bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of two Norepinephrine rescue bolus for Management of Post-spinal Hypotension during Cesarean Delivery: a randomized controlled trial
Authors: Hassabelnaby Yasmin S. , Hasanin Ahmed M. , Adly Nada , Mostafa Maha M. A. , Refaat Sherin , Fouad Eman , Elsonbaty Mohamed , Hussein Hazem A. , Mahmoud Mohamed , Abdelwahab Yaser M. , Elsakka Ahmed , Amin Sarah M. 
Published: April 2020

AbstractBackgroundData on the best norepinephrine bolus dose for management of hypotension are limited. The aim of this study was to compare the efficacy and safety of two norepinephrine bolus doses in the rescue management of maternal hypotension during cesarean delivery.MethodsThis randomized, controlled trial included mothers scheduled for cesarean delivery with spinal anesthesia with a prophylactic norepinephrine infusion. Following spinal anaesthesia administration, a participant was considered hypotensive if systolic blood pressure was ≤80% compared to the baseline reading. Participants were allocated to receive either 6 mcg or 10 mcg norepinephrine bolus for the management of hypotensive episodes. The hemodynamic response after administration of norepinephrine bolus was recorded. The episode was considered successfully managed if systolic blood pressure returned to within 80% from the baseline reading within 2 min after norepinephrine bolus administration, and did not drop again within 6 min after the norepinephrine bolus. The primary outcome was the incidence of successful management of the first hypotensive episode. Other outcomes included systolic blood pressure, heart rate, incidence of maternal bradycardia, and reactive hypertension.ResultsOne hundred and ten mothers developed hypotensive episodes and received norepinephrine boluses for management. The number of successfully managed first hypotensive episodes was 50/57 (88%) in the 6 mcg-treated episodes and 45/53 (85%) in the 10 mcg-treated episodes (p = 0.78). Systolic blood pressure was comparable after administration of either bolus dose. Heart rate was lower after administration of 10 mcg bolus compared to 6 mcg bolus, without significant bradycardia requiring atropine administration. The incidence of reactive hypertension was comparable between both groups.ConclusionIn mothers undergoing elective cesarean delivery under prophylactic norepinephrine infusion at 0.05 mcg/kg/min, there was no advantage to the use of 10 mcg norepinephrine bolus over 6 mcg norepinephrine bolus for the rescue management of first hypotensive episode. Neither of the 2 bolus doses reached a 100% success rate. The incidences of bradycardia and reactive hypertension were comparable between both norepinephrine doses.Trial registrationAt clinicaltrial.gov registry system on January 4, 2019 Clinical trial identifier:NCT03792906.
Retrospective analysis of salvage surgery for local progression of brain metastasis previously treated with stereotactic irradiation: diagnostic contribution, functional outcome, and prognostic factors
Authors: Mitsuya Koichi , Nakasu Yoko , Hayashi Nakamasa , Deguchi Shoichi , Oishi Takuma , Sugino Takashi , Yasui Kazuaki , Ogawa Hirofumi , Onoe Tsuyoshi , Asakura Hirofumi , Harada Hideyuki 
Published: April 2020

Abstract
Background
Stereotactic irradiation (STI) is a primary treatment for patients with newly diagnosed brain metastases. Some of these patients experience local progression, which is difficult to differentiate from radiation necrosis, and difficult to treat. So far, just a few studies have clarified the prognosis and effectiveness of salvage surgery after STI. We evaluated the diagnostic value and improvement of functional outcomes after salvage surgery. Based on these results, we reconsidered surgical indication for patients with local progression after STI.

Methods
We evaluated patients with brain metastases treated with salvage surgery for local progression from October 2002 to July 2019. These patients had undergone salvage surgery based on magnetic resonance imaging findings and/or clinical evidence of post-STI local progression and stable systemic disease. We employed two prospective strategies according to the eloquency of the lesions. Lesions in non-eloquent areas had been resected completely with a safety margin, utilizing a fence-post method; while lesions in eloquent areas had been treated with minimal resection and postoperative STI. Kaplan-Meier curves were used for the assessment of overall survival. Prognostic factors for survival were analyzed.

