bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of different types of cerebral perfusion for acute type A aortic dissection, unilateral versus bilateral
Authors: liu zhengqin , Wang Chen , Zhang Xiquan , Wu Shuming , fang changcun , pang xinyan 
Published: May 2020

Abstract
Background
Antegrade cerebral perfusion (ACP), including unilateral and bilateral, is most commonly used way for cerebral protection in aortic surgery. There is still no consensus on the superiority of the two methods. Our research was aimed to investigate the clinical effects between u-ACP and b-ACP.
Methods
321 patients with type A aortic dissection were studied retrospectively. 124 patients (38.6%) received u-ACP and 197 patients(61.4%) received b-ACP. We compared the incidence of postoperative neurological complications and other collected data between two groups. We also analyzed perioperative variables in order to find the potential associated factors for neurolocial dysfunction (ND).
Results
For u-ACP group, 54 patients (43.5%) had postoperative neurological complications including 22 patients (17.7%) with permanent neurologic dysfunction (PND) and 32 patients (25.8%) with temporary neurologic dysfunction (TND). For b-ACP group, 47 patients (23.8%) experienced postoperative neurological complications including 16 patients (8.1%) of PND and 31 patients (15.7%) of TND. The incidence of PND and TND were significantly different between two groups along with shorter CPB time (p = 0.016), higher nasopharyngeal temperature (p ≦ 0.000), shorter awakening time (p = 0.030) and lower incidence of hypoxia (p = 0.022). Furthermore, multivariate stepwise logistic regression analysis confirmed that preoperative neurological dysfunction (OR = 1.20, P = 0.028), CPB duration (OR = 3.21, P = 0.002 ) and type of cerebral perfusion (OR = 1.48, P = 0.017) were strongly associated with postoperative ND.
Conclusions
In our study, we found that b-ACP procedure had many advantages compared to u-ACP and we inferred that b-ACP may be more suitable for patients with type A AD undergoing total arch replacement.
Prevalence of diabetes, prediabetes, awareness, treatment and control among people 35 years and up
Authors: Shamshirgaran Seyed Morteza , Ghorbani Zohreh , Najafipour Farzad , Sarbakhsh Parvin , Aminisani Nayyereh 
Published: May 2020

Abstract
Background Despite the current endeavors in the prevention and treatment of diabetes, it is, still, one of the leading causes of mortality, morbidity, and health system costs worldwide. The aim of this study was to determine the prevalence of pre-/diabetes, awareness, treatment, and control of diabetes and its correlates among people participating in the pilot phase of the Azar cohort study in the Northwest of Iran.Methods A total of 1038 adults aged 35 years and older in Khamene city, East Azerbaijan province, Northwest of Iran, were recruited for the pilot phase of Azar cohort; a province-level of a nationwide PERSIAN cohort study. A comprehensive questionnaire including sociodemographic and clinical information was completed, and biological samples were collected. The quantities of HbA1C and FBS were adopted as benchmarks for assessing the status of subjects about having diabetes and pre-diabetes. All analyses were performed using STATA (version 14), the statistical software.Results The overall prevalence of diabetes and pre-diabetes was 18.2% and 34.8%, respectively. The result of the multivariate regression model showed, females had a better awareness (2.00 (CI: 0.94–4.26)), and their reception of diabetes’ medicine was higher: 2.57 (CI: 1.25–5.29). Having at least one comorbid condition was associated with an increased awareness of diabetes (3.13 (CI: 1.47–6.66)); in addition, here, the possibility of receiving medication was,also, higher: 4.54 (CI: 2.21–9.32). Furthermore, people who were smokers had a lower awareness. There was a significant increase in diabetes’ control among people with secondary and high school education (2.4 (CI: 0.92–6.23).Conclusions The current study demonstrated the increased prevalence of pre-/diabetes as well as low awareness, inadequate treatment and control. More effective and corrective factors in reducing the risk of diabetes and its control require more attention.
Patient Safety Culture In Primary And Home Care Services
Authors: Lousada Letícia , Dutra Francisco Clécio , Silva Beatriz , Oliveira Natália , Bastos Ismael , Vasconcelos Patrícia , de Carvalho Rhanna Emanuela Fontenele Lima 
Published: May 2020

