bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined Use of Intravenous and Topical Tranexamic Acid Efficiently Reduce Blood Loss in Patients Undergoing 2-level lumbar fusion
Authors: Li Jianjiang , Wang Long , Bai Tao , Liu Yanlu , Huang Yifei 
Published: February 2020

Abstract
Purpose: The current study was conducted to assess the efficacy and safety of the intravenous (IV) administration combined with topical administration of tranexamic acid （TXA）in patients (aged over 60) scheduled for 2-level lumbar fusion surgery. Methods: 280 patients scheduled for 2-level lumbar fusion surgery were randomized into four groups, including an IV group, a local group, a combined group, and a control group. Patients in the combined group, in the IV group, in the topical group, and in the control group were administrated with 15 mg/kg of IV-TXA + 2 g TXA in local,15 mg/kg IV-TXA, 2 g TXA in local ,and 100 ml IV, respectively. The results of total blood loss (TBL) , maximum hemoglobin drop, the transfusion rate, and the number of allogeneic blood units were compared. Deep venous thrombosis (DVT) and pulmonary embolism (PE) events were monitored and recorded. Results: The TBL was 635.49 ± 143.60, 892.62 ± 166.85, 901.11 ± 186.25, and 1,225.11 ± 186.25 mL for the combined group, the IV group, the topical group, and the control group, respectively.(p = 0.015, p = 0.001 respectively).The average maximum hemoglobin drop in the four above groups was 2.18 ± 0.24, 2.80 ± 0.37, 2.40 ± 0.64 ，and 3.40 ± 1.32 g/dL, respectively. No PE event was reported during the follow-up. Although asymptomatic DVT events was reported by 1, 2, and 2 patients in the combined group, topical group, and control group, respectively, there is no intergroup difference. Conclusions: The combined use of TXA effectively reduced total blood loss and blood transfusion rate in patients aged over 60 scheduled for 2-level lumbar fusion, without increasing the incidence of DVT and PE formation. Keywords: Tranexamic acid, Total hip arthroplasty, Blood loss, Combined treatment
Quality of Life as a predictor of mortality in the general population: a systematic review and meta-analysis
Authors: Phyo Aung Zaw Zaw , Freak-Poli Rosanne , Craig Heather , Gasevic Danijela , Stocks Nigel , Gonzalez-Chica David A. , Ryan Joanne 
Published: February 2020

Abstract
Background: Quality of life (QoL) is multi-dimensional concept of an individual’ general well-being status in relation to their value, environment, cultural and social context in which they live. This study aimed to quantitatively synthesise available evidence on the association between QoL and mortality in the general population.Methods: An electronic search was conducted using three bibliographic databases, MEDLINE, EMBASE and PsycINFO. Inclusion criteria were studies that assessed QoL using standardized tools and examined mortality risk in a non-patient population. Qualitative data synthesis and meta-analyses using a random-effects model were performed.Results: Of 4,184 articles identified, 47 were eligible for inclusion, involving approximately 1,200,000 participants. Studies were highly heterogeneous in terms of QoL measures, population characteristics and data analysis. In total, 43 studies (91.5%) reported that better QoL was associated with lower mortality risk. The results of four meta-analyses indicated that higher health-related QoL (HRQoL) is associated with lower mortality risk, which was consistent for overall HRQoL (HR 0.633, 95% CI: 0.514 to 0.780), physical function (HR 0.987, 95% CI: 0.982 to 0.992), physical component score (OR 0.950, 95% CI: 0.935 to 0.965), and mental component score (OR 0.980, 95% CI: 0.969 to 0.992).Conclusion: These findings provide evidence that better QoL/HRQoL was associated with lower mortality risk. The utility of these measures in predicting mortality risk indicates that they should be considered further as potential screening tools in general clinical practice, beyond the traditional objective measures such as body mass index and the results of laboratory tests.
Experiences And Needs Concerning Health Related Information For Newly Arrived Refugees In Sweden
Authors: Mårtensson Lena , Lytsy Per , Westerling Ragnar , Wångdahl Josefin 
Published: February 2020

