bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiopulmonary resuscitation during the COVID-19 pandemic: a scientific statement on CPR management protocol of Kasr Al-Ainy University Hospital is presented
Authors: Taha Hesham S. , Shaker Mirna M. , Abdelghany Mohamed M. 
Published: October 2020

Abstract
Background
The COVID-19 pandemic poses a major burden to the healthcare system in Egypt, and in the face of a highly infective disease which can prove fatal, healthcare systems need to change their management protocols to meet these new challenges.

Main body
This scientific statement, developed by the cardiology department at Cairo University, emphasized 6 different aspects that are intended to guide healthcare providers during cardiopulmonary resuscitation (CPR) in the era of the COVID-19 pandemic. It highlighted the importance of dealing with all cardiac arrest victims, during the pandemic, as potential COVID-19 cases, and the use of appropriate personal protective equipment (PPE) by health care providers during the procedure. It also stated that the CPR procedure should be done in a separate room with the door closed and that the number of providers present during the procedure should be limited to only those who are essential for patient resuscitation. It also stressed that family members and accompanying personnel of patients with possible COVID-19 should not be in the vicinity of CPR site. The statement also pointed out that CPR procedure should be done in the standard manner with precautions to minimize spread of infection to the staff and accompanying people. Early intubation was prioritized, and the use of rapid sequence intubation with appropriate PPE was recommended. For delivery of CPR for the prone ventilated patient, delivery of chest compressions by pressing the patient’s back, while a team prepares to turn the patient supine, was recommended. During intra-hospital transport, it was emphasized that the receiving intensive care unit (ICU) should be notified about the possibility of the patient being COVID-19 positive, so that appropriate infection control precautions are taken.

Conclusion
Cardiopulmonary resuscitation of cardiac arrest patients in the COVID-19 era poses a significant challenge, and all health care providers should deal with any cardiac arrest victim presenting to the emergency department as potential COVID-19 suspects and should use the appropriate PPE.
The clinical significance of blood lactate levels in evaluation of adult patients with veno-arterial extracorporeal membrane oxygenation
Authors: Laimoud Mohamed , Alanazi Mosleh 
Published: October 2020

Abstract
Background
Veno-arterial ECMO is a life-supporting procedure that can be done to the patients with cardiogenic shock which is associated with hyperlactatemia. The objective of this study was to detect the validity of serial measurements of arterial lactate level in differentiating hospital mortality and neurological outcome after VA-ECMO support for adult patients with cardiogenic shock. All consecutive patients ≥ 18 years admitted with cardiogenic shock and supported with VA-ECMO between 2015 and 2019 in our tertiary care hospital were retrospectively studied.

Results
The study included 106 patients with a mean age of 40.2 ± 14.4 years, a mean BMI of 26.5 ± 7 and mostly males (69.8%). The in-hospital mortality occurred in 56.6% and acute cerebral strokes occurred in 25.5% of the enrolled patients. The non-survivors and the patients with acute cerebral strokes had significantly higher arterial lactate levels at pre-ECMO initiation, post-ECMO peak and after 24 h of ECMO support compared to the survivors and those without strokes, respectively. The peak arterial lactate ≥ 14.65 mmol/L measured after ECMO support had 81.7% sensitivity and 89.1% specificity for predicting hospital mortality [AUROC 0.889, p < 0.001], while the arterial lactate level ≥ 3.25 mmol/L after 24 h of ECMO support had 88.3% sensitivity and 97.8% specificity for predicting hospital mortality [AUROC 0.93, p < 0.001]. The peak lactate ≥ 15.15 mmol/L measured after ECMO support had 70.8% sensitivity and 69% specificity for predicting cerebral strokes [AUROC 0.717, p < 0.001], while the lactate level ≥ 3.25 mmol/L after 24 h of ECMO support had 79.2% sensitivity and 72.4% specificity for predicting cerebral strokes [AUROC 0.779, p < 0.001]. Progressive hyperlactatemia (OR = 1.427, 95% CI 1.048–1.944, p = 0.024) and increasing SOFA score after 48 h (OR = 1.819, 95% CI 1.374–2.409, p < 0.001) were significantly associated with in-hospital mortality after VA-ECMO support. Post hoc analysis detected a significantly high frequency of hypoalbuminemia in the non-survivors and in the patients who developed acute cerebral strokes during VA-ECMO support.

