bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in treatment strategy over time for arteriovenous malformation in a Japanese high-volume center
Authors: Komatsu Katsuya , Takagi Yasushi , Ishii Akira , Kikuchi Takayuki , Yamao Yukihiro , Yoshida Kazumichi , Miyamoto Susumu 
Published: August 2020

Abstract
Background
Despite rapid developments in devices used to treat arteriovenous malformation (AVM), a randomised trial of Unruptured Brain Arteriovenous malformations published in 2014, recommended conservative treatment for nonhemorrhagic AVM.
Objective
The purpose of the current retrospective study was to confirm how AVM treatment in Japan has changed and to assess the safety of treatment for hemorrhagic and nonhemorrhagic AVMs.
Methods
We enrolled 242 consecutive patients with AVM; each patient's treatment was selected and performed at our hospital. The type of onset, Spetzler–Martin (S–M) grade, age, sex, selected treatment, mortality, and morbidity were compared between the first and second periods of our study.
Results
In patients with grade I–III AVM, the selected treatment changed between the first and second periods; however, in grade IV and V patients, the selected treatment did not change. Overall, interventions by microsurgery alone decreased (p < 0.001), the proportion of total treatments including microsurgery decreased (p = 0.005), interventions using stereotactic radiosurgery (SRS) alone increased (p = 0.009), and interventions including SRS increased (p = 0.002). Morbidity associated with intervention was 0.92% in the first period and 0% in the second period, and mortality was 0.92% in the first period and 1.67% in the second.
Conclusions
With the development of new devices, the selected treatment was changed in patients with S–M grade I–III AVM, but was not changed in patients with grade VI and V. The complication rate was low and did not change throughout the periods. These findings suggest that the safety of treatment depends on a full understanding of device development and the selection of proper treatment, not on hemorrhagic onset. Further treatment innovations are expected to change the treatment for grade IV and V AVMs.
The Endogenous Capacity to Produce Proinflammatory Mediators by the Ex Vivo Perfused Human Lung&nbsp;
Authors: Leligdowicz Aleksandra , Ross James T. , Nesseler Nicolas , Matthay Michael A. 
Published: August 2020

Abstract
Background: The ex vivo human perfused lung model has enabled optimizing donor lungs for transplantation and delineating mechanisms of lung injury. Perfusate and airspace biomarkers are a proxy of the lung response to experimental conditions. However, there is a lack of studies evaluating biomarker kinetics during perfusion and after exposure to stimuli. In this study we analyzed the ex vivo perfused lung response to three key perturbations: exposure to the perfusion circuit, exogenous fresh whole blood, and bacteria.Results: 99 lungs rejected for transplantation underwent ex vivo perfusion. One hour after reaching experimental conditions, fresh whole blood was added to the perfusate (n=55). Two hours after reaching target temperature, Streptococcus pneumoniae was added to the perfusate (n=42) or to the airspaces (n=17). Perfusate and airspace samples were collected at baseline (once lungs were equilibrated for 1 hour, but before blood or bacteria were added) and 4 hours later. Interleukin (IL)-6, IL-8, Angiopoietin (Ang)-2, and soluble tumor necrosis factor receptor (sTNFR)-1 were quantified. Baseline perfusate and airspace biomarker levels varied significantly, and this was not related to pre-procurement PaO2:FiO2 ratio, cold ischemia time, and baseline alveolar fluid clearance (AFC). After 4 hours of ex vivo perfusion, the lung demonstrated a sustained production of proinflammatory mediators. The change in biomarker levels was not influenced by baseline donor lung characteristics (cold ischemia time, baseline AFC) nor was it associated with measures of experimental epithelial (final AFC) or endothelial (percent weight gain) injury. In the presence of exogenous blood, the rise in biomarkers was attenuated. Lungs exposed to intravenous (IV) bacteria relative to control lungs demonstrated a significantly higher rise in perfusate IL-6.Conclusions: The ex vivo perfused lung has a marked endogenous capacity to produce inflammatory mediators over the course of short-term perfusion that is not significantly influenced by donor lung characteristics or the presence of exogenous blood, and only minimally affected by the introduction of systemic bacteremia. The lack of association between biomarker change and donor lung cold ischemia time, final alveolar fluid clearance, and experimental percent weight gain suggest that the maintained ability of the human lung to produce biomarkers is not merely a marker of lung epithelial or endothelial injury, but may support the function of the lung as an immune cell reservoir.
Differences and similarities of high-resolution computed tomography features between Pneumocystis pneumonia and Cytomegalovirus pneumonia in AIDS patients
Authors: Du Chunjing , Liu Jingyuan , Chen Hui , Yan Shuo , Pu Lin , Xiong Haofeng , Xiang Pan , Li Chuansheng , Zhang Ming , Chen Budong , Li Ang 
Published: August 2020

