bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Educator-Facilitated Schwartz Centre Rounds in Second-Year Medical Students: “A Facilitated Whinge”?
Authors: Smith Joshua , Stewart Molly , Foggin Emily , Matthews Stuart , Harris Joanne , Thomas Peter , Cooney Andrew , Stocker Claire 
Published: April 2020

Abstract
Background Medical students are increasingly being exposed to the clinic at early stages in their education, with the benefits becoming widely realised. This early exposure to such a highly pressurized environment can result in increased levels of stress and emotional unrest. Schwartz Center Rounds, reflective forums primed to aid social and emotional issues healthcare professionals’ experience, are now a relatively common and effective means to combat these effects in hospitals in the UK and USA. Recent studies show that the Schwartz Center Round format may also provide positive benefits for medical students. It has been suggested that students may be able to develop good coping strategies from discussions with “real” professionals.Methods This study investigated whether the guidance of Schwartz Center Rounds in year 2 of an MBChB by junior doctors enriches students’ appreciation and benefits of the Schwartz Center Round.Results The results reinforce the concept that Schwartz Center Rounds are an effective way of fostering empathy and understanding towards both patients and colleagues. Moreover, the facilitation of the Round by Clinical Educators, who also act as an imperfect role model, provides a pertinence to the exercise. The results show that early-year undergraduate medical students generally engage positively with SRs and demonstrate an ability to empathise with each other and share feelings regarding early clinical exposure without inhibition. However, correlation analyses suggest that engagement with the Schwartz Center Round is fundamental to gaining an understanding of its purpose and concurrently gain the most awareness of the emotional needs of themselves, their colleagues and patients.Conclusion Schwartz Center Rounds are an effective way of fostering empathy and understanding towards patients and colleagues in the healthcare environment. There is some evidence that the inclusion of Clinical Educators made the Round feel more pertinent to the students with the junior doctors’ clinical experiences being described as a useful addition to the discussion. Moreover, the students that benefitted most from the Round were the ones who engaged with and understood the process best and therefore it is important to help students realise that Schwartz Rounds are not merely a “facilitated whinge”.
Inflammation induced-PINCH expression leads to actin depolymerization and mitochondrial mislocalization in neurons
Authors: Natarajaseenivasan Kalimuthusamy , Shanmughapriya Santhanam , Velusamy Prema , Sayre Matthew , Garcia Alvaro , Gomez Nestor Mas , Langford Dianne 
Published: April 2020

Abstract
Diseases and disorders with a chronic neuroinflammatory component are often linked with changes in brain metabolism. Among neurodegenerative disorders, people living with human immunodeficiency virus (HIV) and Alzheimer’s disease (AD) are particularly vulnerable to metabolic disturbances, but mechanistic connections of inflammation, neurodegeneration and bioenergetic deficits in the central nervous system (CNS) are poorly defined. The particularly interesting new cystine histidine-rich protein called PINCH is nearly undetectable in healthy mature neurons, but is robustly expressed in tauopathy-associated neurodegenerative diseases including HIV infection and AD. Although robust PINCH expression has been reported in neurons in the brains of patients with HIV and AD, the molecular mechanisms and cellular consequences of increased PINCH expression in CNS disease was not known. In this context, we have identified the transcription factor responsible for PINCH induction in neuroinflammatory conditions and the effects of increased PINCH expression in neurons. Given that AD and neuroHIV share pathological features including cognitive impairment with chronic neuroinflammation, TNFa plays an important role in neurodegenerative processes. The viral protein Tat, is produced in the brain and is one of the main drivers of neuroinflammation and strongly induces TNFa. Our data show that TNFα-mediated activation of MEF2A via increased cellular calcium induces PINCH. In turn, this leads to disruption of the PINCH-ILK-Parvin ternary complex, cofilin activation by Tesk1 inactivation, and actin depolymerization. Disruption of actin led to perinuclear mislocalization of mitochondria by destabilizing the kinesin-dependent mitochondrial transport machinery resulting in impaired neuronal metabolism. Blocking TNFα-induced PINCH preserves mitochondrial localization and maintains metabolic functioning. These data report for the first time mechanistic and biological consequences of PINCH expression in neurons in the CNS in diseases with a chronic neuroinflammatory component. These findings point to maintenance of PINCH at normal physiological levels as a new therapeutic target for neurodegenerative diseases with impaired metabolism.
Total and high-molecular weight plasma adiponectin associates with markers of inflammation and circulating chemokines in subjects with untreated newly diagnosed rheumatoid arthritis.
Authors: Vasileiadis Georgios K. , Lundell Anna-Carin , Zhang Yuan , Andersson Kerstin , Gjertsson Inger , Rudin Anna , Maglio Cristina 
Published: April 2020

