bluuebunny/crossref_metadata_2025_split huggingface dataset:
GlideScope® versus C-MAC®(D) videolaryngoscope versus Macintosh laryngoscope for double lumen endotracheal intubation in patients with predicted normal airways: a randomized, controlled, prospective trial
Authors: Huang Ping , Zhou Renlong , Lu Zhixing , Hang Yannan , Wang Shanjuan , Huang Zhenling 
Published: March 2020

Abstract
Background The double lumen endotracheal tube (DLT) is the most widely-used device for single lung ventilation in current thoracic anesthesia practice. In recent years, the routine application of the videolaryngoscope for single lumen endotracheal intubation has increased; nevertheless there are few studies of the use of the videolaryngoscope for DLT. We wondered whether there were benefits to using the videolaryngoscope for DLT placement in patients with predicted normal airways. Therefore, this study was designed to compare the performances of the GlideScope ® , the C-MAC ® (D) videolaryngoscope and the Macintosh laryngoscope in DLT intubation. Methods This was a randomized, controlled, prospective study. We randomly allocated 90 adult patients with predicted normal airways into three groups. All patients underwent routine anesthesia using different laryngoscopes according to group allocation. We compared DLT insertion times, first-pass success rates, numerical rating scales (NRS) of DLT delivery and DLT insertion, Cormack-Lehane degrees (C/L), hemodynamic changes and incidences of intubation complications. All outcomes were analyzed using SPSS13.0. Results Compared with the GlideScope, the Macintosh gave shorter times for DLT insertion (median: 96 (IQR: 51 [min–max: 62–376] s vs 73 (26 [48–419] s, p = 0.003); however, there was no difference between the Macintosh and C-MAC(D) (p = 0.610). The Macintosh had a significantly higher successful first attempt rate than did the GlideScope or C-MAC(D) (p = 0.001, p = 0.028, respectively). NRS of DLT delivery and insertion were significantly lower in the Macintosh than in the others (p <0.001). However, the C/L degree in the Macintosh was significantly higher than in the others (p <0.001). The incidences of oral bleeding, hoarseness, sore throat and dental trauma were low in all groups (p >0.05). There were no significant differences in DLT misplacement, fiberoptic time or hemodynamic changes among the groups. Conclusions Compared with the Macintosh laryngoscope, the GlideScope ® and C-MAC ® (D) videolaryngoscopes may not be recommended as the first choice for routine DLT intubation in patients with predicted normal airways.
Utilization of clinical practice guideline on antimicrobial in China: An exploratory survey on multilevel determinants
Authors: Deng Qingwen , Liu Wenbin 
Published: March 2020

Abstract
Background: Nowadays, irrational use of antimicrobials has threatened public health. It’s necessary to expand the use of clinical practice guideline (CPG) on antimicrobial for facilitating the proper use of antimicrobial. However, the utilization status of CPG on antimicrobial and the influencing factors, especially the ones at the organizational level, remain largely unknown.
Methods: A cross-sectional questionnaire survey was conducted on a sample among physicians from 16 public hospitals in the eastern, central and western parts of China. A multilevel regression model was employed to examine factors associated with physicians’ utilization of CPG on antimicrobial.
Results: A total of 815 physicians were included in this study. About 80% of the surveyed physicians reported their adherence to the CPG on antimicrobial. Dimensions of “subjective norm”, “perceived risk” and “behavioral intention” from the domain of physician belief, a dimension of “ease of use” from the domain of CPG traits, and dimensions of “top management support” and “organization & implementation” from the domain of hospital practice were significantly associated with physicians’ utilization of CPG on antimicrobial. And except for working department, most demographics characteristics of the physician were not found to be significantly related to the CPG use. In addition, it also showed that region is a significant factor affecting physicians’ CPG use.
Conclusions: This study depicted the current status of CPG on antimicrobial and comprehensively identified its potential determinants not only from the three domains at the individual level, such as physician belief, but also from the location region at the organizational level. The results will provide a direct reference for the implementation of CPG on antimicrobial.
Comparison of the clinical outcomes of percutaneous vertebroplasty vs. kyphoplasty for the treatment of osteoporotic Kümmell’s disease:a prospective cohort study
Authors: Chang Jian-Zhong , Bei Ming-Jian , Shu Dong-Ping , Sun Cheng-Jun , Chen Ji-Bin , Xiao Ya-Ping 
Published: March 2020