Abstract
Background Accurately differentiating pneumocystis from cytomegalovirus pneumonia is crucial for correct therapy selection in AIDS patients. Hence, the goal of this study was to compare the CT features of pneumocystis pneumonia and cytomegalovirus pneumonia in AIDS patients and identify clinical hallmarks to accurately distinguish these two pathologies.Methods A total of 112 AIDS patients (78 with pneumocystis pneumonia and 34 were cytomegalovirus pneumonia) were included in this study. Two experienced chest radiologists retrospectively reviewed CT images for 17 features including ground-glass opacity, consolidation, nodules, and halo sign. Significance was calculated by the chi-square (χ2) test.Results The presence of consolidation (61.77% in cytomegalovirus pneumonia, 35.9% in pneumocystis pneumonia, p=0.011), halo signs (32.35% in cytomegalovirus pneumonia, 11.54% in pneumocystis pneumonia, p＜0.001), and nodules (47.06% in cytomegalovirus pneumonia, 8.97% in pneumocystis pneumonia, p＜0.001), especially small nodules (32.5% in cytomegalovirus pneumonia, 6.41% in pneumocystis pneumonia, p＜0.001) without perilymphatic distribution, were significantly more frequent in patients with cytomegalovirus pneumonia than in those with pneumocystis pneumonia. Large nodules were not found in any of patients with cytomegalovirus pneumonia. The presence of ground-glass opacity (100% in pneumocystis pneumonia and cytomegalovirus pneumonia), reticulation (57.69% in pneumocystis pneumonia, 52.94% in cytomegalovirus pneumonia, p=0.782) and bronchial wall thickening (34.62% in pneumocystis pneumonia, 47.06% in cytomegalovirus pneumonia, p=0.213) were common in both groups. Conclusions Analysis of consolidation, nodules, and halo signs may contribute to the differential diagnosis of pneumocystis pneumonia or cytomegalovirus pneumonia. However, some CT features considered typical in one or other diseases appear with similar frequency in both cohorts of AIDS patients.
Association between post-traumatic stress disorder symptoms and bone fractures after the Great East Japan Earthquake in older adults: a prospective cohort study from the Fukushima Health Management Survey
Authors: Hayashi Fumikazu , Ohira Tetsuya , Nakano Hironori , Nagao Masanori , Okazaki Kanako , Harigane Mayumi , Yasumura Seiji , Maeda Masaharu , Takahashi Atsushi , Yabe Hirooki , Suzuki Yuriko , Kamiya Kenji 
Published: August 2020

Abstract
Background Psychological stress has been known to affect bone metabolism and increase fracture risk. However, the association between post-traumatic stress disorder (PTSD) and bone fractures remains unclear. The current study aimed to clarify the effects of disaster-induced PTSD symptoms on fracture risk in older adults.Methods This study analyzed responses from 17,459 individuals aged ≥65 without a history of fractures at the time of the Great East Japan Earthquake who answered the Mental Health and Lifestyle Survey component of the Fukushima Health Management Survey conducted in 2011. Obtained data were able to determine the presence or absence of fractures until 2016. Age, sex, physical factors, social factors, psychological factors, and lifestyle factors were subsequently analyzed. Survival analysis was then performed to determine the relationship between each factor and fractures. Thereafter, univariate and multivariate Cox proportional hazard models were constructed to identify fracture risk factors.Results A total of 2,097 (12.0%) fractures occurred during the follow-up period. Accordingly, univariate and multivariate Cox proportional hazard models showed that PTSD symptoms (total PTSD checklists scoring ≥ 44) [hazard ratio (HR): 1.26; 95% confidence interval (CI): 1.10–1.44; P = 0.001], history of cancer (HR: 1.48; 95% CI: 1.23–1.79; P < 0.001), history of stroke (HR: 1.26; 95% CI: 1.04–1.52; P = 0.021), history of heart disease (HR: 1.30; 95% CI: 1.13–1.49; P < 0.001), history of diabetes (HR: 1.23; 95% CI: 1.09–1.39; P = 0.001), current smoking (HR: 1.27; 95% CI: 1.01–1.61; P = 0.045), and high dissatisfaction with sleep or no sleep at all (HR: 1.36; 95% CI: 1.04–1.77; P = 0.024) promoted a significant increase in fracture risk independent of age and sex.Conclusions The present study indicate that disaster-induced PTSD symptoms and insomnia could contribute to increased fracture risk among older adults residing in evacuation areas within Fukushima prefecture.
Older age and frailty are the chief predictors of mortality in COVID-19 patients admitted to an acute medical unit in a secondary care setting- A cohort study
Authors: Chinnadurai Rajkumar , Ogedengbe Onesi , Agarwal Priya , Money-Coomes Sally , Abdurrahman Ahmad Z , Mohammed Sajeel , Kalra Philip A , Rothwell Nicola , Pradhan Sweta 
Published: August 2020

