bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic dilemma in postpartum associated hemolytic uremic syndrome in a 38th week pregnant 31-year-old Congolese: a case report
Authors: Tshilanda Marc , Kanmounye Ulrick Sidney , Tendobi Céline , Mbuyi Freddy 
Published: August 2020

Abstract
Background
Thrombotic microangiopathy is associated with HELLP syndrome, thrombotic thrombocytopenic purpura, or atypical hemolytic uremic syndrome (aHUS) during pregnancy. Standard laboratory and physical examinations can help distinguish between these three diseases promptly and guide their management. This is critical because their managements and prognoses differ considerably. The ADAMTS13 test, complement tests, and biopsies can help ascertain the diagnosis; however, they take time, and are not widely available. In this case report, we present a case that highlights the diagnostic and therapeutic dilemmas associated with the aforementioned diseases.

Case presentation
A 31-year old P3G3 patient presented at 38 weeks with high blood pressure, bilateral pitting edema, and a low fetal heart rate. A cesarean section was performed to extract the fetus. On postoperative day 2, the suites were marked by anemia, low platelet count, acute kidney injury, declining liver function, and the presence of schistocytes on the peripheral thin smear. The patient was lucid, coherent, and presented no neurological deficits. The ADAMTS13 test and anti-complement therapy were not readily available, so the team made a presumptive diagnosis of aHUS based on the history, clinical presentation, and standard laboratory results. Due to a lack of anticomplement therapy, the patient was prescribed four sessions of hemodialysis. The renal function and platelet count gradually increased, and the patient was discharged on postoperative day 18. The patient was followed for over a year and did not present relapses of thrombocytopenia or microangiopathic hemolytic anemia.

Conclusions
The prompt diagnosis and management of aHUS lead to favorable outcomes. Healthcare providers should be able to rapidly differentiate between pregnancy-associated thrombotic microangiopathies and prescribe appropriate management. Here, we highlighted the challenges of diagnosing and managing postpartum associated aHUS in a low-resource setting.
Effect of high-intensity interval training on cardiorespiratory fitness, physical activity and body composition in people with schizophrenia: a randomized controlled trial
Authors: Andersen Eivind , Bang-Kittilsen Gry , Bigseth Therese Torgersen , Egeland Jens , Holmen Tom Langerud , Martinsen Egil Wilhelm , Stensrud Trine , Engh John Abel 
Published: August 2020

Abstract
Background
Exercise may improve cardiorespiratory fitness in people with schizophrenia, however, possible condition-specific cardiorespiratory disadvantages, a scarcity of methodologically sound studies, and conflicting results raise questions about the effect of exercise on maximal oxygen uptake (VO2max) in this group. The primary aim of this study, therefore, was to investigate the effect of high-intensity interval training on VO2max in people with schizophrenia. Second, we sought to determine whether the intervention would have an effect on general physical activity (PA) level and body composition.

Methods
Eighty-two patients with schizophrenia were randomly assigned to supervised high-intensity interval training or computer gaming skills training, performed twice a week for 12 weeks. Oxygen uptake was measured directly, during a maximum exercise session on a treadmill. PA level were assessed using ActiGraph accelerometer, and body composition was assessed by bioelectrical impedance. Differences between groups were assessed by analysis of variance using a univariate general linear model.

Results
There were no significant differences between the groups on any of the cardiorespiratory variables neither at baseline nor after the program. There were also no significant within-group differences in any of the cardiorespiratory fitness variables between the baseline and post-program time points, despite that 61% of the participants performing high-intensity interval training showed a significant increase in workload on the treadmill. However, 47% of the participants in the high-intensity interval training group had a ≥ 5% increase in VO2max. Participants supervised by mental health care providers with PA competence (e.g. rehabilitation center staff, sport scientist, physical trainer) had a much larger increase in VO2max compared to participants supervised by mental health workers without such competence, and when adding PA competence to the model, the intervention group increased VO2max significantly compared to the comparison group. The intervention had no significant effect on PA level or body composition.

Conclusions
The intervention did not improve VO2max, PA level or body composition but succeeded in increasing workload on the treadmill. With regard to VO2max, approximately half of the patients may be considered responders.