Abstract
Background Owing to communication challenges and a lack of knowledge about the health care system, refugees may be at risk of having limited health literacy, meaning that they will have problems in achieving, understanding, appraising and using health information or navigating in the health care system. The aim of this study was to explore experiences and needs concerning health related information for newly arrived refugees in Sweden. Methods A qualitative design with a focus group methodology was used. The qualitative content analysis was based on seven focus group discussions, including 28 Arabic and Somali speaking refugees. Results Four categories emerged. ‘Concrete instructions and explanations’ includes appreciation of knowledge about how to act when facing health problems. ‘Contextual knowledge’ comprises experienced needs of information about the health care system, about specific health risks and about rights in health issues. ‘A variation of sources’ describes suggestions as to where and how information should be given. ‘Enabling communication’ includes the wish for more awareness among professionals from a language and cultural point of view. Conclusion Concrete instructions and explanations are experienced as valuable and applicable. Additional information about health issues and the health care system is needed. Information concerning health should be spread by a variety of sources. Health literate health organizations are needed to meet the health challenges of refugees, including professionals that emphasize health literacy.
Effectiveness over 10 years (2004-2014) of the echinococcosis control progamme in China: Impact on humans and dogs population
Authors: Yu Qing , Han Shuai , Tian Tian , Xiao Ning , Zhou Xiaonong 
Published: February 2020

Abstract
Background A national control program for echinococcosis has been in effect since 2005 in China. This program has applied a comprehensive strategy, and good control results have been achieved. The objective of this study is focusing on the effectiveness of the programme with two indices, including patients treatment and registered dogs deworming, in endemic areas of echincoccosis control over the period of 10 years (2004-2014) in China. MethodsThe study was conducted in the pastoral and farming-pastoral regions of project counties in 10 provinces and autonomous regions, a database was established that included demography at county and township levels, grouping available patients into those subjected to surgery and those receiving drug treatment after population screening. Information was given regarding the diagnosis (CE, AE, co-infection or unclassified) and the number of registered dogs and that of those dewormed. All statistical analyses were performed using SPSS software version 18 (SPSS Institute, Chicago, IL, USA). The results are shown as percentages with the corresponding 95% confidence intervals (95% CIs). The situation with respect to humans and dogs were described using epidemiological descriptive analyses and the direct costs calculated after discount. ResultsOur study showed that over the 10-years period, the coverage rate for the patients treatment had increased 32.4% on surgical treatment as well as 81.3% on medical treatment, meanwhile, it had increased by 58.6% for registered dog deworming since 2007. The accumulated costs of US 27.03 $ million after discount on patients and registered dog treatment, it has account for 1/4 on total accumulated inputs (110.67 $ million) by Chinese government, in addition, it was by 57-fold on the annual inputs whereas 368-fold on accumulated inputs since the national program implementation. Conclusions As found through this study, it is suggested that sustainable follow-up evaluations are crucial for success and continued implementation of the national program, which will be necessary until the disease is under control and has been eliminated in all endemic areas of China. Based on the results obtained through this study, we recommend that more attention should be paid to controlling stray dogs during the ongoing program period. Keywords: Control progamme; Effectiveness, Echinococcosis, humans and dogs
Socioeconomic status, social capital, health risk behaviors, and health-related quality of life among Chinese older adults
Authors: Yang Ying , Wang Shizhen , Chen Lei , Luo Mi , Xue Lina , Cui Dan , Mao Zongfu 
Published: February 2020

Abstract
Background: The present study described the occurrence of health risk behaviors among Chinese older adults, and developed a structural equation model (SEM) to assess the associations between socioeconomic status (SES), social capital, health risk behaviors, and health-related quality of life (HRQoL). Methods: We conducted this cross-sectional study in Hubei, Jiangxi, Guangdong, and Fujian provinces, etc., China between January and March 2018. Demographic characteristics (age, gender, marital status, place of residence), SES (education level, family income), and health risk behaviors (smoking, alcohol consumption, physical inactivity, unhealthy diet, overweight or obesity, and sleep insufficient or excessive) were investigated. Social capital and HRQoL were assessed by the 16-item Personal Social Capital Scale (PSCS-16) and WHOQOL-Old, respectively. Structural equation modeling was applied to assess the associations between variables. Results: A total of 5439 older adults were included in this study. The prevalence of smoking, alcohol consumption, physical inactivity, unhealthy diet, overweight or obesity, and sleep insufficient or excessive were 34.7%, 34.4%, 64.3%, 45.0%, 26.6%, and 40.1%, respectively. 75% of the participants reported ≥2 health risk behaviors. Elderly individuals with more co-occurrence number of health risk behaviors demonstrated significant poor HRQoL ( F = 52.99, p <0.01). Smoking, physical inactivity, and unhealthy diet exhibited significant negative associations with HRQoL. Social capital, SES, as well as overweight or obesity, and sleep insufficient or excessive showed positive associations with HRQoL. Higher level of social capital positively associated with the occurrence of alcohol consumption, sleep insufficient or excessive, and negatively associated with physical inactivity, unhealthy diet, and overweight or obesity. Conclusions: Chinese older adults demonstrated high prevalence of health risk behaviors, as well as the proportion of their co-occurrences. Socioeconomic status, social capital, and health risk behaviors were important predictors of the elderly’s quality of life. Increasing elderly’s social capital, so as to prevent and control the occurrence of health risk behaviors, which might be an effective approach to improve the elderly’s health.
Changes in the geomagnetic field has little effect on the overwintering range of Eastern North American fall migratory monarch butterflies (Danaus plexippus), indicating a lack of an innate magnetic map sense for navigation
Authors: Guerra Patrick Anthony , Matter Stephen 
Published: February 2020

