bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intravenous Zanamivir: A Viable Option for Critically Ill Patients With Influenza
Authors: Slain Douglas 
Published: October 2020

Objective: To review the pharmacology, clinical trial data, and clinical implications for the intravenous formulation of zanamivir. Data Sources: MEDLINE, PubMed, EMBASE, and Google Scholar were searched during November 2019 to July 2020. Search terms zanamivir and neuraminidase inhibitor were used. Study Selection and Data Extraction: All human trials and major reports from compassionate use programs with the intravenous zanamivir (IVZ) formulation were assessed and reviewed here. Data Synthesis: IVZ was found to be similar but not superior to oral oseltamivir in hospitalized patients when studied in populations with very low baseline oseltamivir resistance. IVZ provides an effective alternative for critically ill patients when oral antiviral therapy is not preferred or when oseltamivir resistance is increased. Relevance to Patient Care and Clinical Practice: IVZ was recently authorized for use by the European Medicines Agency, and it is eligible for consideration in emergency use protocols and US stockpile inclusion. It will be of particular interest in critically ill patients especially during influenza seasons with appreciable oseltamivir and peramivir resistance. Conclusions: The available information suggests that the intravenous formulation of zanamivir offers a viable alternative treatment for critically ill patients with influenza, especially when resistance to other agents is present.
Breast Microinvasive Carcinoma With Different Morphologies: Analysis of Clinicopathologic Features of 121 Cases
Authors: Feng ChangYin , Zheng QiaoLing , Yang YingHong 
Published: October 2020

Purpose: To investigate the clinicopathological features of patients with breast microinvasive carcinoma (MI). Methods: The clinical data of 121 cases with breast MI were retrospectively collected. The whole tumor in each case was stained with hematoxylin and eosin (H&E) for pathological evaluation. The relationships among size of tumor, histological grade, tumor-infiltrating lymphocytes (TILs), the number of MIs, type of MI, and lymph node metastasis were analyzed. Results: It was revealed that 86% of the cases had high-grade ductal carcinoma in situ (DCIS) and 63.6% had multiple MIs. The larger size of the tumors, the higher the grade of DCIS, the more the number of MIs; 3.3% of cases had rich TILs (lymphocyte/stroma > 30%) in the DCIS, and 26.5% had rich TILs in MIs. The type A of MIs is characterized by single cells and small clusters of solid cells. Tumor cells in type B of MIs can form glandular ducts. Formal grading of microinvasive is challenging/impossible due to its limited size precluding a representative mitotic count. But nuclear grade and tubule (differentiation) grades can be reported. In addition, 72.7% of cases had type A of MIs and 27.3% of cases had type B of MIs. Type B was found to be highly accompanied by moderate-grade DCIS. Only 6.6% of patients with MI had lymph node metastasis, which was mainly related to MIs with less TILs. Conclusion: Breast MI is easy to occur in high-grade DCIS, and multiple infiltration foci may be observed in case with tumor size of higher than 3.5 cm. Microinvasive carcinoma with poor TILs maybe a risk factor for lymph node metastasis in patient with DCIS-Mi.
Virtual care to increase military medical centre capacity in the primary health care setting: A prospective self-controlled pilot study of symptoms collection and telemedicine
Authors: Tan Nan-Guang , Yang Lily Wei-Yun , Tan Mark Zhong-Wei , Chng Jeremiah , Tan Marcus Hong-Tat , Tan Clive 
Published: October 2020

Introduction The Singapore Armed Forces (SAF) recognises the potential benefits and looks to harnessing telemedicine for primary health care services. In this prospective self-controlled pilot study, we aimed to evaluate the safety, efficiency and user satisfaction outcomes of virtual care (VC) at a military medical centre. Methods Out of 320 patients seen during the study period, 28 were enrolled in this study and underwent on-premises VC, comprising digital symptoms collection and telemedicine in addition to the usual in-person physician consultation. Safety outcomes were measured based on the diagnostic concordance between physicians. Efficiency was measured based on consultation times, and user satisfaction was evaluated using a standard questionnaire. Results There was a higher caseload of both upper respiratory infections and dermatological conditions in our population, in which telemedicine performed well. In terms of safety, telemedicine achieved a mean diagnostic concordance of 92.8% compared to in-person consultations. In terms of efficiency, consultation times were 26.2% – or 2 minutes and 15 seconds – shorter on average with telemedicine ( p = 0.0488). User satisfaction was favourable, with 85.5% of patients satisfied with the VC experience. Discussion This study has been invaluable in showing that on-premises telemedicine is a safe, efficient and effective means to extend and increase our surge capacity for primary health care. Our results have given us reasonable confidence to explore a larger-scale implementation in our network of military medical centres in the future.
Starman or Sterrenman: An acquisitional perspective on the social meaning of English in Flanders
Authors: Zenner Eline , Rosseel Laura , Speelman Dirk 
Published: October 2020