Trial registration
ClinicalTrials.gov; NCT02205684, registered July 2014,
Sickness absence trajectories following labour market participation patterns: a cohort study in Catalonia (Spain), 2012–2014
Authors: Hernando-Rodriguez Julio C. , Serra Laura , Benavides Fernando G. , Ubalde-Lopez Monica 
Published: August 2020

AbstractBackgroundPrevious studies have focused on the relationship between employment pathways and health-related outcomes based on cross-sectional or longitudinal approaches. However, little is known about the cumulative effects of employment status mobility on sickness absence (SA) over time. The aim of the present study was to examine the association between prior labour market participation (LMP) patterns and SA trajectories from a life-course perspective.MethodsThis cohort study was based on a sample of 11,968 salaried workers living in Catalonia and affiliated with the Spanish Social Security system, who accumulated more than 15 days on SA in at least one quarter during 2012–2014. Individuals were grouped into three different working life stages: early (18–25 years), middle (26–35 years), and late (36–45 years). To identify LMP patterns, we applied sequence analysis and cluster analysis (2002–2011), and we used latent class growth modelling to identify SA trajectories (2012–2014). Finally, we applied multinomial logistic regression models to assess the relationship between LMP patterns and SA trajectories.ResultsThe analyses yielded six LMP patterns: stable employment (value range: 63–81%), increasing employment (5–22%), without long-term coverage (7–8%), decreasing employment (4–10%), fluctuant employment (13–14%), and steeply decreasing employment (7–9%). We also identified four SA trajectories: low stable (83–88%), decreasing (5–9%), increasing (5–11%), and high stable (7–16%). However, the only significant association we identified for LMP patterns and SA trajectories was among young men, for whom an increasing employment pattern was significantly associated with a lower risk for increased days on SA (adjusted odds ratio: 0.21; 95% confidence interval: 0.05–0.96).ConclusionsSA trajectories are generally not related to prior 10-year LMP patterns at any stage of working life. To disentangle this relationship, future research might benefit from considering working life transitions with a quality-of-work approach framed with contextual factors closer to the SA course.
Energy drink: the consumption prevalence, and awareness of its potential health implications among commercial drivers in the Ho municipality of Ghana
Authors: Saku Emmanuella Yayra , Nuro-Ameyaw Peter , Amenya Priscilla Cecilia , Kpodo Fidelis Mawunyo , Esua- Amoafo Paul , Kortei Nii Korley 
Published: August 2020

Abstract
Background
Consumption of energy drinks has become an escalating global public health problem. The work schedule and irregular sleeping habits of commercial bus drivers make them highly susceptible to getting fatigued, hence most of them consume energy drinks as a fatigue management strategy. However, consumption of energy drinks produces numerous psychomotor side effects that if consumed among drivers puts the traveling public in danger of road accidents. This study sought to assess the prevalence of energy drink consumption and awareness of associated potential health problems among commercial long-distance bus drivers operating from the Ho municipality.

Methods
The study population comprised about 266 commercial bus drivers. This was a cross-sectional study involving 132 participants who completed a structured questionnaire on the participants’ socio-demographic characteristics, frequency of consumption and reasons for consumption. It also included questions to assess the knowledge of the ingredients and side effects of energy drinks. Respondents were selected using a convenience sampling technique. Descriptive analysis and Chi-square test of association were used to analyse the data.

Results
A majority (62.1%) of the drivers had more than 10 years of commercial driving experience. A 75% energy drink consumption prevalence was recorded with driving performance enhancement (78.8%) as the predominant reason for consumption. 7–10 bottles per week were consumed by most (32.2%) of the drivers. Also, 72.0% had poor knowledge of the side effects linked with energy drink consumption as well as the ingredients for preparation.

Conclusion
Energy drinks were consumed by the majority of the drivers at the Ho main bus terminal of which most of the drivers had poor knowledge of the potential health problems linked with the consumption of these drinks. The consumption of energy drinks was observed to be higher among the drivers with lower education levels, higher monthly income and those who worked long hours in a day. The Ghana National Road Safety Commission (GNRC) in collaboration with other private road transport unions in Ghana should organize regular seminars for commercial bus drivers on the potential dangers and effects associated with energy drink consumption.
A randomized trial on the effects of root resorption after orthodontic treatment using pulsating force
Authors: Wang Jue , Lamani Ejvis , Christou Terpsithea , Li Peng , Kau Chung How 
Published: August 2020

Abstract
Background
An orthodontic device that moves teeth with pulsating force was invented and underwent a single center, controlled, clinical trial to test its safety and efficacy for treatment. The device has a custom-made thermo-plastic mouthpiece which fits over the teeth with an inflatable silicone element. A console that measures and controls the pulsating force level in real-time controls the air pressure that delivers a pulsating force. In this study, the effect of the device on root resorption during orthodontic treatment was evaluated using 3D cone beam computed tomography and compared with a control group of patients who received Invisalign treatment.

Methods
Twenty-eight subjects were enrolled in the investigational arm and 15 in the control group. Subjects were followed until the average score of the mandibular and maxillary teeth achieved a Little’s Irregularity Index of 1.5 mm or less.