Abstract
Background Adiponectin is an adipokine circulating in blood in three forms, whereof the high molecular weight (HMW) is supposed to mediate the metabolic effects of adiponectin. Subjects with rheumatoid arthritis (RA) have elevated levels of adiponectin in serum and synovial fluid but it is unclear if circulating adiponectin associates with disease activity markers in subjects with RA. Here we aimed to determine whether total and/or HMW adiponectin levels associate with markers of disease activity and plasma chemokines in a cohort of subjects with untreated newly diagnosed RA.Methods Inflammation and disease activity were assessed in a cohort of 70 subjects with untreated newly diagnosed RA using erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), number of tender or swollen joints, as well as disease activity scores (DAS28 and CDAI) Plasma levels of 15 chemokines were measured using flow cytometry bead-based immunoassay or ELISA. Total and HMW adiponectin plasma levels were determined with ELISA.Results Both total and HMW adiponectin were positively associated with CRP (both P = 0.001) and ESR (P = 0.001 and P < 0.001 respectively). Furthermore, a positive association was found between total adiponectin and CXCL10 (P = 0.021), CCL2 (P = 0.012) and CXCL9 (P = 0.044), whereas HMW adiponectin associated with CXCL9 only (P = 0.033).Conclusion Total and HMW adiponectin are associated with markers of inflammation as well as pro-inflammatory chemokines in a cohort of 70 subjects with untreated newly diagnosed RA. Our results support the hypothesis that adiponectin might be a pro-inflammatory factor involved in the pathogenesis of RA.
Foot Care Knowledge and Practices Among Japanese Nurses and Care Workers in Home Care and Adult Service Center: A Cross Sectional Study
Authors: Fujii Kashiko , Komoda Takuyuki , Maekawa Atsuko , Nishikawa Mariko 
Published: April 2020

Abstract
Background Foot care knowledge and practices among nurses and care workers in the community greatly impact foot health maintenance and prevention of foot-related problems among older people. This study aimed to explore and examine the current foot care knowledge, practices, and perceptions among nurses and care workers at home care and adult day service center, along with their demographic characteristics and daily care for clients.Methods This study analyzed 232 randomly selected front-line nurses and care workers working at home care or adult day service center in N City, A Prefecture, Japan. Data were obtained using questionnaires and subsequently analyzed using descriptive statistics, t-tests, Chi-square tests, Wilcoxon rank-sum tests, and Spearman’s rank correlation tests.Results Among the 305 surveyed, 232 (63 nurses; 170 care workers) provided data. Although 57 nurses (91.9%) and 142 care workers (83.5%) showed interest in foot care, 33 nurses (53.2%) and 133 care workers (78.2%) stated that foot care education was insufficient. Knowledge and practice scores were associated with working status.
Impact of hypertension on short- and long-term survival of Patients Who Underwent Emergency Surgery for Type A Acute Aortic Dissection
Authors: Wang Zhigang , Wang Dongjin , Chen Tao , Ge Min , Chen Cheng , Zong Qiuyan , Lu Lichong 
Published: April 2020