Abstract
Background: The safety culture in primary care and home care services is still poorly studied, although this level of care is the gateway to health services. This study aims to evaluate the culture of patient safety in Primary and Home Care Services. Methods: This is an observational cross-sectional study carried out with 147 professionals from nine district linked to the Better Home Program and six basic health units. For the evaluation of culture, the Safety Attitudes Questionnaire (SAQ) was used, which considers a positive patient safety culture with scores ≥ 75. Results: Men who work in home care with length of service of three to four years scored better for the Safety Climate, Job Satisfaction, Team Work Climate and Total SAQ. Perception of management and Working Conditions received lower scores from professionals with longer working time.Conclusions: It is concluded that the evaluation of safety culture in the home care service was positive when compared to basic health units.
Efficacy of a High-Dose Proton Pump Inhibitor in Patients with Extraesophageal Symptoms of Gastroesophageal Reflux Disease: A Single Center, Randomized, Open-Label Trial
Authors: Cho Jae Ho , Shin Cheol Min , Yoon Hyuk , Park Young Soo , Kim Nayoung , Lee Dong Ho 
Published: May 2020

Abstract
Background
The extraesophageal manifestations of gastroesophageal reflux disease (GERD) are more difficult to manage than the typical symptoms. The efficacy of high-dose and standard-dose proton pump inhibitors against these atypical symptoms is not yet established.
Methods
In this single center, randomized, open-label study, patients with GERD received rabeprazole for 8 weeks, either 20 mg once daily (standard-dose group) or 20 mg twice daily (high-dose group). Patients were assessed before treatment and at weeks 4 and 8 with a 5-graded scale questionnaire consisting of 2 typical symptoms (heartburn and acid regurgitation) and 8 atypical symptoms (chest pain, cough, globus, wheezing, laryngopharyngitis, hoarseness, belching, and dysphagia). Sufficient improvement of reflux symptoms was defined as ≥ 50% reduction from the initial questionnaire score.
Results
Final analyses included 35 patients in the standard-dose group and 38 patients in the high-dose group. The rate of sufficient improvement for typical symptoms was significantly higher in the high-dose group than in the standard-dose group (100.0% vs. 84.0%, P = 0.040). For atypical symptoms, the rate of sufficient improvement tended to be higher in the high-dose group than in the standard-dose group (82.4% vs. 63.0%, P = 0.087). Scores of typical and some atypical symptoms (cough and globus) improved after treatment, with significant inter-group differences in time-course changes.
Conclusions
High-dose rabeprazole may be more effective for relieving atypical symptoms as well as typical GERD symptoms than a standard-dose regimen.
Trial registration:
This research was enrolled in a registry of clinical trials run by United States National Library of Medicine at the National Institutes of Health (ClinicalTrials.gov Protocol Registration and Results system ID: NCT04001400). This study was registered on June 26, 2019 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04001400.
Efficacy of combination-chemotherapy with pirarubicin, ifosfamide, and etoposide for soft tissue sarcoma: A single-institution retrospective analysis
Authors: Saito Shiro , Aiba Hisaki , Yamada Satoshi , Okamoto Hideki , Hayashi Katsuhiro , Kimura Hiroaki , Miwa Shinji , Otsuka Takanobu , Murakami Hideki 
Published: May 2020

Abstract
Background: The standard chemotherapy regimens for soft tissue sarcoma are doxorubicin-based. This phase 2 study aimed to assess the efficacy and safety of pirarubicin, ifosfamide, and etoposide combination therapy for patients with this disease.Methods: Between 2008 and 2017, 25 patients with soft tissue sarcoma were treated with pirarubicin (30 mg/m2, 2 days), ifosfamide (2 g/m2, 5 days), and etoposide (100 mg/m2, 3 days) every 3 weeks. The primary endpoint was overall response, and the secondary endpoint was adverse events of this regimen.Results: Response to this regimen according to RECIST criteria was 36% PR (n = 9), 36% SD (n = 9) and 28% PD (n = 7). During the treatment phase, frequent grade 3 or worse adverse events were haematological toxicities including white blood cell decreases (96%), febrile neutropenia (68%), anemia (68%), and platelet count decreases (48%). No long-term adverse events were reported during the study period.Conclusion: This regimen was comparable to previously published doxorubicin-based combination chemotherapy in terms of response rate. Although there were no long lasting adverse events, based on the results, severe haematological toxicity should be considered.
Impact of an Interprofessional, Longitudinal, Undergraduate Student-Initiated Home Visit Program Towards Interprofessional Education
Authors: Ng Kennedy , Leung Gloria Yao Chi , Yow Ka Shing , Ngiam Nerice Heng Wen , Yeo Dillon Guo Dong , Tey Angeline Jie-Yin , Lim Melanie Si Rui , Tang Aaron Kai Wen , Chew Bi Hui , Tham Celine , Yeo Jia Qi , Lau Tang Ching , Wong Sweet Fun , Wong Chek Hooi , Koh Gerald Choon-Huat 
Published: May 2020