Conclusion
Progressive hyperlactatemia after VA-ECMO initiation for adult patients with cardiogenic shock is a sensitive and specific predictor of hospital mortality and acute cerebrovascular strokes. According to our results, we could recommend early VA-ECMO initiation to achieve adequate circulatory support and better outcome.
Advanced and futuristic approaches for breast cancer diagnosis
Authors: Mishra Jayanti , Kumar Bhumika , Targhotra Monika , Sahoo P. K. 
Published: October 2020

Abstract
Background
Breast cancer is the most frequent cancer and one of the most common causes of death in women, impacting almost 2 million women each year. Tenacity or perseverance of breast cancer in women is very high these days with an extensive increasing rate of 3 to 5% every year. Along with hurdles faced during treatment of breast tumor, one of the crucial causes of delay in treatment is invasive and poor diagnostic techniques for breast cancer hence the early diagnosis of breast tumors will help us to improve its management and treatment in the initial stage.

Main body
Present review aims to explore diagnostic techniques for breast cancer that are currently being used, recent advancements that aids in prior detection and evaluation and are extensively focused on techniques that are going to be future of breast cancer detection with better efficiency and lesser pain to patients so that it helps to a physician to prevent delay in treatment of cancer. Here, we have discussed mammography and its advanced forms that are the need of current era, techniques involving radiation such as radionuclide methods, the potential of nanotechnology by using nanoparticle in breast cancer, and how the new inventions such as breath biopsy, and X-ray diffraction of hair can simply use as a prominent method in breast cancer early and easy detection tool.

Conclusion
It is observed significantly that advancement in detection techniques is helping in early diagnosis of breast cancer; however, we have to also focus on techniques that will improve the future of cancer diagnosis in like optical imaging and HER2 testing.
Associations of a Preoperative Anemia and Suboptimal Iron Stores Screening and Management Clinic in Colorectal Surgery With Hospital Cost, Reimbursement, and Length of Stay: A Net Cost Analysis
Authors: Trentino Kevin M. , Mace Hamish , Symons Kylie , Sanfilippo Frank M. , Leahy Michael F. , Farmer Shannon L. , Watts Rory D. , Hamdorf Jeffrey M. , Murray Kevin 
Published: October 2020

BACKGROUND:
In 2016, a preoperative clinic was implemented to screen, evaluate, and manage anemia and suboptimal iron stores at a major tertiary care medical center in Western Australia. Few studies compare the costs and reimbursements associated with preoperative anemia and suboptimal iron stores management. The objective of our study was to conduct a net cost analysis associated with the implementation of this clinic.

METHODS:
We designed a retrospective cohort study involving elective colorectal surgical admissions over a 3-year period. The baseline year selected was the 2015–2016 financial year, with outcomes in the 2016–2017 and 2017–2018 year compared to baseline. The study perspective was the Western Australian Health System. Hospital costs were extracted from the health service clinical costing system, which captures costs at the admission level. The primary outcome was net cost, defined as gross cost minus reimbursement (or funding) received.

RESULTS:
Our 3-year study included 544 admissions for elective colorectal surgery. After the implementation of the preoperative clinic, 73.4% (n = 257) of admissions were screened for anemia and suboptimal iron stores, and 31.4% (n = 110) received intravenous iron. In our adjusted analysis, when comparing the final year (2017–2018) with baseline (2015–2016), the units of red blood cells transfused per admission decreased 53% (142 vs 303 units per 1000 discharges; P = .006), and mean hospital length of stay decreased 15% (7.7 vs 9.1 days; P = .008). When comparing the final year with baseline, rectal resection admissions were associated with a mean decrease in the net cost of Australian dollar (A$) 7619 (95% confidence interval, 4230-11,008; P < .001) between 2015–2016 and 2017–2018. For small and large bowel procedures, there was a mean decrease of A$6744 (95% confidence interval, 2430-11,057; P = .002).