Abstract
Background Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are widely used in the treatment of Kümmell's disease. The purpose of this article is to investigate the clinical efficacy of PVP and PKP for Kümmell's disease. Methods The clinical data that 56 cases of Kümmell's disease treated with either PVP (28 cases) or PKP (28 cases) from December 2015 to December 2017 were prospectively analyzed. Gender, age, course of disease, injury segment, bone mineral density (BMD), visual analogue scale (VAS), Oswestry disability index (ODI), imaging measurement indexes before surgery between the two groups showed no significant difference (all P>0.05). The bone cement leakage rate, bone cement injection amount, operation time, VAS, ODI, the rate of vertebral compression, correction rate of kyphosis and refracture rate of adjacent vertebra in 2 years were compared between the two groups to calculate clinical efficacy. Results The two groups were followed up for 24-48 months. There was no significant difference in the follow-up time, amount of bone cement injected, incidence of bone cement leakage and refracture rate of adjacent vertebrae between the two groups (all P> 0.05). The operation time, intraoperative blood loss and fluoroscopy times of the PVP group were significantly lower than those of the PKP group (all P = 0.000). VAS score and ODI of the two groups were significantly lower at 1 day, 1 year and 2 years after surgery than before surgery (all P <0.05), but there was not statistically significant difference between the two groups at each time point after surgery (all P> 0.05). The rate of vertebral compression and kyphosis correction in the two groups were significantly corrected (P <0.05, respectively) and decreased significantly with time (all P <0.05), But there was not significant difference between the two groups at any time point (all P> 0.05). Conclusion Both PVP and PKP can achieve similar effects in the treatment of Kümmell's disease. Because the cost, operation time, blood loss, radiation exposure and surgical procedure of PVP are less than those of PKP, PVP has more clinical priority value.
Unsafe medication administration experience in nursing practice at Public Hospitals of Harari region, eastern Ethiopia: Phenomenological Study.
Authors: Fekadu Gelana , Oljira Amanuel , Geda Biftu , Egata Gudina 
Published: March 2020

Abstract
Background: The unsafe medication administration is one of the most medication related problems which causes harm and death to the patients and threatens the healthcare system. Given medication administration is predominantly the role of nurses. This study was aimed to explore the nurse’s experience of unsafe medication administration at public hospitals in Harari region, eastern Ethiopia. Methods: A phenomenological study design was conducted and the data were collected from 11 nurses from March 1 to March 31, 2019. The tape recorder and note taking was used to collect the data by in-depth interviews and key informant interviews. Open code software version 3.4 was used to write memos, coding and categorizing under their inductive thematic areas. Thematic analysis method were used.Result: The study had explored nurse’s experience and contributing factors for unsafe medication administration. Nurses have reported that they have ever experienced unsafe medication administration like, wrong time, medication, patient and self-stick injury during their practice. i) Organizational factors: inadequate resource, lack of clear policy and job description, lack of supervision and poor collaboration among staffs. The identified themes were, ii) Precondition challenges: expensive medication, frequently changed and too much prescription for a single patient, new medications with limited information. iii) Individual nurses factor: work absenteeism, lack of training and knowledge gap.Conclusion: The organizational culture, precondition challenges and individual nurse’s factors was found to be a major factors linked to unsafe medication administration practice. So tailored intervention is needed to reduce the unsafe medication administration in nursing practice.
Bioprospecting the antimicrobial, antibiofilm and antiproliferative activity of Symplocos racemosa Roxb. Bark phytoconstituents along with their biosafety evaluation and detection of antimicrobial components by GC-MS
Authors: Sood Henna , Kumar Yashwant , Gupta Vipan Kumar , Arora Daljit Singh 
Published: March 2020