Abstract
BackgroundIndividuals of many species that perform annual long-distance migrations are capable of stopping at specific overwintering destinations, despite having not been there before. The iconic monarch butterfly (Danaus plexippus) and its annual long-distance fall migration is a famous example of this phenomenon. During the fall, Eastern North American monarch butterflies use various compass mechanisms to properly orient their flight southwards, in order to leave their summer breeding grounds in Southern Canada and the Northern United States, and reach their overwintering sites in Central Mexico. It remains a mystery, however, how monarchs locate and stop at these specific, consistent overwintering sites, especially since these individuals are on their maiden voyage. MethodsWe test the hypothesis that fall migrant monarchs locate these overwintering sites by using an innate, inherited map sense based on sensing and responding to specific geomagnetic signatures that are correlated with the overwintering sites. Using a natural displacement approach, we examined if the locations of overwintering sites and the abundance of monarchs at them, changes with the natural shift of the Earth’s magnetic field over time (2004-2018).ResultsWe found that despite the natural displacement of the geomagnetic field over the years, the locations of the overwintering sites and monarch abundance were unaffected. For example, fall monarchs continued to overwinter at the most southern sites in Mexico, even when the geomagnetic coordinates associated with these sites would have shifted north due to the natural shift of the Earth’s magnetic field, placing these sites significantly outside the range of the overwintering area.ConclusionsOur results suggest that monarchs do not employ a map sense based on geomagnetic cues for finding their overwintering sites, and might instead use other mechanisms or strategies for locating them (potentially using localized sensory cues) once they are near or have arrived in Central Mexico. We suggest that future work should now focus on understanding what these cue parameters are, in order to inform conservation efforts that are aimed at protecting the threatened monarch butterfly and preserving its annual long-distance migration.
Recurrent Sequence Evolution After Independent Gene Duplication
Authors: Dunk Samuel Hermann Alexander Von Der , Snel Berend 
Published: February 2020

Abstract
Background Convergent and parallel evolution provide unique insights into the mechanisms of natural selection. Some of the most striking convergent and parallel (collectively recurrent ) amino acid substitutions in proteins are adaptive, but there are also many that are selectively neutral. Genome-wide assessment of recurrent substitutions has only been performed for orthologs. These studies have revealed that the pervasiveness of recurrent substitutions is for a large part explained by purifying selection. At any position in a protein, only a subset of amino acids is allowed, increasing the chance of the same substitution happening in different lineages. ResultsWe developed a framework that detects patterns of recurrent differentiation in paralogs across 90 divergent eukaryotic genomes. A skew in recurrent substitutions serves as a proxy for a recurrent trend in function. We find remarkable examples of recurrent sequence evolution after independent duplication, in some cases involving more than ten different lineages where duplicates show a similar differentiation. We reveal the implicated functional patterns for the gene families Hint1/Hint2, Sco1/Sco2 and vma11/vma3. ConclusionsThe presented methodology provides a means to study the biochemical underpinning of functional differentiation between paralogs. For instance, two abundantly repeated substitutions are identified between independently derived Sco1 and Sco2 paralogs. Such identified substitutions allow direct experimental testing of the biological role of these residues for the repeated functional differentiation. The present study uncovers a diverse set of families with recurrent sequence evolution and reveals trends in the functional and evolutionary trajectories of this hitherto understudied phenomenon.
Trigger team activation for acute patients. A cohort study at a level 1 university hospital in Denmark
Authors: Posth Stefan , Froberg Lonnie , Bak Søren , Jensen Lisette Okkels , Brabrand Mikkel , Lassen Annmarie 
Published: February 2020