CONCLUSIONS:
The implementation of a preoperative anemia and suboptimal iron stores screening and management clinic in elective colorectal surgery was associated with reductions in red cell transfusions, length of stay, and net costs.
Bound by Sovereignty
Authors: Miranda J. V. 
Published: October 2020

Abstract
Recently scholars have called for an Indigenous turn in medieval studies that challenges the historical assumptions of the field by actively engaging in a decolonial and anticolonial praxis. This essay argues that this turn must confront the problem of reciprocity that arises from distinct Indigenous and medieval articulations of sovereignty, which reveal the potential of this tenuous intersection despite the possibility of irreconcilable antagonisms. Tracing sovereignty—specifically through a “politics of recognition” as proposed by the Yellowknives Dene scholar Glen Coulthard—in Dante’s Monarchia (and Paradiso) and Leslie Marmon Silko’s Ceremony provides an analytic example of this comparative framework, since both authors challenge readers to question the imposition of authority and the logics that legitimate and justify dominant forms of governance. Yet Dante and Silko also draw on distinct articulations of sovereignty that suggest the limitations of decolonial and anticolonial praxis within a field bound to a Western episteme that underwrites colonial and imperial authority.
Frequency and clinical significance of prostatic involvement in men with febrile urinary tract infection: a prospective observational study
Authors: Arjunlal Thayyil Shahilal , Deepanjali Surendran , Manikandan Ramanitharan , Medha Rajappa 
Published: October 2020

Background: Frequent asymptomatic involvement of the prostate has been demonstrated in men with febrile urinary tract infection (fUTI). In view of this, men with fUTI are often given a longer duration of antibiotic treatment; however, evidence to support this is limited.Methods: We prospectively studied adult men with fUTI admitted under the Department of Medicine in a tertiary care hospital in southern India. fUTI was defined as fever of ≥38°C with at least one symptom/sign of UTI and pyuria, requiring hospitalization. We estimated serum total prostate-specific antigen (PSA) levels at enrollment, one month and three months after treatment completion. We assessed prostatic volume by transrectal ultrasonography (TRUS) and estimated the serum high sensitivity C-reactive protein (hs-CRP) levels at baseline and after three months.Results: We enrolled 64 men (median [IQR] age 53 [45-60] years); 50 patients completed follow-up. At baseline, 24 (38%) of 64 patients had elevated serum PSA values compared to age-specific upper limit. The median (IQR) serum PSA level was 2.15 (1.18-3.02) ng/mL and median (IQR) serum hs-CRP level was 2.23 (1.85-2.74) mg/dL (N=64). At three months, serum PSA levels decreased by ≥25% in 47 (94%) of 50 patients. The median (IQR) of prostatic volume was 25.4 (18.9-34) mL at baseline (N=64), and ≥10% decrease in prostatic volume was observed in 24 (48%) of 50 patients at three months. The change in the serum PSA levels did not correlate with clinical findings like prostatic tenderness or with prostatic volume changes. Further, serum PSA levels did not correlate with hs-CRP levels. On follow-up, seven patients had lower urinary tract symptoms; only one of them had recurrent fUTI. Conclusions: Asymptomatic prostatic involvement, although common in men with fUTI, does not seem to influence the treatment outcomes.
Botulism outbreak after the consumption of vegetarian pâté in the south of Viet Nam
Authors: Ngan Nguyen Thi Thuy , Tho Vo Ngoc Anh , Khanh Do Thi Ngoc , Hien Vo Thi Thanh , Day Jeremy N. , Sang Nguyen Ngoc , Tam Hua Thoai , Thanh Ho Thi Chi , Hung Le Quoc 
Published: October 2020

Botulism is a potentially life-threatening disease caused by toxins produced by Clostridium botulinum. Here we reported a case series of six patients who presented with botulism following ingestion of commercially made pâté. The key features of presentation were acute onset of bilateral cranial nerve palsies and symmetrical descending weakness in the absence of fever resulting in the need for mechanical ventilation in all six patients. The clinical diagnosis of botulism was confirmed through the identification of C. botulinum from the suspected food source. Given that botulinum antitoxin was not available in Vietnam at the time, and their severe status, all patients received a trial of plasma exchange therapy, but no clear benefit was seen. Due to its rarity, diagnosing botulism is a challenge, demanding high clinical suspicion. Successful outcomes depend upon early recognition and rapid initiation of specific treatment with botulinum antitoxin. There is a need to improve global access to antitoxin. These cases, the first in Viet Nam, serve as a reminder of the need to maintain the highest possible food hygiene and preservation practices.
Arthroplasty information on the internet
Authors: Davaris Myles T. , Dowsey Michelle M. , Bunzli Samantha , Choong Peter F. 
Published: October 2020

