 visits by 55,789 patients were included, of which asylum-seeking patients accounted for 1674 (1%) visits by 439 (1%) individuals. The emergency department recorded the highest number of visits in both groups with a lower proportion in asylum-seeking compared to non-asylum-seeking children: 19% (317/1674) and 32% (64,315/200,642) respectively. The median number of visits per patient was 1 (IQR 1-2) in the asylum-seeking and 2 (IQR 1-4) in the non-asylum-seeking children. Hospital admissions were more common in asylum-seeking compared to non-asylum-seeking patients with 11% (184/1674) and 7% (14,692/200,642). Frequent visits (>15 visits per patient) accounted for 48% (807/1674) of total visits in asylum-seeking and 25% (49,886/200,642) of total visits in non-asylum-seeking patients. ConclusionsHospital visits by asylum-seeking children represented a small proportion of all visits. The emergency department had the highest number of visits in all patients but was less frequently used by asylum-seeking children. Frequent care suggests that asylum-seeking patients also present with more complex diseases. Further studies are needed, focusing on asylum-seeking children with medical complexity.
Glide Path Enlargement of Curved Molar Canals Using HyFlex EDM Glide Path File versus PathFile: A Comparative Study of Preparation Time and Postoperative Pain
Authors: Han Yi , Hou Xiao-Mei 
Published: December 2020

Abstract
Background: This randomized clinical trial aimed to compare the preparation time and severity of postoperative pain between the HyFlex Electric Discharge Machine (EDM) Glide Path File (GPF) and PathFile. Methods: Eighty patients whose molar teeth had at least one severely curved canal were treated by the same specialist. After access cavity preparation, the patients were randomly assigned to receive glide path enlargement with either HyFlex EDM GPF or PathFile. ProTaper Next X1 and X2 files were used to prepare the canals. The time of preparation was assessed and the severity of postoperative pain over the next 7 days was recorded. The preparation time and the postoperative pain scores were compared using one-way analysis of variance (ANOVA) (P ≤ 0.05).Results: Glide path enlargement time was significantly shorter with HyFlex EDM GPF (27.828 ± 2.345 sec) than with PathFile (48.942 ± 2.864 sec) (P < 0.001). The highest postoperative pain score was recorded on the first day and the pain decreased over time in both groups. HyFlex EDM GPF group patients reported significantly less postoperative pain than PathFile group patients overall (P < 0.05). Conclusion: Postoperative pain and glide path preparation time could be reduced by using the HyFlex EDM GPF system.Trial registration: PKUSSNCT, PKUSSNCT-17B12, Registered 24 October 2017