Results
Fifty-four salvage surgeries had been performed on 48 patients. The median age of patients was 63.5 years (range 36–79). The median interval from STI to surgery was 12 months. The median overall survival was 20.2 months from salvage surgery and 37.5 months from initial STI. Primary cancers were lung 31, breast 9, and others 8. Local recurrence developed in 13 of 54 lesions (24%). Leptomeningeal dissemination occurred after surgery in 3 patients (5.6%). Primary breast cancer (breast vs. lung: HR: 0.17), (breast vs. others: HR: 0.08) and RPA class 1–2 (RPA 1 vs. 3, HR:0.13), (RPA 2 vs 3, HR:0.4) were identified as good prognostic factors for overall survival (OS) in multivariate analyses. The peripheral neutrophil-to-lymphocyte ratio (NLR) of ≤3.65 predicted significantly longer OS (median 25.5 months) than an NLR > 3.65 (median 8 months).

Conclusion
We insist that salvage surgery leads to rapid improvement of neurological function and clarity of histological diagnosis. Salvage surgery is recommended for large lesions especially with surrounding edema either in eloquent or non-eloquent areas.
Correlates of type 2 diabetes and glycaemic control in adults in Saudi Arabia a secondary data analysis of the Saudi health interview survey
Authors: Al Slamah Thamer , Nicholl Barbara I. , Alslail Fatima Y. , Harris Leanne , Kinnear Deborah , Melville Craig A. 
Published: April 2020

Abstract
Background
There is evidence that type 2 diabetes self-management programmes may have a positive impact on health outcomes of adults living in Gulf countries. However, none of the programmes evaluated were developed using evidence about the specific needs of adults with Type 2 diabetes living in the Gulf countries. This study is part of a wider programme of research, which uses a cultural adaptation framework to generate information on how to tailor type 2 diabetes self-management to the Saudi context.

Methods
Secondary data analysis of the Saudi Health Interview Survey (SHIS) (N = 10,821) was conducted. Bivariate and multivariate logistic regression modelling assessed factors associated with type 2 diabetes and its control / self-management including sociodemographic factors (e.g. age, gender), lifestyle (e.g. diet, physical activity), and health seeking behaviours (e.g. chronic illnesses, health services).

Results
7% (N = 808) of all participants had type 2 diabetes (59% male), however it represents 35% at or above 55 years. In multivariate analysis at older age, being overweight or obese, male, having hypertension, and reporting a reduction in health status in the 12 months prior to questionnaire completion, were significantly associated with having type 2 diabetes. Participants who reported walking for more than 10 min per day were less likely to report type 2 diabetes. Unexpectedly there was a significant association between type 2 diabetes and lower frequency of fast food intake, while increased fruit and vegetable intake was associated with poor glycaemic control.

Conclusions
Being overweight and/or hypertensive are concomitant with type 2 diabetes in Saudi Arabia. Any self-management programmes for type 2 diabetes patients with either of these conditions should be tailored accordingly. Walking behaviours should be prioritised in Saudi self-management programmes. Prediabetes management programmes may be of special importance to the Saudi community.
Use of endoscopic tissue morcellator in removing retroperitoneal fat in retroperitoneoscopic radical nephrectomy
Authors: Yang Guang , Xu Yong , Wan Shaw P. , Qu Genyi , Nie Haibo , Duan Guangjun 
Published: April 2020

Abstract
Background
Evaluate the safety and effectiveness of using an endoscopic tissue morcellator (ETM) to remove the retroperitoneal fat during retroperitoneoscopic radical nephrectomy (RRN).

Methods
The use of ETM in the removal of retroperitoneal fat was retrospectively analyzed in patients who underwent RRN for localized renal cancer in our hospital from January 2010 to January 2018. We accrued the appropriate patients and divided them into two groups. The first group included patients of RRN where ETM was used to remove the retroperitoneal fat, while the second group was comprised of patients of RRN where ETM was not performed, which served as the control group. Each group was further divided into two subgroups, including obese patients (BMI ≥ 28) and patients suffering from high-volume renal cancer (Stage T2a). The differences between the two groups as well as their subgroups were analyzed and statistically compared.

Results
All 222 nephrectomies were completed under retroperitoneoscopy, ETM was used in 105 of these 222 patients. Among them, 31 cases were of obese patients, and 26 cases were of high-volume renal cancer patients. The other 117 patients had undergone RRN without the use of ETM. Among them, 36 cases were of obese patients, and 28 cases were of high-volume renal cancer patients. The differences in age, BMI, tumor position, and tumor size between the two groups were not statistically significant, P > 0.05. Both the surgical time and the blood loss for the ETM group were significantly lower than the control group, p < 0.05. In the subgroup analysis, the obese patients and patients with high tumor volume also showed a significantly lower surgical time and less blood loss, p < 0.05. The postoperative hospitalization time, the total survival rate, and the disease-free survival rate were not statistically significant, p > 0.05.