Objective: This paper reports on an experiment conducted with 174 Flemish children in three age groups, namely first, third and fifth year of primary school, aiming to assess the social meaning children associate with English-sourced lexemes in Belgian Dutch. Method: The children were presented with 2 versions of a cartoon hero developed specifically for this study: Sterrenman, who only uses Dutch words, and Starman, who uses English alternatives for 17 content words in the cartoon’s script. Relying on extensive pretesting, we adapted standard designs and instrumentation from social psychology (the matched guise technique) and language acquisition research to gauge the children’s appreciation of the two heroes, their understanding of the English and Dutch vocabulary used in the script, and their level of language awareness. Findings: The key findings are: rather than an incremental increase in favorable social meaning for English from the first to the third age group under scrutiny, we see a decline of the prestige of Dutch in the oldest age group; the children’s level of language awareness, receptive vocabulary knowledge and age seem associated with their overall appreciation of Sterrenman and Starman; working with children from various age groups inevitably entails methodological risks. Originality: This is a first and hence exploratory study on the acquisition of the social meaning of English lexemes by EL2 children and their ensuing progressing bilingualism. Implications: Overall, the study helps us contribute to both the recent socio-pragmatic turn in anglicism research and to the upcoming field of developmental sociolinguistics, revealing the transition points in children’s acquisition of the social meaning of contact-induced variation and change.
Automated Intensity Modulated Radiation Therapy Treatment Planning for Cervical Cancer Based on Convolution Neural Network
Authors: Jihong Chen , Penggang Bai , Xiuchun Zhang , Kaiqiang Chen , Wenjuan Chen , Yitao Dai , Jiewei Qian , Kerun Quan , Jing Zhong , Tianming Wu 
Published: October 2020

Purpose: To develop and evaluate an automatic intensity-modulated radiation therapy (IMRT) program for cervical cancer, including a Convolution Neural Network (CNN)-based prediction model and an automated optimization strategy. Methods: A CNN deep learning model was trained to predict a patient-specify set of IMRT objectives based on overlap volume histograms (OVH) and high-quality plan of previous patients. A total of 140 cervical cancer patients were enrolled in this study, including 100 patients in the training set, 20 patients in the validation set and 20 patients in the testing set. The input of this model was OVH data and the output were values of IMRT plan objectives. For patients in the testing set, the set of planning objectives were predicted by the CNN model and used to automatically generate IMRT plans. Meanwhile, manual plans of these patients were generated by 1 beginner planner and 1 senior planner respectively. Finally, dose distribution, dosimetric parameters and planning time were analyzed. In addition, the 3 types of plans were blinded compared and ranked by an experienced oncologist. Results: There were almost no statistically differences among these 3 types of plans in target coverage and dose conformity. Dose homogeneity were slightly decreased while the average dose and parameters for most organs-at-risk (OARs) were decreased in automatic plans. Especially in comparison with manual plans by the beginner planner, V40 of bladder and rectum decreased 6.3% and 12.3%, while mean dose of rectum and marrow were 1.1 Gy and 1.8 Gy lower with automatic plans (either P < 0.017). In the blinded comparison, automatic plans were chosen as best plan in 14 cases. Conclusions: For cervical cancer, automatic IMRT plans optimized from the CNN generated objectives have superior dose sparing without compromising of target dose. It significantly reduced the planning time.
LncRNA NORAD as a Novel Predictor of Lymph Node Metastasis and Prognosis in Solid Tumors: A Systematic Review and Meta-Analysis
Authors: Ye Tao , Ye Zhangqun 
Published: October 2020