AimsTotal joint replacement (TJR) is a high-cost, high-volume procedure that impacts patients’ quality of life. Informed decisions are important for patients facing TJR. The quality of information provided by websites regarding TJR is highly variable. We aimed to measure the quality of TJR information online.MethodsWe identified 10,800 websites using 18 TJR-related keywords (conditions and procedures) across the Australian, French, German and Spanish Google search engines. We used the Health on the Net (HON) toolbar to evaluate the first 150 websites downloaded for every keyword in each language. The quality of information on websites was inspected, accounting for differences by language and tertiles. We also undertook an analysis of English websites to explore types of website providers.Results‘Total joint replacement’ had the most results returned (150 million websites), and 9% of websites are HON-accredited. Differences in information quality were seen across search terms (p < 0.001) and tertiles (p < 0.001), but not between languages (p = 0.226). A larger proportion of HON-accredited websites were seen from keywords in the condition and arthroplasty categories. The first tertile contained the highest number of HON-accredited websites for the majority of search terms. Government/educational bodies sponsored the majority of websites.ConclusionClinicians must consider the shortage of websites providing validated information, with disparities in both number and quality of websites for TJR conditions and procedures. As such, the challenge for clinicians is to lead the design of reliable, accurate and ethical orthopaedic websites online and direct patients to them. This stands to reward both parties greatly.
Infection prevention measures for orthopaedic departments during the COVID-2019 pandemic: a review of current evidence
Authors: Baldock Thomas E. , Bolam Scott M. , Gao Ryan , Zhu Mark F. , Rosenfeldt Michael P. J. , Young Simon W. , Munro Jacob T. , Monk A. Paul 
Published: October 2020

Aim The coronavirus disease 2019 (COVID-19) pandemic presents significant challenges to healthcare systems globally. Orthopaedic surgeons are at risk of contracting COVID-19 due to their close contact with patients in both outpatient and theatre environments. The aim of this review was to perform a literature review, including articles of other coronaviruses, to formulate guidelines for orthopaedic healthcare staff. Methods A search of Medline, EMBASE, the Cochrane Library, World Health Organization (WHO), and Centers for Disease Control and Prevention (CDC) databases was performed encompassing a variety of terms including ‘coronavirus’, ‘covid-19’, ‘orthopaedic’, ‘personal protective environment’ and ‘PPE’. Online database searches identified 354 articles. Articles were included if they studied any of the other coronaviruses or if the basic science could potentially applied to COVID-19 (i.e. use of an inactivated virus with a similar diameter to COVID-19). Two reviewers independently identified and screened articles based on the titles and abstracts. 274 were subsequently excluded, with 80 full-text articles retrieved and assessed for eligibility. Of these, 66 were excluded as they compared personal protection equipment to no personal protection equipment or referred to prevention measures in the context of bacterial infections. Results There is a paucity of high quality evidence surrounding COVID-19. This review collates evidence from previous coronavirus outbreaks to put forward recommendations for orthopaedic surgeons during the COVID-19 pandemic. The key findings have been summarized and interpreted for application to the orthopaedic operative setting. Conclusion For COVID-19 positive patients, minimum suggested PPE includes N95 respirator, goggles, face shield, gown, double gloves, and surgical balaclava. Space suits not advised. Be trained in the correct technique of donning and doffing PPE. Use negative pressure theatres if available. Minimize aerosolization and its effects (smoke evacuation and no pulse lavage). Minimize further unnecessary patient-staff contact (dissolvable sutures, clear dressings, split casts).
Dental Implants for Patients with Periodontitis
Authors: Patel Rajiv M. 
Published: October 2020