Abstract
ObjectiveTo explore the clinical characteristics and prognosis of patients with hypertension underwent emergency surgery for type A acute aortic dissection (TA-AAD).MethodsThe present study enrolled 712 consecutive patients diagnosed with TA-AAD who were admitted to our hospital between January 2014 to December 2018. All patients accepted aortic repair surgery during hospitalization. The cohort was separated into two groups based on if they were diagnosed with hypertension upon administration. Before analyzing the short-term outcomes, baseline characteristics were matched for propensity scores. Patients’ clinical characteristics were compared and analyzed before and after propensity scoring. To identify predictors for long-term mortality rate, Kaplan-Meier survival estimation and Cox proportional hazard analysis were performed.ResultsThe 492 patients (69.1% of all patients in the cohort) included in the hypertensive group were generally older and heavier than patients in the non-hypertensive group. Between two groups, preoperative leukocyte count and serum creatinine level were found significant different (P < 0.05). After propensity scoring, 128 pairs (256 patients) were successfully matched. Our analysis showed that there was no significant difference of ventilation duration, 30-day mortality rate, intensive care unit (ICU) stay time and hospitalization time between these patients. However, our observation from surgeries suggested that hypertensive patients presented with less intraoperative aortic valve involvement.There was a significant difference in long-term survival rate (P=0.037) between two groups and Cox regression analysis demonstrated that hypertension was an independent risk factor (hazard ratio [HR], 2.290; 95% confidence interval [CI], 1.013-5.178; P=0.046).Conclusions Our data suggested that TA-AAD patients complicated with hypertension were generally older and heavier compared to non-hypertensive patients. The hypertension diagnosed upon hospital administration was an independent risk factors for long-term survival in TA-AAD patients but did not influence the 30-day mortality rate.
Prevalence of Risk Factors of Non-Communicable Diseases in the Sultanate of Oman: STEPS Survey 2017
Authors: Al-Mawali Adhra , Jayapal Sathish Kumar , Morsi Magdi , Al-Shekaili Waleed , Pinto Avinash Daniel , Al-Kharusi Hilal , Al-Harrasi Ayaman , Al-Balushi Zainab , Idikula John 
Published: April 2020

Abstract
Background Non-Communicable Diseases (NCD) represent a major public health issue and currently are the cause of 71% of deaths globally and 72% deaths in Oman. Hence, there is a need for comprehensive, up-to-date and internationally comparable data on NCD risk factors in order to evaluate the effectiveness of ongoing public health policies and to develop further NCD prevention and control interventions. The aim of the study was to provide evidence-based, up-to-date, extensive, and reliable baseline data on the behavioural and biological risk factors of NCDs in the Sultanate of Oman.Methods A cross-sectional community‐based survey designed to be nationally representative of the Sultanate of Oman was conducted based on the WHO STEPwise approach to Surveillance (STEPS). Multi-stage stratified random sampling according to geographical distribution selected a total of 9053 households (Omani nationals and non-Omani residents). Cluster sampling was used and symmetric equal number of blocks were chosen in each governorate with 823 households chosen from each governorate and one eligible adult selected from each household randomly. The survey used demographic and behavioural information questionnaires along with physical and biochemical measurements among adults aged 18 years and above.Results The prevalence of behavioural risk factors such as tobacco use was 9%, alcohol consumption was 2%, insufficient fruit or vegetable intake was 61%, and insufficient physical activity was 39%. The prevalence of biological risk factors such as overweight and obesity was 66%, raised blood pressure was 33%, raised blood glucose was 16%, and raised blood cholesterol was 36%. The prevalence of multiple risk factors was also determined and 95% of the population were found to have more than one risk factor. Three or more risk factors were found among 33% of population aged 18–69 years and 45% of the population aged 45 years.Conclusions These findings are important to support the formulation and implementation of NCD-related policies and action plans that improve health status and prevent mortality due to NCDs in the Sultanate of Oman.
Incidence and risk factors of Postdural Puncture Headache: Prospective cohort study design
Authors: Weji Bedilu Girma , Obsa Mohammed Suleiman , Melese Kidest Getu , Azeze Gedion Asnake 
Published: April 2020

Abstract
Background: Post-dural puncture headache is one of the complications following spinal anaesthesia and accidental dural puncture. Several modifiable risk factors contribute to the development of headache after lumbar puncture which includes needle size, needle design, direction of the bevel and number of LP attempts. This study aimed to assess the incidence and risk of postdural puncture headache.Methods: This prospective cohort study design was conducted using a consecutive sampling method. Regular supervision and follow up were made. Data was entered in to Epi info version 7 software and transported to SPSS version 20 for analysis. Odd ratio and 95% confidence interval was computed. The findings of the study were reported using tables, figures and narration. Variables that were found to be candidate (p value < 0.25) on binary logistic regression entered into a multiple logistic regression analysis to identify independent predictors of postdural puncture headache.Results: One hundred fifty eligible study participants were included in our study of which 28.67% had developed postdural puncture headache. This study found that needle size, number of CSF drops and multiple attempts as independent predictors of postdural puncture headache at significant level (p < 0.05). In addition, twenty five needle was identified as strongest pre-operative independent predictor with PDPH (AOR = 4.150, CI = 1.433–12.021)Conclusions: Recent study revealed that small size pencil-point spinal needle was much better to large size cutting spinal needle regarding the frequency of postdural puncture headache. Besides, frequent attempts during lumbar puncture and increased CSF leakage were associated with the events. In view of this, we recommend the use of small size pencil-point spinal needle; avoid more leakage of cerebrospinal fluid and multiple in spinal anesthesia and lumbar puncture.
ZnO NPs delay the recovery of psoriasis-like skin lesions through promoting inflammation and keratinocyte apoptosis via nuclear translocation of phosphorylated NF-κB p65 and cysteine deficiency
Authors: Lai Xuan , Wang Menglei , Zhu Yixia , Feng Xiaoli , Liang Huimin , Nie Li , Li Li , Shao Longquan 
Published: April 2020