Results
There were no adverse events reported throughout the study for either treatment arm. No clinically significant root resorption was observed for either group. The investigational device did not cause root resorption greater than the control group. Both devices produced a safety profile compared to current orthodontic techniques.

Conclusion
The investigational device did not produce more root resorption than similar conventional orthodontic appliances.

Trial registration
ClinicalTrials.gov, NCT03421886. Registered 12 January 2018 - Retrospectively registered.
Activation of synovial fibroblasts from patients at revision of their metal-on-metal total hip arthroplasty
Authors: Xu Jing , Yang Junyao , Chen Jian , Zhang Xiaoli , Wu Yuanhao , Hart Alister , Nyga Agata , Shelton Julia C. 
Published: August 2020

Abstract
Background
The toxicity of released metallic particles generated in metal-on-metal (MoM) total hip arthroplasty (THA) using cobalt chromium (CoCr) has raised concerns regarding their safety amongst both surgeons and the public. Soft tissue changes such as pseudotumours and metallosis have been widely observed following the use of these implants, which release metallic by-products due to both wear and corrosion. Although activated fibroblasts, the dominant cell type in soft tissues, have been linked to many diseases, the role of synovial fibroblasts in the adverse reactions caused by CoCr implants remains unknown. To investigate the influence of implants manufactured from CoCr, the periprosthetic synovial tissues and synovial fibroblasts from patients with failed MoM THA, undergoing a revision operation, were analysed and compared with samples from patients undergoing a primary hip replacement, in order to elucidate histological and cellular changes.

Results
Periprosthetic tissue from patients with MoM implants was characterized by marked fibrotic changes, notably an increase in collagen content from less than 20% to 45–55%, an increase in α-smooth muscle actin positive cells from 4 to 9% as well as immune cells infiltration. Primary cell culture results demonstrated that MoM synovial fibroblasts have a decreased apoptosis rate from 14 to 6% compared to control synovial fibroblasts. In addition, synovial fibroblasts from MoM patients retained higher contractility and increased responsiveness to chemotaxis in matrix contraction. Their mechanical properties at a single cell level increased as observed by a 60% increase in contraction force and higher cell stiffness (3.3 kPa in MoM vs 2.18 kPa in control), as measured by traction force microscopy and atomic force microscopy. Further, fibroblasts from MoM patients promoted immune cell invasion by secreting monocyte chemoattractant protein 1 (MCP-1, CCL2) and induced monocyte differentiation, which could also be associated with excess accumulation of synovial macrophages.

Conclusion
Synovial fibroblasts exposed in vivo to MoM THA implants that release CoCr wear debris displayed dramatic phenotypic alteration and functional changes. These findings unravelled an unexpected effect of the CoCr alloy and demonstrated an important role of synovial fibroblasts in the undesired tissue reactions caused by MoM THAs.
Breast cancer surgery during the Covid-19 pandemic: a monocentre experience from the Regina Elena National Cancer Institute of Rome
Authors: Pelle Fabio , Cappelli Sonia , Graziano Franco , Piarulli Loredana , Cavicchi Flavia , Magagnano Domenico , De Luca Assunta , De Vita Roy , Pozzi Marcello , Costantini Maurizio , Varanese Antonio , Panimolle Massimo , Gullo Pietro Paolo , Barba Maddalena , Vici Patrizia , Vizza Enrico , Cognetti Francesco , Sanguineti Giuseppe , Saracca Elena , Ciliberto Gennaro , Botti Claudio 
Published: August 2020