Abstract
Background There is a need for more observational studies across different clinical settings to better understand the epidemiology of the novel COVID-19 infection. Evidence on clinical characteristics of COVID-19 infection is scarce in secondary care settings in Western populations.MethodsWe describe the clinical characteristics of all consecutive COVID-19 positive patients (n=215) admitted to the acute medical unit at Fairfield General Hospital (secondary care setting) between 23 March 2020 and 30 April 2020 based on the outcome at discharge (group 1: alive or group 2: deceased). We investigated the risk factors that were associated with mortality using binary logistic regression analysis. Kaplan-Meir (KM) curves were generated by following the outcome in all patients until 12 May 2020. ResultsThe median age of our cohort was 74 years with a predominance of Caucasians (87.4%) and males (62%). Of the 215 patients, 86 (40%) died. A higher proportion of patients who died were frail (group 2: 63 vs group 1: 37%, p<0.001), with a higher prevalence of cardiovascular disease (group 2: 58 vs group 1: 33%, p<0.001) and respiratory diseases (group 2: 38 vs group 1: 25 %, p=0.03). In the multivariate logistic regression models, older age (odds ratio (OR) 1.03; p=0.03), frailty (OR 5.1; p<0.001) and lower estimated glomerular filtration rate (eGFR) on admission (OR 0.98; p=0.01) were strong and independent predictors of inpatient mortality. KM curves showed a clear significantly shorter survival time in the frail older patients. ConclusionOlder age and frailty are strong and independent risk factors associated with mortality in COVID-19 patients hospitalised to an acute medical unit at secondary care level. A holistic approach by incorporating these factors is warranted in the management of patients with COVID-19 infection.
The Role of Postprandial Very-Low-Density Lipoprotein ­in the Development of Atrial Remodeling in Metabolic Syndrome&nbsp;
Authors: Lee Hsiang-Chun , Shin Shyi-Jang , Huang Jih-Kai , Lin Ming-Yen , Lin Yu-Hsun , Ke Liang-Yin , Jiang He-Jiun , Tsai Wei-Chung , Chao Min-Fang , Lin Yi-Hsiung 
Published: August 2020

Abstract
Background: Negatively charged very-low-density lipoprotein (VLDL-χ) in metabolic syndrome (MetS) patients exerts cytotoxic effects on endothelial cells and atrial myocytes. Atrial cardiomyopathy, manifested by atrial remodeling with a dilated diameter, contributes to atrial fibrillation pathogenesis and predicts atrial fibrillation development. The correlation of VLDL-χ with atrial remodeling is unknown. This study investigated the association between VLDL-χ and left atrial dilatation. Methods: Consecutively, 87 MetS and 80 non-MetS individuals between 23 and 74 years old (50.6% men) without overt cardiovascular diseases were included in the prospective cohort study. Blood samples were collected while fasting and postprandially (at 0.5, 1, 2, and 4 hours after a unified meal). VLDL was isolated by ultracentrifugation; the percentile concentration of VLDL-χ (%) was determined by ultra-performance liquid chromatography. The correlations of left atrial diameter (LAD) with variables including VLDL-χ, LDL-C, HDL-C, triglycerides, glucose, and blood pressure, were analyzed by multiple linear regression models. A hierarchical linear model was conducted to test the independencies of each variable’s correlation with LAD. Results: The mean LAD was 3.4 ± 0.5 cm in non-MetS subjects and 3.9 ± 0.5 cm in MetS patients (P< 0.01). None of the fasting lipid profiles were associated with LAD. VLDL-χ, BMI, waist circumference, hip circumference, and blood pressure were positively correlated with LAD (all P<0.05) after adjustment for age and sex. Significant interactions between VLDL-χ and blood pressure, waist circumference, and hip circumference were observed. When adjusted for obesity- and blood pressure-related variables, 2-hour postprandial VLDL-χ (mean 1.30 ± 0.61%) showed a positive correlation with LAD in MetS patients. Each 1% VLDL-χ increase was estimated to increase LAD by 0.23 cm. Conclusions: Postprandial VLDL-χ is associated with atrial remodeling. VLDL-χ is a novel biomarker and may be a therapeutic target for atrial cardiomyopathy in MetS patients. Trial registration: ISRCTN 69295295. Retrospectively registered 9 June 2020.
Seeking healthcare at their 'right' time; the iterative decision process for women with breast cancer
Authors: AGBEKO ANITA ESEENAM , Arthur Joshua , Bayuo Jonathan , Kaburi Basil Benduri , Kyei Ishmael 
Published: August 2020