Abstract
Background

This study aimed to confirm the safety and risk of applying zinc oxide nanoparticles (ZnO NPs) to pathological skin, such as psoriasis-like skin. The majority of previous studies confirmed the safety of applying ZnO NPs to normal skin. However, we know very little about the risks of using sunscreen, cosmetics and topical drugs containing ZnO NPs for individuals with skin diseases. In addition, some studies claimed that ZnO NPs can penetrate normal or pathological skin, and ZnO NPs have frequently been reported to have proinflammatory and lethal effects in vitro. Therefore, it is necessary to evaluate the safety of applying ZnO NPs to pathological skin.
Results

ZnO NPs passed through gaps between keratinocytes and entered stratum basale of epidermis and dermis in imiquimod (IMQ)-induced psoriasis-like skin lesions. Application of a ZnO NP-containing suspension for 3 connective days delayed the healing of the epidermal barrier; increased the expression levels of inflammatory cytokines; promoted keratinocyte apoptosis and disturbed redox homeostasis. In vitro, ZnO NPs promoted TNF-α, IL-1β and IL-6 secretion and apoptosis of recombinant-human-TNF-α-stimulated HaCaT cells. NF-κB, ERK, p38 and JNK inhibitors blocked ZnO NP-induced inflammation. JSH-23, an inhibitor of the nuclear translocation of p-NF-κB p65, and NAC, an acetylated precursor of L-cysteine, not only inhibited the ZnO NP-induced inflammation but also inhibited apoptosis and cysteine deficiency. Neither erastin nor RSL3 induced p-NF-κB p65 nuclear translocation, but they did reduce cysteine biosynthesis. Additionally, ferropstatin-1, an inhibitor of lipid peroxidation, partially rescued ZnO NP-induced decreases in cell viability and cysteine content.
Conclusions

ZnO NPs delay the recovery of psoriasis-like skin lesions through promoting inflammation and keratinocyte apoptosis via the nuclear translocation of phosphorylated NF-κB p65 and cysteine deficiency. This work reminds the public that ZnO NPs are not safe for pathological skin, especially in inflammatory skin diseases such as psoriasis, and has revealed a partial mechanism by which ZnO NPs delay the recovery of pathological skin, promoting the appropriate use of ZnO NPs.
Ambient and household air pollution on early-life determinants of stunting – a systematic review and meta-analysis
Authors: Pun Vivian Chit , Dowling Russell , Mehta Sumi 
Published: April 2020

Abstract
Background Stunting is an important risk factor for early growth and development with health implications throughout the life course. While maternal exposure to particulate matter (PM) has been linked to early determinants of stunting, existing evidence has rarely captured the most vulnerable populations. Methods We conducted a systematic review and meta-analysis of the peer-reviewed literature to assess the evidence of the association between ambient and household PM pollution exposure and postnatal stunting (height-for-age z-score), and prenatal determinants (i.e., intrauterine growth restriction and small for gestational age) that would greatly increase children’s risk of stunting. Relevant manuscripts published from 2000 to 2019 were reviewed. Random effect models were used to estimate pooled odds ratios (OR). Results Thirty-two studies conducted in 18 countries met our inclusion criteria. We found significant positive associations between prenatal determinants of stunting and a 10 μg/m 3 increase in PM 2.5 during the first trimester (OR=1.02; 95% confidence interval (CI): 1.00–1.04) and second trimester (OR=1.04; 95% CI, 1.01–1.07). Similar associations were found for prenatal determinants of stunting of high versus low quartiles of PM 2.5 exposure during the whole pregnancy. Postnatal stunting was found to be positively, though insignificantly, associated with postnatal exposure to household air pollution. Conclusions Our analysis shows evidence of increased risk of prenatal determinants of stunting with ambient particulate exposure, especially during first trimester, and suggestive evidence of elevated stunting risk with postnatal exposure to household air pollution. This evidence reinforces the importance of promoting clean air as part of an integrated approach to preventing stunting.
Correlation between CT findings and outcomes in 46 Patients with Coronavirus Disease-19
Authors: Lei Qiang , Li Guangming , Ma Xiaofen , Tian Junzhang , Wu Yunfan , Chen Hui , Xu Wen , Li Cheng , Jiang Guihua 
Published: April 2020