AbstractThe Covid-19 pandemic has challenged hard the national health systems worldwide. According to the national policy issued in March 2020 in response to the evolving Covid-19 pandemic, several hospitals were re-configured as Covid-19 centers and elective surgery procedures were rescheduled according to the most recent recommendations. In addition, Covid-19 protected cancer hubs were established, including the Regina Elena National Cancer Institute of Rome, Central Italy. At our Institute, the Breast Surgery Department continued working under the sign of a multidisciplinary approach. The number of professional figures involved in case evaluation was reduced to a minimum and interactions took place in the full respect of the required safety measures. Treatments for benign disease, pure prophylactic surgery and elective reconstructive procedures were all postponed and priority was assigned to the histologically-proven malignant breast tumors and highly suspicious lesions. From March 15th though April 30th 2020, we treated a total of 79 patients. This number is fully consistent with the average quantitative standards reached by our Department under ordinary circumstances. Patients were mostly discharged the day after surgery and none was readmitted due to surgery-related late complications. More generally, post-operative complications rates were unexpectedly low, particularly in light of the relatively high number of reconstructive procedures performed in this emergency situation. A strict follow up was performed based on the close contact with the surgical staff by telephone, messaging apps and telemedicine.Patients ascertainment for their Covid-19 status prior to hospital admission and hospital discharge allowed to maintain the “no-Covid-19” status at our Institution. In addition, during the aforementioned time window, none of the care providers developed SARS-CoV-2 infection or disease, as shown by the results of anti-SARS-CoV-2 immunoglobulin M and G profiling. In conclusions, elective breast cancer surgery procedures were successfully performed in a lockdown situation due to a novel viral pandemic. The well-coordinated regional and hospital efforts in terms of medical resource re-allocation and definition of clinical priorities allowed to maintain high quality standards of breast cancer care while ensuring safety to the cancer patients and care providers involved.
Authorship diversity among systematic reviews in eyes and vision
Authors: Qureshi Riaz , Han Genie , Fapohunda Kolade , Abariga Samuel , Wilson Renee , Li Tianjing 
Published: August 2020

Abstract
Importance
The inclusion of authors from diverse backgrounds and with different lived experiences is critical to ensuring the questions addressed in systematic reviews (SRs), as well as the subsequent conclusions and recommendations made, are representative of the global community.

Objective
To assess the gender and geographic diversity of authors among all Cochrane SRs in eyes and vision as compared with a random sample of non-Cochrane SRs of interventions in the field of eyes and vision.

Design
The Cochrane Eyes and Vision US Satellite maintains a database of SRs in the field of eyes and vision. We selected all (n = 313) eyes and vision intervention SRs published in The Cochrane Library and a random sample of 313 eyes and vision intervention SRs published elsewhere for this study. We determined gender of the first and corresponding authors (“woman,” “man,” or “unknown”) using a previously developed algorithm and their location based on institution country and the World Health Organization region.

Results
From the 626 reviews included in our sample, we identified 751 unique authors who comprised 887 author positions (i.e., first and/or corresponding authors). We were able to ascertain the gender of 647/751 (86%) authors: 276 women and 371 men. Among Cochrane eyes and vision SRs, the proportions of women in first and/or corresponding author positions were consistent and approximately equal to men. Among non-Cochrane eyes and vision SRs, the representation of women was markedly lower as corresponding authors than other positions. Most authors of Cochrane eyes and vision SRs were from the UK (31%) and USA (26%), whereas most authors of non-Cochrane SRs were from China (34%).

Conclusions and relevance
Compared with authors of non-Cochrane SRs in eyes and vision, authors of Cochrane SRs appear to have approximately equal representation of women and men among perceived important author positions and be located in European and North American countries, possibly due to the locations of the Cochrane editorial teams. Cochrane Eyes and Vision should continue to recruit authors from around the world in locations that reflect the global burden of eye disease.
3D evaluation of the morphological and volumetric changes of the tongue and oral cavity before and after orthognathic surgery for mandibular prognathism: a preliminary study
Authors: Teramoto Airy , Suzuki Shoichi , Higashihori Norihisa , Ohbayashi Naoto , Kurabayashi Toru , Moriyama Keiji 
Published: August 2020

Abstract
Background
The volumetric ratio of the tongue to the oral cavity has been recognized to be one of the important factors for the maintenance of stable occlusion. Oral cavity capacity is changed after orthognathic surgery in patients with mandibular prognathism; however, the volumetric changes of the oral cavity including the tongue before and after surgery have not been analyzed. The purpose of this study was to evaluate the morphological and volumetric changes of the tongue and oral cavity following orthognathic surgery using a newly developed vinyl polysiloxane impression method.

Materials and methods
The study was performed in fifteen subjects who underwent surgical orthognathic treatment. Impressions of the tongue together with the oral cavity were obtained before orthognathic surgery and 1, 3, and 6 months after orthognathic surgery. These impression patterns were scanned using cone-beam computed tomography (CT), and three-dimensional (3D) images of the oral cavity including the tongue, and the upper and lower dental arches were reconstructed. The morphological and volumetric changes in the oral cavity capacity and the tongue volume were examined.

Results
The volume of the tongue with the volume of the oral cavity decreased after orthognathic surgery. There was a correlation between the decrease in the oral cavity capacity and tongue volume. The volumetric ratio of the tongue to the oral cavity seems to be maintained before and after orthognathic surgery.

Conclusion
VPS method, free from radiation exposure, may be useful for investigating the morphological and volumetric changes of the tongue and oral cavity, which may possibly influence the stability of the dental arch and occlusion during surgical orthodontic treatment.