Abstract
BACKGROUND: About 85% of breast cancer patients attending Komfo Anokye Teaching Hospital (KATH), Ghana, present with stage III/IV disease. In spite of great investments into the early diagnosis and management of breast cancer, late presentation persists and poses a barrier to realising the possible benefits of the gains made in breast cancer management. This study assessed the symptom appraisal and medical health seeking behaviour of women with either locally advanced or metastatic breast cancer attending breast clinic at KATH METHOD: In-depth interviews of women presenting with clinical stage III/IV breast cancer were conducted to explore the women’s care seeking pathways after symptom identification until arrival at KATH from May 2015 to March 2016. Thematic data analysis was conducted using the Andersen behavioural model for health service use. RESULTS: Fifteen women aged 24 – 79 years were interviewed. The time from symptom identification to reporting to KATH was 4 - 24 months. The initial symptom was a breast lump or breast swelling which all the women identified themselves. These were initially appraised as not serious because most importantly, they did not interfere with their daily function. Symptom progression such as prevented them from undertaking their usual economic, social and family function triggered seeking care from health facilities. The availability of money to pay for care and diagnostic investigations influenced the time taken to navigate the referral pathway. While the women initially deferred healthcare for reasons related to their ability to perform economic, family and social roles, ultimately, aggressively pursuing healthcare was also for the same economic, family and social reasons or goals.CONCLUSION: Deciding to seek care and pursue treatment for breast cancer symptoms may be much more complicated than it appears. Economic, family and social function significantly drive the health seeking process both at the personal and health facility phases of health seeking. Breast cancer education messages must be adapted to incorporate these functional goals and their influence on symptom appraisal and decision making to seek help and not just focus on the breast symptom as an isolated entity.
Common and distinct neural representations of aversive somatic and visceral stimulation in healthy individuals
Authors: Wager Tor , Oudenhove Lukas Van , Kragel Philip , Dupont Patrick , Ly Huynh Giao , Pazmany Els , Enzlin Paul , Rubio Amandine , Delon-Martin Chantal , Bonaz Bruno , Aziz Qasim , Tack Jan , Fukudo Shin , Kano Michiko 
Published: August 2020

Abstract
Pain is a primary driver of motivated behavior and learning. Different varieties of pain may be encoded in different brain circuits, but the neural similarities and differences across different types of pain are not well understood. Here, we examine the similarites and differences in brain processing of visceral and somatic pain, one of the most fundamental distinctions in the pain field. We analyze data from 7 fMRI studies (N = 165) and 5 types of pain and discomfort—esophageal, gastric, and rectal distension, cutaneous thermal stimulation, and vulvar pressure—to establish and validate generalizable pain representations. We first evaluate an established multivariate brain measure, the Neurologic Pain Signature (NPS), as a potential common nociceptive pain system across all pain types. Then, we develop a multivariate classifier for visceral vs. somatic pain. The NPS (1) responded robustly in 98% of participants across all types, (2) correlated with perceived intensity of visceral pain/discomfort, and (3) showed specificity to pain when compared with non-painful cognitive and affective conditions drawn from 12 additional studies (total N = 180, AUROC 0.93). Pre-defined signatures for other types of negative affect did not respond to visceral pain. The novel visceral vs. somatic classifier reliably distinguished somatic (thermal) from visceral (rectal) stimulation in both cross-validation and independent cohorts (AUROC 0.84). Other types reflected mixtures of somatic and visceral patterns. These results validate the NPS as measuring a common core nociceptive pain system across pain types, and lay a foundation for new brain-based biomarkers for particular types of pain.
A Cross-Sectional Study on the Practice of Wet Nursing Among Muslim Mothers
Authors: Rahim Norsyamlina Che Abdul , Hamjah Salasiah Hanin , Majid Latifah Abdul , Kusrin Zuliza , Hashim Nurhidayah Muhammad , Saidon Rafeah , Bahari Nora’inan , Ilias Muhamad Zariff , Ahmad Noor Ani 
Published: August 2020