This article provides a narrative review of the use of dental implants in patients with periodontitis. Using clinical examples where possible, consideration is given to the survival and success of implants, peri-implantitis, comparison of periodontally compromised teeth to implants and to treatment planning to help achieve favourable outcomes. The challenges associated with restoring an edentulous arch or partially dentate dentition with implants where significant alveolar atrophy has occurred can be considerable. Compromised outcomes may be commonplace. Dental implant treatment is more likely to be successful for those patients who attain and maintain excellent plaque control. Professional support should focus on managing underlying periodontitis prior to commencing implant therapy and providing long term, regular supportive periodontal care upon completion of treatment.
Online Hoaxes, Existential Threat, and Internet Shutdown: A Case Study of Securitization Dynamics in Indonesia
Authors: Lee Antony 
Published: October 2020

As one of the countries in the world with the highest growth of internet users, Indonesia is experiencing a rapid growth in social media usage. Some use social media for networking but some others use it to spread hoaxes, fake information, or disinformation. During presidential election in Indonesia in the period from 2017 to 2019, hoaxes and disinformation were widely circulated through social media and instant messaging. This phenomenon has triggered heated public debates on the nexus between digital spaces and security, which include how the online disinformation has threatened Indonesian security. For example, hoaxes were represented in the public sphere as an existential threat to Indonesian unity. Immediate question regarding this phenomenon is:why are online hoaxes and fake information represented in public spheres as a security threat? This paper argues that as a response toward the increase of online hoaxes, there were securitizing moves made by political elites and special agencies in Indonesia before and in the aftermath of the 2019 Indonesian presidential election. Employing discourse analysis of selected relevant news articles around the period of 2017-2019, this paper analyses the dynamic of the securitization of online hoaxes in Indonesia. Grounded within Securitization Theory, this paper analyses; the facilitating condition; the triumvirates of securitizations, which are the securitizing actors, the threats posed by hoaxes, and the audiences; as well as extraordinary measures executed to handle the threats; internet throttling and internet shutdown when necessary.
Fecal Microbiota Transplants Annually and Their Positive Clinical Impact
Authors: Mamoon Lamia , Olesen Scott W. 
Published: October 2020

INTRODUCTION:
Although fecal microbiota transplantation (FMT) is a recommended, clinically efficacious, and cost-effective treatment for recurrent Clostridioides difficile infection (CDI), the scale of FMT use in the United States is unknown.

METHODS:
We developed a population-level CDI model.

RESULTS:
We estimated that 48,000 FMTs could be performed annually, preventing 32,000 CDI recurrences.

DISCUSSION:
Improving access to FMT could lead to tens of thousands fewer C. difficile episodes per year.
Pancreatitis, Pancreatic Cancer, and Their Metabolic Sequelae: Projected Burden to 2050
Authors: Cho Jaelim , Petrov Maxim S. 
Published: October 2020

INTRODUCTION:
Future burden has been modeled from population-based data for several common gastrointestinal diseases. However, as we enter the third decade in the 21st century, there are no such data on diseases of the pancreas holistically. The study aimed to estimate future incidence of pancreatitis, pancreatic cancer, diabetes of the exocrine pancreas (DEP), and exocrine pancreatic dysfunction (EPD) as well as years of life lost (YLL) due to premature death in individuals with those diseases up to 2050.

METHODS:
Historical New Zealand nationwide data on hospital discharge, pharmaceutical dispensing, cancer, and mortality were obtained. Annual incidence of each disease and annual YLLs due to premature death in individuals with each disease were calculated. A time series analysis using the stepwise autoregressive method was conducted.

RESULTS:
Pancreatitis yielded the highest projected incidence (123.7 per 100,000; 95% confidence interval, 116.7–130.7) and YLL (14,709 years; 13,642–15,777) in 2050. The projected incidence and YLL of pancreatic cancer were 18.6 per 100,000 (95% confidence interval, 13.1–24.1) and 14,247 years (11,349–17,144) in 2050, respectively. Compared with pancreatitis and pancreatic cancer, DEP and EPD yielded lower but more steeply increasing projected incidence rates and YLLs.

DISCUSSION:
The findings suggest that the burden of pancreatitis, pancreatic cancer, DEP, and EPD will rise in the next 3 decades unless healthcare systems introduce effective prevention or early treatment strategies for diseases of the pancreas and their sequelae.