Conclusions
The use of ETM in removing the retroperitoneal fat during the RRN can potentially reduce the surgical time and lessen the blood loss. This technique is especially advantageous for obese and large-volume tumor patients.
A treatment with a boiled aqueous extract of Hancornia speciosa Gomes leaves improves the metabolic status of streptozotocin-induced diabetic rats
Authors: Neto Leila S. , Moraes-Souza Rafaianne Q. , Soares Thaigra S. , Pinheiro Marcelo S. , Leal-Silva Thaís , Hoffmann Juliana C. , Américo Madileine F. , Campos Kleber E. , Damasceno Débora C. , Volpato Gustavo T. 
Published: April 2020

Abstract

Background
Hancornia speciosa is usually used in Brazilian folk medicine to treat diabetes. The hypothesis of the present study is that this medicinal plant exerts beneficial effects on hyperglycemia, preventing diabetic complications. Therefore, the aim of this study was to evaluate the treatment effect of the aqueous extract of H. speciosa leaves on metabolic parameters of diabetic rats.

Methods
The H. speciosa extract (400 mg/Kg) was administered to both nondiabetic and severely diabetic female Wistar rats by gavage. The Oral Glucose Tolerance Test was performed and the area under the curve (AUC) was estimated on day 17 of pregnancy. After 21 days of treatment, the animals were anesthetized and killed to obtain organ weights. Blood samples were collected for an analysis of serum biochemical parameters.

Results
After treatment with the H. speciosa extract, the parameters of nondiabetic rats remained unchanged. In treated diabetic rats, glycemia, AUC, dyslipidemia parameters, and relative organ weights were decreased compared with nontreated diabetic rats. Severely diabetic rats showed decompensated hyperglycemia, polydipsia, hyperphagia and dyslipidemia. However, the aqueous extract of H. speciosa leaves decreased diabetes complications (indicating a lack of toxicity), reduced blood glucose levels, and exerced lipid-lowering effects.

Conclusion
Based on or findings, the H. speciosa leaf extract may be a safe and promising candidate treatment for diabetes and other diseases.
Development and pilot testing of a health education program to improve immigrants’ access to Canadian health services
Authors: Ghahari Setareh , Burnett Shawna , Alexander Libby 
Published: April 2020

Abstract
Background
In Canada’s increasing immigrant population, a phenomenon called the “healthy immigrant effect” has arisen in which health declines after four years of settling. Access to healthcare is an important consideration. There is strong evidence that immigrants lack confidence and knowledge for navigating health services. The aim of this study was to develop and pilot test the Accessing Canadian Healthcare for Immigrants: Empowerment, Voice & Enablement (ACHIEVE) program.

Method
The study employed an exploratory sequential mixed methods design. A qualitative study was completed. Program content was developed based on a scoping review and refined in a formative evaluation. Then, a pilot test of the program measured participants’ perceived efficacy in improving confidence in healthcare navigation, program satisfaction, and learning in individual sessions.

Results
Researchers found significantly higher rates of health navigation and an increase in knowledge about the Canadian health system post-program.

Conclusions
Results provide promising evidence that ACHIEVE may improve confidence in healthcare access among immigrants, demonstrating potential for dispersion on a larger scale.
Cost–related unmet need for healthcare services in Kenya
Authors: Njagi Purity , Arsenijevic Jelena , Groot Wim 
Published: April 2020

Abstract
Background
The assessment of unmet need is one way to gauge inequities in access to healthcare services. While there are multiple reasons for unmet need, financial barriers are a major reason particularly in low- and middle-income countries where healthcare systems do not offer financial protection. Moreover, accessibility and affordability are paramount in achieving universal health coverage. This study examines the extent of unmet need in Kenya due to financial barriers, the associated determinants, and the influence of regional variations.

Methods
We use data from the 2013 Kenya household health expenditure and utilization (KHHEUS) cross sectional survey. Self-reported unmet need due to lack of money and high costs of care is used to compute the outcome of interest. A multilevel regression model is employed to assess the determinants of cost-related unmet need, confounding for the effect of variations at the regional level.