Abstract
Background: The practice of wet nursing or the breastfeeding of another woman’s child in Malaysia is on the rise due to the emergence of awareness among the public about the importance and advantages contained in breast milk. This can be further explored by examining the benefits of breastfeeding, and society is acting by making breastfeeding a complement to breastfeeding in a variety of ways and circumstances. This study aims to investigate and determine the practice of wet nursing among Muslim mothers in Selangor.Methods: This cross-sectional study was conducted on 100 women who had breastfed another child in Selangor. Data were obtained using a validated questionnaire (Cronbach alpha = 0.8) and processed using the SPSS software.Results: Results showed 43.0% of respondents had at least breastfed one someone else’s child. Meanwhile, there were 3.0% of the respondents who were nursing seven to ten other children. A total of 237 children has been nourished by the respondents (n = 100). Of these, 21.5% were breastfed less than five times, while 78.5% were ever breastfed less than five times. Most mothers recorded milk child background data were breastfed, and this shows that the community aware of the importance of data documenting the suckler and indirectly proves that the authorities should act on these current needs.Conclusions: This study obtained a lot of useful information that indicated there is a wet-nursing practice in society. We hope the authorities take appropriate measures so that wet-nursing practices can be officially recorded and monitored to maintain the sustainability and welfare of the Muslims in the state and Malaysia in general.
Cultural adaptation and feasibility of trauma-focused cognitive behavioural therapy in China
Authors: Li Jia , Li Jina , Yuan Lin , Zhou Ying , Qu Zhiyong 
Published: August 2020

Abstract
Background: The contradiction between the burden of post-traumatic stress disorder (PTSD) and the lack of evidence-based treatments (EBTs) is common in low- and middle-income countries of Asia. The adaptation of trauma-focused cognitive behavioural therapy (TF-CBT) is helpful for meeting the needs of children in these countries. The objectives of this study were to describe the cultural adaptation process of TF-CBT and to explore the feasibility and acceptability of adapted interventions in China.Method: Based on the Map of the Adaptation Process (MAP), this study adapted the types of participants, form, content elements, length and language of TF-CBT. A total of 58 children and 8 facilitators participated in a feasibility study. Feasibility was measured by the retention of children. Acceptability was assessed by the client satisfaction questionnaire (CSQ-8) and interviews with the children and facilitators.Result: An intervention based on TF-CBT that included 7 group sessions and 3 individual sessions was developed. The results of the feasibility study showed that children had a high average retention rate (above 97%) and satisfaction (78.95%) with the intervention. Qualitative interviews showed that children and facilitators had high acceptance of the adapted intervention.Conclusion: The adapted group-based TF-CBT had good participant retention and satisfaction. It could be smoothly implemented in the Chinese school environment.Trial registration: Chinese Clinical Trial Registry, ChiCTR1800019837. Registered 2 December 2018, http://www.chictr.org.cn/showproj.aspx?proj=33479.
O USO DA METODOLOGIA TEAM BASED LEARNING COMO ESTRATÉGIA PARA REVISÃO DE CONTEÚDOS UTILIZANDO O SOFTWARE TBLActive
Authors: Scherer Adriana Paula Zamin 
Published: August 2020

As metodologias ativas de aprendizagem tornam o aluno o centro do processo de aprendizagem. Dentre tais metodologias, a Team Based Learning destaca-se pelo aprendizado efetivo de conteúdos técnicos e pelo desenvolvimento da tomada de decisão, do trabalho em equipe e colaborativo. A metodologia é dividida em 03 (três) partes: preparo prévio que ocorre em ambiente externo à sala de aula; Garantia de preparo ocorre no ambiente de sala de aula e é composto por uma dinâmica de respostas a um conjunto de questões que os estudantes respondem inicialmente individualmente e posteriormente em equipes; Aplicação de conceitos é o momento em que os estudantes aplicam o que aprenderam através da resolução de problemas que, normalmente, envolvem aspectos com a área de atuação futura do aluno. Este trabalho tem o objetivo de relatar a experiência de utilização desta metodologia, em uma turma de estudantes do Curso de Sistemas de Informação de uma instituição de ensino privado. Ao final da atividade, os estudantes responderam a um questionário avaliativo e os resultados demonstraram um grau de satisfação muito elevado com a aplicação do método e uma percepção de aprendizado significativo.