Abstract
Background
Interprofessional (IP) practice is an essential aspect of healthcare to meet the challenges of an aging population. Tri-Generational HomeCare (TriGen) is an undergraduate student-initiated, longitudinal, IP home visit program focused on older patients with frequent hospital readmissions.
Methods
Teams comprising healthcare undergraduates and secondary school (SS) students performed home visits for frequently admitted patients (three or more visits in past six months) on a fortnightly basis over a period of six months. They were supported and trained by healthcare professionals from Khoo Teck Puat Hospital (KTPH), a regional healthcare system, and North West Community Development Council (NWCDC), a social service organisation. A multimethod approach was used, with the administration of Readiness for Interprofessional Learning Scale (RIPLS) pre- and post-intervention, and gathering post-intervention quantitative and qualitative feedback.
Results
80.1% of 226 undergraduate participants from 2015 to 2018 enrolled in the study. There was a significant decrease in RIPLS total score from a mean of 80.3 pre-intervention to 79.0 post-intervention with a mean difference of 1.3 (-2.5 – -0.089, p = 0.035). Subscale analysis revealed a significant increase in the subscale “Roles and Responsibility” with a mean difference of 0.46 (0.14–0.77, p < 0.01). There was no significant change in the subscale “Teamwork” and a significant decrease in the subscale “Professional Identity” with a mean difference of -0.14 (-2.1– -0.77, p < 0.01). This was discordant to the participants’ feedback. 91.6% of respondents agreed they could “better appreciate the importance of IP collaboration (IPC) in the care of patients”. Qualitative analysis revealed takeaways including learning from and teaching one another, understanding one’s own role and the role of other healthcare professionals, appreciating teamwork and developing friendship with undergraduates from other professions.
Conclusion
We demonstrated the feasibility of an IP, longitudinal, undergraduate-initiated home visit program that may improve attitudes towards one’s role and responsibilities in IP care for future IPC.
Perioperative serum albumin a predictor of adverse outcomes in major abdominal surgery: Prospective Cohort hospital based study.
Authors: Issangya Christian Ephata , Msuya David , Chilonga Kondo , Herman Ayesiga , Shao Elichilia Robert , Shirima Febronia , Naman Elifaraja , Mkumbi Henry , Pyuza Jeremia , Mtui Emmanuel , Sanga Leah Anku , Abdul Seif , John Beatrice , Chugulu Samuel 
Published: May 2020

Abstract
Background
Albumin is an important protein that transports hormones, fatty acids, and exogenous drugs; it also maintains plasma oncotic pressure. Albumin is considered a negative active phase protein because it decreases during injuries and sepsis. In spite of other factors predicting surgical outcomes, the effect of pre and postoperative serum albumin to surgical complications could be assessed by calculating percentage decrease in albumin (Delta albumin). This study aimed to explore perioperative serum albumin as a predictor of adverse outcomes in major abdominal surgeries.
Methodology:
All adults’ eligible participants from Kilimanjaro Christian Medical Centre Surgical Department were enrolled conveniently. Data were collected using study questionnaire. Full Blood Count (FBP), serum albumin levels preoperatively and on postoperative day 1 was measured abiding to Laboratory Standard Operating Procedures (SOP). Data was entered and analyzed using STATA version 14. Association and extent of decrease in albumin levels as a predictor of surgical site infection (SSI), delayed wound healing and death within 30days of surgery was determined using ordinal logistic regression model. In determining the diagnostic accuracy, a Non-parametric Receiver Operating Curve (ROC) model was used. We adjusted for ASA classification which had negative confounding effect on the predictive power of percent drop in albumin to adverse outcomes.
Results
61 participants were studied; the mean age was 51.6 (SD16.3), majorities were males 40 (65.6%) and post-operative adverse outcome happened to 28 (45.9%) participants. In preoperative serum albumin values, 40 (67.8%) had lower than 3.4 g/l while 51 (91%) had postoperative albumin values lower than 3.4 g/l. Only 15 (27.3%) had high delta albumin with the median percentage value of 14.77%. Delta albumin was an independent significant factor associated with adverse outcome (OR: 6.68; 95% CI: 1.59, 28.09); with a good predictive power and area under ROC curve (AUC) of 0.72 (95% CI 0.55 0.89). The best cutoff value was 11.61% with the sensitivity of 76.92% and specificity of 51.72%.
Conclusion
Early perioperative decrease in serum albumin level may be a good, simple and cost effective tool to predict adverse outcomes in major abdominal surgeries.
The Ebb and Flow of Identity Formation and Competence Development in Sub-specialty Residents: Study of a Continuity Training Setting
Authors: Huda Noureen , Faden Lisa , Wilson Claire A. , Plouffe Rachel A. , Li Edmond , Saini Manpreet Kaur , Chahine Saad 
Published: May 2020