Abstract
Background: The increased occurrence of the antibiotic resistance has added up to the misery of mankind. There is an immediate need to search alternatives and Symplocos racemosa is one such potent medicinal plant . The aim of the study was to explore various activities of its phytoconstituents, confirm their biosafety and identify the active components.Methods: The ethylacetate extract and the major group of phytoconstituents were tested for minimal inhibitory concentration, viable cell count studies, Post antibiotic effect, activity against 34 multi-drug resistant microorganisms, anti-biofilm and anti proliferative potential. The biosafety was evaluated by Ames and MTT assay. In vivo safety of flavonoids was determined by acute oral toxicity test using Swiss albino mice. The antimicrobial components in flavonoids were also identified by using TLC and GC-MS analysis.Results: Ethyl acetate was the best organic extractant. The phytochemical analyses revealed the presence of flavonoids, cardiac glycosides, saponins, tannins, triterpenes and Phytosterols. Flavonoids exhibited the highest antimicrobial potential whereas tannins, triterpenes and phytosterols were completely inactive. Their Minimum Inhibitory Concentration ranged from 0.5-10 mg/ml; exhibited a bactericidal mode of action and a prolonged post antibiotic effect. The phytoconstituents displayed a significant antibiofilm potential by inhibiting the initial cell attachment, disrupting the pre-formed biofilms and reducing the metabolic activity of biofilms. The phytoconstituents were significantly active against the drug-resistant strains of E.coli , MRSA and Salmonella spp. Flavonoids showed significant cytotoxic effect against the RD, L20B and Hep2 cell lines (IC 50 361-494 µg/ml). All the test extracts were biosafe as depicted by the Ames test, MTT assay. Also, flavonoids did not induce any abnormality in biochemical parameters and Organs’ histopathology of the Swiss albino mice during the in vivo acute oral toxicity studies. The flavonoids were resolve into 4 bands (S1-S4) using TLC, where S3 was the most active and its GC-MS analysis revealed the presence of Bicyclo [2.2.1]heptan-2-one,1,7,7-trimethyl-, (1S)- at an RT of 11.14 as the major compound.Conclusions: These findings suggest that Symplocos racemosa bark could be a potential source of antimicrobial metabolites, which could substantially contribute to the arsenal of existing natural drugs for combating the antimicrobial resistance.
Moral-uncertainty-distress related to Advance Directives: a qualitative study
Authors: Ribeiro Uiara Raiana Vargas de Castro Oliveira , Swiech Liliane Mayumi , Souza Waldir , Guirro Úrsula Bueno do Prado , Corradi-Perini Carla 
Published: March 2020

Abstract
Background: moral-uncertainty-distress (MUD) is defined as moral distress related to moral conflict about best course of action, impacting the clinical decision making process in morally complex situations. This study aims to correlate physician’s perception about advance directives (AD) with presence or absence of MUD, identifying the impact that AD promotes on clinical decision making.Methods: this is a qualitative, cross-sectional, exploratory study. Data was collected through semi-structured interviews with physicians of a hospital in southern Brazil. Interviews content was submitted to categorization analysis content technique by Laurence Bardin.Results: eight physicians were interviewed. The analysis contend identified two categories: (1) AD as a morally challenging element and (2) recognition of AD as instruments that exercises patient’s autonomy. In the first, paternalistic attitude; insecurities in uncertain prognoses; uncertainty about patient values and motivations to write the document; and little previous knowledge about AD, were elements of MUD for physicians. In second category, autonomy in AD was seen as prima facie principle and as shared autonomy.Conclusion: although AD were comprehended as instruments of exercise of patient’s autonomy by the participants, some elements were morally challenging for them, which can be a source of MUD to physician during decision making process.
Costs analysis of Staged Versus Simultaneous Bilateral Total Knee and Hip Arthroplasty: a university affiliated hospital survey of 1579 Chinese patients
Authors: Hou Ji-Fei , hu Chuan , Zhang Yun , Liu Yan-Zheng , Zhang Chi , Li Jing 
Published: March 2020