Results
Cost-related barriers are the main cause of unmet need for outpatient and inpatient services, with wide variations across the counties. A positive association between county poverty rates and cost-related unmet is noted. Results reveal a higher intraclass correlation coefficient (ICC) of 0.359(35.9%) for inpatient services relative to 0.091(9.1%) for outpatient services. Overall, differences between counties accounted for 9.4% (ICC ~ 0.094) of the total variance in cost-related unmet need. Factors that positively influence cost-related unmet need include older household heads, inpatient services, and urban residence. Education of household head, good self-rated health, larger household size, insured households, and higher wealth quintiles are negatively associated with cost-related unmet need.

Conclusion
The findings underscore the important role of cost in enabling access to healthcare services. The county level is seen to have a significant influence on cost-related unmet need. The variations noted in cost-related unmet need across the counties signify the existence of wide disparities within and between counties. Scaling up of health financing mechanisms would fundamentally require a multi-layered approach with a focus on the relatively poor counties to address the variations in access. Further segmentation of the population for better targeting of health financing policies is paramount, to address equity in access for the most vulnerable and marginalized populations.
Evaluation of an online training tool for scoring programmed cell death ligand-1 (PD-L1) diagnostic tests for lung cancer
Authors: Jasani Bharat , Bänfer Gudrun , Fish Rebecca , Waelput Wim , Sucaet Yves , Barker Craig , Whiteley Jessica L. , Walker Jill , Hovelinck Rudy , Diezko Rolf 
Published: April 2020

Abstract
Background
Numerous studies indicate that higher tumour programmed cell death ligand-1 (PD-L1) expression is associated with greater response to anti-programmed cell death-1 (PD-1)/PD-L1 immunotherapy in non-small cell lung cancer (NSCLC). In the era of precision medicine, there is a need to provide reliable, standardised training for pathologists to improve their accuracy of interpretation and scoring, as the results are used directly to inform clinical decisions. Here we present findings regarding reader reproducibility of PD-L1 tumour cell (TC) staining scoring for NSCLC using a PD-L1 e-trainer tool as part of a PD-L1 immunohistochemistry reader training course.

Methods
The PD-L1 training course was developed based on the use of VENTANA PD-L1 (SP263) and Dako PD-L1 IHC PharmDx 22C3 stained NSCLC samples in combination with a PD-L1 e-trainer tool. Five-hundred formalin-fixed, paraffin-embedded archival samples were obtained from commercial sources and stained for PD-L1. Slides were scored by two expert pathologists, then scanned to produce digital images and re-scored. Thirty-three cases were selected and sorted into three sets: a training set and two self-assessment tests (pre-test and ‘competence’ test). Participants (all selected board-certified pathologists) received face-to-face training including use of an e-trainer tool. Statistical analyses were performed using the competence test set. Overall percentage agreement (OPA) was assessed between the participant pathologists’ registered scores and the reference scores assigned by expert pathologists at clinically relevant PD-L1 cut-offs (≥1%, ≥25% and ≥ 50%).

Results
Seven sessions were held and 69 participant pathologists completed the training. Inter-reader concordance indicated high OPA (85–95%) for PD-L1 TC scoring at clinically relevant cut-offs, with Fleiss’ Kappa > 0.5.

Conclusions
Use of this web-based training tool incorporated into classroom-style training was associated with an overall moderately good level of inter-reader reproducibility at key cut-offs for TC PD-L1 expression testing in NSCLC. Overall, the online training tool offers a means of standardised training for practising pathologists in a clinical setting.
Impaired brain glucose metabolism and presynaptic dopaminergic functioning in a mouse model of schizophrenia
Authors: Tomasella Eugenia , Falasco German , Urrutia Leandro , Bechelli Lucila , Padilla Lucia , Gelman Diego M. 
Published: April 2020