Abstract
Background

Professional identity and competence development are evolving processes, shaped by clinical experiences and socialization in the workplace. The purpose of this study was to investigate the simultaneous development of professional identify formation and competence in a sub-specialty training program.
Methods

The study was conducted in a General Internal Medicine sub-specialty (PGY-4 and PGY-5) continuity training setting, at an academic health sciences center, in Canada. Participants included: current residents, recent graduates, attending physicians and administrative assistants. Data was collected from 2017–2018. A constructivist grounded theory approach was used to analyze anonymized focus group and individual interviews.
Results

The study identified the following: 1) learning activities that support professional identity formation in advanced residents; 2) the relationship between professional identity formation and competencies; 3) the role of administrative assistants and continuity training supervisors in supporting professional identity formation; and 4) a set of invisible learning experiences that occurred as a result of assumptions made by residents about expectations of training and expectations of patient care. Although, there was limited data available on the latter, findings suggested that invisible learning experiences may adversely impact residents’ functioning as independent physicians.
Conclusions

Residents’ professional identities continue to evolve with increasing competency requirements during training. Training programs, for sub-specialty residents, must balance granting of independence with supporting ongoing professional identity formation. They must also be explicit about what constitutes healthy patient care expectations and how practicing physicians manage these expectations.
Patterns of recurrence in adenocarcinoma of the esophagogastric junction: a retrospective study
Authors: Xu Haitao , Zhang Lianguo , Miao Jing , Liu Shuai , Liu Hongjian , Jia Teng , Zhang Qingguang 
Published: May 2020

Abstract
Background
The prognosis of adenocarcinoma of the esophagogastric junction (AEG) is poor. Understanding the postoperative recurrence pattern of AEG is helpful to verify the effectiveness of treatment and optimize subsequent treatment, so as to improve prognosis.
Methods
This single centre,retrospective study included patients with stage III AEG who underwent surgical treatment between January 2009 and December 2016. According to the different postoperative treatment arm, patients were divided into surgery and surgery plus chemotherapy groups. Recurrence-free survival was used as the outcome to compare the recurrence site and pattern between the groups.
Results
In total, enrolled 306 patients, 123 in the surgery group and 183 in the surgery plus chemotherapy group.During follow-up (median 522 days) of 730 days after surgery, 62.0% of patients had tumor recurrence. The overall recurrence rates in the surgery and surgery plus chemotherapy group were 86.9% and 77.0%, respectively. The recurrence patterns of both groups were mainly distant metastasis. Postoperative chemotherapy reduced the incidence of hematogenous dissemination from 51.2–42.0%. Multivariate Cox analysis showed that pN stage increased the risk of recurrence,while surgery plus chemotherapy reduced the risk.
Conclusions
Patients with AEG have a risk of hematogenous dissemination after surgery. Postoperative treatment arm and pN stage were independent risk factors in patients with AEG.Surgery plus chemotherapy can improve RFS and reduce distant metastasis, but they do not have a beneficial role in controlling local recurrence.
CXCR4-CXCL12 axis and distant metastatic outgrowth in head and neck malignancy
Authors: Li Yin , Bahadori Leila , Fritsche Kristin , Knolle Percy , Krüger Achim , Bier Henning , Knopf Andreas 
Published: May 2020