Abstract
Background While patients with major trauma, suspected ST-elevation myocardial infarction (STEMI) or stroke have implemented pathways for quick access to specialized trigger teams, other patients with time dependent diseases present with less obvious aetiology and have less documented pathways at arrival to the hospital. Aim To describe the number, diagnosis and prognosis of patients arriving to the trigger teams for trauma, suspected STEMI, suspected stroke, and Medical emergency patients (MEP) Method Retrospective cohort study of all patients who between November 2012 and September 2015 had either a trauma, STEMI, stroke or MEP trigger team activation at arrival to Odense University Hospital – a level 1 trauma centre, a direct referral centre for patients with suspected STEMI to the catheterization laboratory or stroke, and with a trigger team at emergency department arrival of MEP patients from the local area. Results There were 8,075 activations of a trigger team at hospital arrival, median 7.6 calls per day (range 1-18); 16.7% trauma, 28.3% STEMI, 19.7% stroke and 35.3% MEP calls. This corresponds to 161/100,000 person years (py) with trauma calls, 64/100,000 py STEMI calls, 72/100,000 py stroke calls and 340/100,000 py MEP calls. Patients from the different calls had a 30-day mortality of 12% (trauma), 8% (STEMI), 5% (stroke), and 25% (MEP). Whereas patients from trauma, STEMI and stroke calls were mainly discharged within a few ICD10 (International classification of diseases, version 10) main coding areas, patients from MEP calls had discharge diagnosis within many different ICD10 main coding areas. Conclusion Trauma, STEMI and stroke trigger teams are used at a daily base, treat a prehospitally well-defined patient population and have a relatively low 7-day mortality. Patients with MEP calls are more frequent, have a diverse aetiology and a higher mortality than patients in the other trigger teams.
A New Modeling Method Base on Candidate Window for Clinical Concept Extraction
Authors: Tang Yongtao , Li Shasha , Ji Bin , Yu Jie , Tan Yusong , Wu Qingbo 
Published: February 2020

Abstract
Background Recently, how to structuralize electronic medical records (EMRs) has attracted considerable attention from researchers. Extracting clinical concepts from EMRs is a critical part of EMR structuralization. The performance of clinical concept extraction will directly affect the performance of the downstream tasks related to EMR structuralization. We propose a new modeling method based on candidate window classification, which is different from mainstream sequence labeling models, to improves the performance of clinical concept extraction tasks under strict standards by considering the overall semantics of the token sequence instead of the semantics of each token. We call this model as slide window model. MethodIn this paper, we comprehensively study the performance of the slide window model in clinical concept extraction tasks. We model the clinical concept extraction task as the task of classifying each candidate window, which was extracted by the slide window. The proposed model mainly consists of four parts. First, the pre-trained language model is used to generate the context-sensitive token representation. Second, a convolutional neural network (CNN) is used to generate all representation vector of the candidate windows in the sentence. Third, every candidate window is classified by a Softmax classifier to obtain concept type probability distribution. Finally, the knapsack algorithm is used as a post-process to maximize the sum of disjoint clinical concepts scores and filter the clinical concepts. Results Experiments show that the slide window model achieves the best micro-average F1 score(81.22%) on the corpora of the 2012 i2b2 NLP challenges and achieves 89.25% F1 score on the 2010 i2b2 NLP challenges under the strict standard. Furthermore, the performance of our approach is always better than the BiLSTM-CRF model and softmax classifier with the same pre-trained language model. ConclusionsThe slide window model shows a new modeling method for solving clinical concept extraction tasks. It models clinical concept extraction as a problem for classifying candidate windows and extracts clinical concepts by considering the semantics of the entire candidate window. Experiments show that this method of considering the overall semantics of the candidate window can improve the performance of clinical concept extraction tasks under strict standards.
Need Assessment and Development of a Mobile-based Medication Dosage Calculation Application for ICU nurses
Authors: Abbasi Faeze , Khajouei Reza , Nejad Mehdi Ahmadi , Razban Faride , Jahani Yunes 
Published: February 2020

Abstract
Background Medication dosage calculation errors are among the most common errors of nurses in intensive care unit (ICU). Information technologies, particularly mobile devices, can advance drug dosage calculation processes. The objective of this study was to develop a medication dosage calculation application for nurses in intensive care units. Methods This study was performed in the ICUs of teaching hospitals in Kerman University of Medical Sciences in 2018. First, a need assessment survey of nurses was conducted to determine the required features of the application. As well two specialists were interviewed to determine the medications used in the ICUs. Second, a medication dosage calculation application was developed using formative usability testing. Results Overall, 80% of the participants (n=120) answered the need assessment questionnaire. Of 29 features determined in the needs assessment, 19 were selected to develop the application. Moreover, 25 medications were selected by specialists and participants for the development of the application and its prototype. The usability test of the prototype found 15 problems. After fixing these problems 2 problems were identified, which were fixed in the final version. Conclusion According to the participants, development of the medication dosage calculation application increases the accuracy of drug dosage and reduces the errors. The user-identified features were developed in-app. User-centered usability testing in this study improved development based on needs of users. The method used in this study can be used by developers of health applications to develop applications which are consistent with user needs.