AbstractBackgroundSchizophrenia is a disease diagnosed by visible signs and symptoms from late adolescence to early adulthood. The etiology of this disease remains unknown. An objective diagnostic approach is required. Here, we used a mouse model that shows schizophrenia-like phenotypes to study brain glucose metabolism and presynaptic dopaminergic functioning by positron emission tomography (PET) and immunohistochemistry. PET scannings were performed on mice after the administration of [18F]-FDG or [18F]-F-DOPA. Glucose metabolism was evaluated in basal conditions and after the induction of a hyperdopaminergic state.ResultsMutant animals show reduced glucose metabolism in prefrontal cortex, amygdala, and nucleus reuniens under the hyperdopaminergic state. They also show reduced [18F]-F-DOPA uptake in prefrontal cortex, substantia nigra reticulata, raphe nucleus, and ventral striatum but increased [18F]-F-DOPA uptake in dorsal striatum. Mutant animals also show reduced tyrosine hydroxylase expression on midbrain neurons.ConclusionsDopamine D2 mutant animals show reduced glucose metabolism and impaired presynaptic dopaminergic functioning, in line with reports from human studies. This mouse line may be a valuable model of schizophrenia, useful to test novel tracers for PET scanning diagnostic.
Correction to: The cost-effectiveness of albumin in the treatment of decompensated cirrhosis in Germany, Italy, and Spain
Authors: Runken M. Chris , Caraceni Paolo , Fernandez Javier , Zipprich Alexander , Carlton Rashad , Bunke Martin 
Published: April 2020

Following publication of the original article [1], the authors reported that one of the numbers within Fig. 6 contains a mistake.
The regulatory effect of Lactobacillus rhamnosus GG on T lymphocyte and the development of intestinal villi in piglets of different periods
Authors: Shonyela Seria Masole , Feng Bo , Yang Wentao , Yang Guilian , Wang Chunfeng 
Published: April 2020

AbstractThe maturation and development of T cells were not completed until T cells were selected in thymus. It was not until the early 1960s that j.f.a.p. discovered the importance of thymus in T cell development. Twelve healthy piglets were randomly divided into two groups, the experimental group (LGG group) and the control group (saline group). The LGG group piglets were given 1 ml LGG (6 × 109 CFU/ml) per day. The saline group was given 1 ml of normal saline per day. The piglets were slaughtered at 30 days and 45 days, respectively, and the MLN, jejunum and ileum PPs, LP of the piglets were taken. The expression of CD3+CD4+ T lymphocytes was detected by flow cytometry, and intestinal villi development was observed by intestinal paraffin section. The results showed that the flow cytometry results at 30 days and 45 days showed that the CD3+CD4+ T lymphocytes in the MLN group were significantly different from those in the saline group (P < 0.05, P < 0.01).The CD3+CD4+ T lymphocytes in the jejunum PP of piglets in LGG group were significantly different from those in saline group (P < 0.05). The CD3+CD4+ T lymphocytes in the ileum PP of the LGG group were significantly different from those in the saline group (P < 0.05, P < 0.01). CD3+CD4+ T lymphocytes and normal saline in the piglets of the LGG group There was a significant difference between the two groups (P < 0.001, P < 0.05). P < 0.001). HE staining results showed the length of the LGG group ileal villi in piglets at 30 days, 45 days was significantly different from that in normal saline group (P < 0.01, P < 0.01). LGG can also regulate the proliferation of T lymphocytes in the intestine of early weaned piglets at 30 days and 45 days increase the number of CD3+CD4+ T lymphocytes.
Comparison of the intensity of biofilm formation by Listeria monocytogenes using classical culture-based method and digital droplet PCR
Authors: Grudlewska-Buda Katarzyna , Skowron Krzysztof , Gospodarek-Komkowska Eugenia 
Published: April 2020

AbstractListeria monocytogenes is a Gram-positive bacterium, commonly found in food, water or sewage. This microorganism is capable of forming biofilm on different surfaces such as steel, glass, polypropylene etc. Recently an increase in cases of listeriosis has been noted, making L. monocytogenes the important health threat. Therefore, there is a need for rapid and sensitive detection of this pathogen. This study aimed to compare the number of L. monocytogenes cells recovered from the biofilm (prepared on steel and polypropylene) using the detection and amplification of the hlyA gene (droplet digital PCR, ddPCR) and the classical culture method. The research material consisted of 96 L. monocytogenes strains. A total of 58 isolates were obtained from clinical samples and 38 isolates derived from the municipal sewage treatment plant. Additionally, the reference strain ATCC®19111™ (WDCM00020) was used. The Pearson correlation coefficient for the results obtained by the classical culture-based method and ddPCR was 0.864 and 0.725, for biofilms produced on AISI 304 stainless steel surface and the polypropylene surface, respectively. Correlations were statistically significant (p ≤ 0.001), indicating that the ddPCR technique is an effective tool for the assessment of bacteria number in the biofilm.