Abstract
Background: To analyze whether distant metastatic outgrowth in different head and neck malignancies (HNM) underlies the CXCR4-CXCL12 axis as overriding molecular mechanism. Methods: Clinic-pathological data of 1,250 HNM was included. HNM were collected due to different capability to exhibit distant metastasis comprising basal cell, squamous cell, and adenoid-cystic carcinoma as well as melanoma. MMP2/9, TIMP1/2, CXCR4, and CXCL12 immunohistochemistry was done in 190 randomly selected specimens.Results: Immunohistochemistry visualized a significant increase in MMP2/9, TIMP1/2, CXCR4, and CXCL12 protein expression following the clinical occurrence of distant metastasis. CXCR4, CXCL12, and TIMP2-expression significantly increases with number of affected organs by distant metastasis. Cox regression demonstrated CXCR4-overexpression and advanced T-status being independent risk factors of distant metastasis associated death.Conclusion: The CXCR4-CXCL12 axis is associated with the occurrence of distant metastases in different HNM. The increased risk of distant metastasis associated death was identified at primary tumour site and, therefore, potentially influences further treatment protocols.
Phospholipid signaling pathway in Capsicum chinense suspension cells as a key response to a consortium infection
Authors: Sánchez-Sandoval Eugenia , Di-Palma Graciela E Racagni , González-Mendoza Victor M , Cab-Guillén Yahaira A , Muñoz-Sanchez Armando , Ramos-Diaz Ana Luisa , Hernandez-sotomayor Teresa 
Published: May 2020

Abstract
Mexico is considered to be a diversification center for the chili species, but at the same time, these crops have been susceptible to infection by pathogens, such as Colletotrichum, which causes anthracnose diseases and postharvest decay in general. Different studies have been carried out with isolated strains of Colletotrichum in Capsicum plants, however, under growing conditions, the microorganisms are interacting with others, which can increase or decrease their infective capacity. This study presents the first report between plant-pathogen interactions and their biochemical responses in phospholipid pathways for C. chinense to microbial consortium with mainly Colletotrichum ignotum pathogen. The results showed morphological changes in the first hours (h) in the presence of the microbial consortium, and high levels of diacylglycerol pyrophosphate (DGPP) and phosphatidic acid (PA) were found after 6 h postinoculation (hai). These metabolic changes were correlated with high transcription levels of diacylglycerol-kinase (CchDGKs) expressed for 3, 6 and 12 hai and related to pathogen gene markers, such as CchPR1 and CchPR5. Finally, this study shows how the phospholipase C/DGK (PLC/DGK) pathway offers insight into the microbial infection responses of chili crops with damping-off diseases in the Yucatan.
The Association Between Residual Neuromuscular Blockade (RNMB) and Critical Respiratory Events: A Prospective Cohort Study
Authors: Alenezi Faraj , Alnababtah Khalid , Alqahtani Mohammed , Harbi Mohammed Al 
Published: May 2020

Abstract
Background: Inadequate neuromuscular recovery might impair pulmonary function among adult patients who undergo general anaesthesia and might thus contribute to critical respiratory events in the post-anaesthesia care unit (PACU). The aim of this study to investigate whether critical respiratory events (CREs) that described in a modified Murphy’s criteria are significantly associated with residual neuromuscular blockade (RNMB).Method: A prospective cohort study from January to March 2017 from a tertiary hospital from Saudi Arabia for thirty adult patients over 18 years old scheduled for elective surgery under general anaesthesia with neuromuscular blocking drugs (NMBDs) were enrolled in the study. The Mann-Whitney U tests, Chi-Square tests and Independent-Samples T tests were used. The Train-of-four (TOF) ratios were measured upon arrival in the PACU by using Acceleromyography with TOF-Scan. Subjects’ demographics, perioperative data, and the occurrence of postoperative CREs in the PACU were recorded.Results: 26 (86.7%) patients out of thirty in the study has received Rocuronium as NMBDs while Neostigmine as a reversal drug with only 23 (76.7%). The incidence of RNMB (TOF ratio < 0.9) was in 16 patients (53.3%). The incidence of RNMB was significantly higher in female patients (p= 0.033), in patients who had not undergone quantitative neuromuscular monitoring before extubation (p= 0.046) and in patients with shorter duration of surgery (p= 0.001). Postoperative CREs occurred in twenty patients (66.7%), and there were significantly more of these CREs among patients with RNMB (P= 0.001). In addition, a statistically significant difference was observed in the occurrence of CREs according to body mass index (P= 0.047).Conclusion: This research showed that RNMB is a significant contributing factor to the development of critical respiratory events during PACU stay. Therefore, optimal antagonism of neuromuscular blockade and routine quantitative neuromuscular monitoring are recommended to reduce the incidence of RNMB.