Background: Non-coding RNA-activated by DNA damage (NORAD), a novel identified lncRNA, was found to be aberrantly expressed in various types of cancer. This meta-analysis was performed to evaluate the value of lncRNA NORAD as a prognostic biomarker in human cancers. Methods: We searched PubMed, Web of Science, PMC, and Embase databases thoroughly for eligible literatures. Studies which explored the relationship of lncRNA NORAD expression with clinical outcomes in human cancers were included in our meta-analysis. Review Manager version 5.3 and Stata SE 12.0 were used to perform the data analyses. Results: Our meta-analysis results indicated that cancer patients with high lncRNA NORAD expression tended to have unfavorable overall survival (OS) (HR = 1.67; 95% CI, 1.44-1.95; P < 0.00001). Moreover, elevated lncRNA NORAD expression showed a significant relationship with poor tumor grade (OR = 1.61; 95% CI, 1.01-2.56; P = 0.05) and more lymph node metastasis (LNM) (OR = 2.66; 95% CI, 1.60-4.43; P = 0.0002). Conclusions: LncRNA NORAD could serve as a valuable biomarker to predict poor prognosis and LNM in various human tumors.
The development and testing of a co-designed distance learning programme to improve the knowledge of trained auxiliary nurse midwives in normal midwifery practice in central India
Authors: Foss Mary , le May with Andrée , Gobbi Mary 
Published: October 2020

Background In the Indian State of Madhya Pradesh maternal health is poor, and women’s social status is low. For some women, autonomy and decision-making within the family is limited as they seek medical treatment through their husband or father-in-law. The then state government identified a need to strengthen midwifery care given by auxiliary nurse midwives to improve maternal and neonatal health.>* Methods This cross-cultural, two phase study was designed in partnership with an Indian non-governmental organisation, utilising Elliot’s action research model within the paradigm of critical theory. Phase 1 investigated the then current situation and established a potential solution to strengthening midwifery practice within Madhya Pradesh. This comprised an educational approach using a specifically designed self-directed distance learning programme focussing on normal pregnancy and childbirth. The distance learning programme was a hard copy workbook supported by a multimedia resource informed by the Rowntree and Analysis Design Development Implementation Evaluation models of educational material development. Phase 2 involved the use and evaluation of the distance learning programme with an initial primary group sample of 28 comprising auxiliary nurse midwives (22), lady health visitors (4) and staff nurses (2) in Madhya Pradesh. Fourteen auxiliary nurse midwife participants completed knowledge tests using a pre- and post-programme multiple choice question paper. This primary group negotiated a 3-day workshop to cover identified gaps within their original 12-week study period. Nineteen additional auxiliary nurse midwife participants joined this workshop (group 2). Results The multiple choice question test results indicated that the first group had poor knowledge of the normal process of pregnancy and childbirth. After the workshop, they marginally improved their personal performance scores. The second group demonstrated greater change, which suggests that coupling self-directed guided study material with an enabling, face-to-face environment can be successful. Conclusions Distance learning among auxiliary nurse midwives in central India may be enhanced when accompanied by face-to-face workshops. Partnership working – at organisational, team and individual levels, was a crucial, and empowering, component of this cross-cultural action research study. Both points have relevance for others undertaking similar studies.
Laparotomy for duodenal obstruction, caused by a renal haematoma after extracorporeal shockwave lithotripsy
Authors: Saunders Rebecca 
Published: October 2020

Extracorporeal shockwave lithotripsy is a widely used, acceptable and common first line treatment for non-conservatively managed renal and ureteric stone disease. Although considered a relatively safe non invasive treatment for renal and ureteric stones, can carry with it significant associated morbiditiy especially in high risk patients, such as those who are anticoagulated. Renal haematomas are not an uncommon finding after extracorporeal shockwave lithotripsy, however, fewer than 1% of patients presenting with a symptomatic renal haematoma require intervention in the form of urgent embolisation under interventional radiology, or emergency nephrectomy. Rare cases of splenic and hepatic haematomas have been reported and rarer still cases of gastro-intestinal perforation following extracorporeal shockwave lithotripsy. We report a case with a significant renal haematoma needing emergency embolisation of the renal artery, and subsequent development of duodenal obstruction from direct haematoma compression requiring a laparotomy and intended duodenal jejunal bypass. Level of evidence: 5
Comparing Return to Sports After Patellofemoral and Knee Arthroplasty in an Age- and Sex-Matched Cohort
Authors: Schneider Brandon L. , Ling Daphne I. , Kleebad Laura J. , Strickland Sabrina , Pearle Andrew 
Published: October 2020