Abstract
Background Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are required for many patients. No recent studies that concentrate on the costs for each of the payment items both for TKA and THA when comparing simultaneous bilateral procedures with staged arthroplasty. This study aimed to evaluate the medical costs, length of stay(LOS), blood transfusion, and in-hospital complications in patients undergoing simultaneous TKA or THA and staged TKA or THA. Methods A retrospective cohort study was conducted by analyzing 1,579 patients from a single institution. All patients who underwent primary bilateral TKA or THA from 2013 to 2018 were divided into three groups: TKA,THA and all patients. Then, we grouping simultaneous bilateral groups and staged bilateral groups in these three groups respectively. Finally, these two sub-groups(simultaneous bilateral groups and staged bilateral groups) were compared between the three groups(TKA, THA, and pooled groups). Results All categories of medical costs, except for materials fees which were higher in the simultaneous bilateral THA and pooled groups but with no statistical significance, were lower in the simultaneous TKA, THA and pooled simultaneous groups. The total average medical costs in simultaneous and staged bilateral TKA groups were $15,535.621and $16,747.192, p <0.001), respectively; THA groups were $15,046.210 and $16,126.808, ( p =0.003), respectively; pooled groups were $16,506.971and $15,467.561, ( p <0.001), respectively. All costs were presented in the United States dollar. The highest and lowest costs were materials fees and nursing care fees. No significant differences were found for five common co-morbidities and postoperative complications between the two sub-groups in three groups. The simultaneous groups had a shorter LOS, a higher incidence of blood transfusion than staged groups whether it is TKA groups or THA or pooled groups. Conclusions These results indicate that simultaneous bilateral TKA and THA with a shorter LOS is more economical than staged bilateral TKA and THA. Counts of complications were not affected by the choice for staged or simultaneous bilateral total arthroplasty. But blood transfusion was more prevalent in the simultaneous groups both for TKA and THA.
Resection outcomes for primary and local recurrent retroperitoneal liposarcoma patients
Authors: Yan Yang , Du Xiaohui , Xia Shaoyou , Li Songyan , Teng Da , Hu Shidong , Wang Yufeng , Li Rong 
Published: March 2020

Abstract
Aim: The clinical characteristics of primary retroperitoneal liposarcoma(PR RPLPS) and local recurrent retroperitoneal liposarcoma(LR RPLPS) cases were compared to determine related factors involved in postoperative survival.Methods: A total of 90 patients who underwent surgery between 2006 and 2013 were included in this study. Clinicopathological data that was prospectively gathered was analyzed to identify factors associated with overall survival and progression-free survival.Results: The PR cases showed a higher complete resection rate when compared to the LR group. The LR group showed a greater number that were poorly differentiated and highly malignant. More blood loss was observed in the LR compared to the PR group. Multivariate analysis suggested that blood loss and tumor grade were prognostic factors for OS and PFS of the PR group, but extent of resection was a prognostic factor only for OS. In the LR group, the extent of resection was a significant prognostic factor associated with OS, whereas tumor grade was associated with PFS.Conclusions: Complete surgical resection is the most important factor for the survival of RPLPS patients. Tumor grade is an independent prognostic factor for PFS. In PR RPLPS, poor tumor classification and increased intraoperative bleeding are associated with a poor prognosis.
Drug repurposing against MERS CoV and SARS-COV-2 PLpro in silico
Authors: Elfiky Abdo , Ibrahim Noha , Elshemey Wael 
Published: March 2020

Abstract
Aim: The Middle East Respiratory Syndrome coronavirus (MERS-CoV) and COVID-19 cause severe acute, deadly, pneumonia. Papain-like protease (PLpro), is HCoV cysteine protease encoded within the Non-Structural protein 3. Materials and Methods: Molecular docking is performed to test the binding performance of six protease inhibitors against MERS CoV and SARS-CoV-2 PLpro. Results: The compound, GRL-0667, shows the highest binding affinity to MERS CoV PLpro, while Grazoprevir shows the highest binding affinity against HCV NS3. Moreover, the interaction pattern in the case of HCV NS3 is the same as in the case of coronaviruses. Conclusion: The present study shows the ability of some anti-SARS CoV and anti-HCV NS3 drugs to inhibit MERS CoV PLpro, interestingly, including the newly emerged SARS-COV-2 PLpro.
Ethno-botanical study of traditional medicinal plants used to treat human and livestock ailments in Raya Alamata District, Northern Ethiopia
Authors: Sime Getachew , Hagos Abadi 
Published: March 2020