Abstract
Purpose: The aim of this study was to retrospectively analyze chest Computed Tomography (CT) findings in COVID-19 pneumonia and identify features associated with poor prognosis.Methods: This retrospective review included 46 patients with RT-PCR confirmed COVID-19 infection. Basic clinical characteristics and detailed CT features were evaluated and compared between patients who recovered (n = 40) from coronavirus and those who expired (n = 6). Chest CT examinations for ground-glass opacity, crazy-paving pattern, consolidation, and fibrosis were scored by two reviewers. The total CT score comprised the sum of lung involvement (5 lobes, scores 1-5 for each lobe, range; 0, none; 25, maximum) was determined.Results: We analyzed clinical data from 46 patients (26 males and 20 females; age 9-82 years) with confirmed COVID-19 pneumonia were evaluated. The chest CTs showed 27 (58.7%) patients had ground-glass opacity, 19 (41.3%) had ground glass and consolidation, and 35 (76.1%) patients had crazy-paving pattern. None of the patients who expired had fibrosis, in contrast to six (15%) patients who recovered from coronavirus. Most patients had subpleural lesions (89.0%), bilateral (87.0%) and lower (93.0%) lung lobe involvement. Diffuse lesions were present in four (67%) patients who succumbed to coronavirus, but only one (2.5%) patient who recovered (p = 0.000). CT identified a greater area of lung lobe involvement in patients who died (p = 0.000). In the group of patients who expired, the total CT score was higher than that of the recovery group (17.2 ± 7.8 vs. 7.1 ± 4.3, p = 0.005). Patients in the death group had lower lymphocyte count and higher C-reactive protein than those in the recovery group (p = 0.011 and p = 0.041, respectively).Conclusion: The CT of patients with COVID-19 mainly showed ground-glass opacity and ground-glass opacity plus consolidation, with a peripheral lower lobe preference. Early fibrosis may correlate with well prognosis. Lymphopenia, elevated C-reactive protein, and high CT score in conjunction with diffuse distribution of lung lesions are indicative of disease severity and short- term mortality.
Temporal lung changes on thin-section CT in patients with COVID-19 pneumonia
Authors: Zhang Zhiyan , Tang Runhui , Sun Heyang , Dai Haiyang , Chen Kangyin , Ye Xinmiao , Ye Wei , Li Shengkai , Lan Bowen , Li Li , Ou Chun-Quan 
Published: April 2020

Abstract
We examined characteristics of chest CT during different time periods for patients with coronavirus disease 2019 (COVID-19) pneumonia in Huizhou, China. This study included 56 COVID-19 patients having abnormal CT acquired between January 22 and March 3, 2020. Scans of 56 patients were classified into 4 groups (Group 1-Group 4) based on the date on which scan was obtained at the 1st, 2nd, 3rd week and longer than 3 weeks after illness onset. Forty-five patients with follow-up scans were categorized into 4 groups according to extents that lesions reduced. GGO was prevalent in Groups 1-4 (58.1-82.6%). Consolidation was the more common in Group 2 (26.2%) and then declined in Group 3 and 4 (20.0%; 9.7%). The highest frequency of fibrous stripes occurred in Group 3 (46.7%) and then decreased to 35.5% in Group 4. CT scores were higher for Group 2 than others. Among 45 follow-up patients, 11 (24.4%) of them recovered with lesions reducing ≥75% and had shorter hospital durations compared with others. There were temporal patterns of lung abnormalities in COVID-19 patients, with the highest extent of lesion involvement occurring in the 2nd week. Isolation and review are required for COVID-19 patients who have been discharged from hospital.