Background: Return to sports is an important outcome in ensuring patient satisfaction after knee-replacement surgery. However, few studies have directly compared unicompartmental knee arthroplasty (UKA), total knee arthroplasty (TKA), and patellofemoral arthroplasty (PFA). Hypothesis: TKA will result in lower rates of return to sports than either UKA and PFA due to increased complexity and invasiveness. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent UKA, TKA, or PFA with 1 to 2 years of follow-up were sent a questionnaire regarding return to sports, satisfaction with return to sports, pain, the University of California, Los Angeles activity scale, and the High Activity Arthroplasty Score (HAAS). The patients who underwent either TKA or UKA were matched 2:1 with regard to age and sex to patients who underwent PFA. Differences were compared using analysis of variance, t tests, and chi-square tests. Results: A total of 202 patients were eligible. After matching, the final cohort consisted of 23 PFA patients, 46 UKA patients, and 46 TKA patients. The majority of patients were female (87%), and the mean ± SD age was 56 ± 9.1 years. The UKA group had higher HAAS values than the TKA group pre- and postoperatively (9.9 vs 7.1 [ P = .001] and 12.4 vs 9.5 [ P < .001], respectively). Patients with UKA had higher rates of return to sports after surgery than those with TKA or PFA (UKA, 80.5%; TKA, 71.7%; PFA, 69.5%; P = 0.08). In addition, the UKA group had the highest satisfaction with this outcome. Improvement between pre- and postoperative scores was similar in all 3 groups. Conclusion: Patients who underwent UKA reported better activity scores and return-to-sports rates than patients who had TKA and PFA. No differences were found in improvement after surgery, suggesting that preoperative differences were reflected postoperatively. These findings inform shared decision making and can help to manage patient expectations after surgery.
Whole-genome sequencing reveals potent therapeutic strategy for monomorphic epitheliotropic intestinal T-cell lymphoma
Authors: Huang Dachuan , Lim Jing Quan , Cheah Daryl Ming Zhe , Kahliab Khalilatul Hanisah Binte Mohd , Laurensia Yurike , Pang Jane Wan Lu , Wong Esther Kam Yin , Chia Burton Kuan Hui , Goh Jasmine , Zhang Xiyun , Chan Jason Yongsheng , Chow Edward Kai-Hua , Tan Soo Yong , Lim Soon Thye , Ong Choon Kiat 
Published: October 2020

Key Points
Whole genomic and transcriptomic analyses of MEITL revealed multiple potential therapeutic targets. Synergistic effects of pimozide and romidepsin are shown in a well-characterized MEITL PDX model.
Updated guidance on the management of COVID-19: from an American Thoracic Society/European Respiratory Society coordinated International Task Force (29 July 2020)
Authors: Bai Chunxue , Chotirmall Sanjay H. , Rello Jordi , Alba George A. , Ginns Leo C. , Krishnan Jerry A. , Rogers Robert , Bendstrup Elisabeth , Burgel Pierre-Regis , Chalmers James D. , Chua Abigail , Crothers Kristina A. , Duggal Abhijit , Kim Yeon Wook , Laffey John G. , Luna Carlos M. , Niederman Michael S. , Raghu Ganesh , Ramirez Julio A. , Riera Jordi , Roca Oriol , Tamae-Kakazu Maximiliano , Torres Antoni , Watkins Richard R. , Barrecheguren Miriam , Belliato Mirko , Chami Hassan A. , Chen Rongchang , Cortes-Puentes Gustavo A. , Delacruz Charles , Hayes Margaret M. , Heunks Leo M.A. , Holets Steven R. , Hough Catherine L. , Jagpal Sugeet , Jeon Kyeongman , Johkoh Takeshi , Lee May M. , Liebler Janice , McElvaney Gerry N. , Moskowitz Ari , Oeckler Richard A. , Ojanguren Iñigo , O'Regan Anthony , Pletz Mathias W. , Rhee Chin Kook , Schultz Marcus J. , Storti Enrico , Strange Charlie , Thomson Carey C. , Torriani Francesca J. , Wang Xun , Wuyts Wim , Xu Tao , Yang Dawei , Zhang Ziqiang , Wilson Kevin C. 
Published: October 2020

BackgroundCoronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome-coronavirus-2. Consensus suggestions can standardise care, thereby improving outcomes and facilitating future research.MethodsAn International Task Force was composed and agreement regarding courses of action was measured using the Convergence of Opinion on Recommendations and Evidence (CORE) process. 70% agreement was necessary to make a consensus suggestion.ResultsThe Task Force made consensus suggestions to treat patients with acute COVID-19 pneumonia with remdesivir and dexamethasone but suggested against hydroxychloroquine except in the context of a clinical trial; these are revisions of prior suggestions resulting from the interim publication of several randomised trials. It also suggested that COVID-19 patients with a venous thromboembolic event be treated with therapeutic anticoagulant therapy for 3 months. The Task Force was unable to reach sufficient agreement to yield consensus suggestions for the post-hospital care of COVID-19 survivors. The Task Force fell one vote shy of suggesting routine screening for depression, anxiety and post-traumatic stress disorder.ConclusionsThe Task Force addressed questions related to pharmacotherapy in patients with COVID-19 and the post-hospital care of survivors, yielding several consensus suggestions. Management options for which there is insufficient agreement to formulate a suggestion represent research priorities.
An evaluation of rural–urban disparities in treatment outcomes for obstructive sleep apnoea: study protocol for a prospective cohort study
Authors: Corrigan Jennifer , Ogah Imhokhai , Ip-Buting Ada , Sharpe Heather , Laratta Cheryl R. , Peller Peter , Tsai Willis H. , Pendharkar Sachin R. 
Published: October 2020

BackgroundObstructive sleep apnoea (OSA) is a common and treatable chronic condition that is associated with significant morbidity and economic cost. Geography is increasingly being recognised as a barrier to diagnosis and treatment of many chronic diseases; however, no study to date has investigated the impact of place of residence on health outcomes in OSA.ObjectiveThe purpose of this study is to determine whether treatment outcomes for patients initiating continuous positive airway pressure (CPAP) for OSA differ between those who live in urbanversusrural settings.MethodsA prospective cohort design will be used. Participants will be recruited through community-based CPAP providers and assigned to either the rural or urban cohort based on residential postal code. The primary outcome will be the difference in nightly hours of CPAP use between the two groups, measured 3 months after initiation of therapy. Secondary outcomes will include symptoms, quality of life, patient satisfaction and patient-borne costs.Anticipated resultsThis study will determine whether there are differences in CPAP adherence or patient-reported outcomes between rural and urban patients with OSA. These results will highlight potential challenges with providing OSA care in rural populations and may inform health interventions to reduce urban–rural inequities.
Alteration in angiotensin-converting enzyme 2 by PM1during the development of emphysema in rats
Authors: Chuang Hsiao-Chi , Chen Yi-Ying , Hsiao Ta-Chih , Chou Hsiu-Chu , Kuo Han-Pin , Feng Po-Hao , Ho Shu-Chuan , Chen Jen-Kun , Chuang Kai-Jen , Lee Kang-Yun 
Published: October 2020

IntroductionAngiotensin-converting enzyme 2 (ACE2) provides an adhesion site for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patients with COPD could have severe outcomes after SARS-CoV-2 infection. The objective of this study was to investigate ACE2 regulation by air pollution during the development of COPD.MethodsSprague Dawley rats were exposed to unconcentrated traffic-related air pollution for 3 and 6 months. We examined lung injury markers, oxidative stress, inflammation, emphysema, ACE2 and angiotensin II receptor type 1 (AT1) and 2 (AT2) in the lungs after exposure.ResultsLung injury occurred due to an increase in permeability and lactate dehydrogenase cytotoxicity was observed after 6 months of exposure to fine particulate matter of <1 μm in aerodynamic diameter (PM1). An α1-antitrypsin deficiency and neutrophil elastase production with emphysema development were observed after 6 months of PM1exposure. 8-isoprostane and interleukin-6 were increased after 3 and 6 months of PM1exposure. Caspase-3 was increased after exposure to PM1for 6 months. Upregulation of ACE2 was found after 3 months of PM1exposure; however, ACE2 had decreased by 6 months of PM1exposure. AT1 and AT2 had significantly decreased after exposure to PM1for 6 months. Furthermore, smooth muscle hypertrophy had occurred after 6 months of PM1exposure.ConclusionsIn conclusion, short-term exposure to PM1increased the ACE2 overexpression in lungs. Long-term exposure to PM1decreased the ACE2 overexpression in emphysema. Air pollution may be a risk for SARS-CoV-2 adhesion during the development of COPD.