Abstract
Background

In Ethiopia, traditional medicine based mainly on medicinal plants, has been used for centuries for the treatment of human and animal health problems. The objective of this study was to document medicinal plants used to treat human and domestic animals ailments as well as the associate indigenous knowledge and conservation methods in Raya Alamata District in Northern Ethiopia.

Methods

Ethno-botanical data were collected through semi-structured interviews, guided field walks, group discussions, field observations, preference ranking, paired comparison and direct matrix. The data were analyzed by descriptive statistics, informant consensus factor, and various ranking methods.

Results

The results showed 47 medicinal plant species belonging to 44 genera and 31 families. The plants were used to treat 27 human and 8 livestock diseases. Among others, members of Fabaceae were leading in terms of the number of medicinal plant species composition, consisting of 9 species. Of these species, the majority (53.19%) grew naturally in the wild. Herbs took the lead in terms of the number of plants used in the preparation of remedies, constituting 46.81% of the species, followed by shrubs that instituted 27.66%. Leaves were the most commonly used plant part, constituting 41.94% of the total uses, followed by roots, constituting 20.97%. Dermal route of administration was the most commonly used route of administration (43.55%), followed by oral route of administration (38.71%). Direct matrix ranking showed Balanites aegyptiaca L. as the most preferred multipurpose species in the community. Paired ranking indicated that Aloe megalacantha Bak. as the most commonly used medicinal plants for healing external wounds. Agricultural activity for new agricultural lands became seriously threatened medicinal plant resources. Many of the local communities with traditional medicinal knowledge gave priority to the immediate use of medicinal plants than to the sustainable uses. Particularly, the collection method of plants or plant parts for medicinal use is mostly destructive.

Conclusion

local communities heavily depend on traditional medicinal plants and associated knowledge for treating human and livestock ailments. However, medicinal plants and the associated knowledge are eroding mainly due to agricultural expansion, deforestation and land degradation for seeking new agricultural lands and firewood, as well as the unsustainable practices of plant or plant part sampling for medicinal values. Thus, public awareness needs to be raised among local communities and all other stakeholders on sustainable utilization and management of medicinal plant resources and associated knowledge. On the top of that ex-situ and in-situ conservation measures in particular should be taken for the sustainable management of medicinal plants and the indigenous knowledge.
New protocol treatment of pseudo-syndactyly in the Epidermolysis Bullosa hand using the dermal regeneration template glove
Authors: Lembo Fedele , Parisi Domenico , Cecchino Liberato Roberto , Ciancio Francesco , Innocenti Alessandro , Portincasa Aurelio 
Published: March 2020

Abstract
BACKGROUNDː The Epidermolysis Bullosa (EB) is a rare congenital disease associated with blistering skin caused by minimal trauma. Because of its exposed position and its continued use in daily activities, the hand is constantly at risk of microtrauma and is therefore one of the organs most affected by the disease with highly disabling deformities that represents a challenging field in hand surgery practice.METHODSː The Authors present their experience in the microsurgical treatment of pseudosyndactylies comparing the classic dressing with vaseline gauze with our innovative “glove protocol” using a Dermal Regeneration Template. The endpoints analyzed were: healing times, hospital stay time, discomfort for the patient, free-recurrence interval, follow-up range and major complications.RESULTSː A total of 34 procedures were performed on 24 EB patients with hand deformities according to the proposed treatment strategy. We observed reduction of: hospital stay time, complete healing times, discomfort after dressings and average time to free recurrence.CONCLUSIONSː The microsurgical approach followed by our new protocol described in the study has been beneficial in providing consistent and successful long-term results for these patients.