bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of the COVID-19 Outbreak on Pediatric Patients’ Admissions to the Emergency Department in an Italian Orthopedic Trauma Hub
Authors: Verdoni Fabio , Ricci Martina , grigoli Cristina Di , Rossi Nicolò , Curci Domenico , Lombardo Michele Davide Maria , Viganò Marco , Accetta Riccardo , Mangiavini Laura , Peretti Giuseppe Maria 
Published: November 2020

Abstract

Background: The rapid diffusion of Coronavirus disease (Covid-19) in Northern Italy led Italian government to dictate national lockdown since March 12th 2020 to May 5th 2020. Aim of the study is to analyze the differences in the number of pediatric patients’ admission to the Emergency Room (ER) and in the type and causes of injury. Methods: The pediatric population was divided in a Pandemic group (PG) and Non-Pandemic group (NP). Sex, age, triage color-code at admission, declared cause of trauma and presence of symptoms related to COVID-19 infection, discharge diagnosis and discharge modes were investigated. Results: The Lockdown period led to a reduction of 87.0% in the ER admissions with a particular decrease in patients older than 12 years old from 41.8% in NG to 22.3% in PG. Moreover, a trend towards more severe codes was observed in the PG and the diagnosis of fracture was less frequent in NG (p<0,0001) and injuries at home were more frequent (34.8% compared to 6.8% in NG).Conclusions: A significant decrease in the ER attendances in our Trauma Hub center was reported after the outbreak of Covid-19 pandemic. Furthermore, a shift in the cause and type of injury undoubtedly was observed and only the most serious traumas sought the medical care with an higher percentage of severe triage codes and fractures.Level of evidence: III
Two Hyperparasitaemic Plasmodium Falciparum Cases Successfully Treated with Artemisinin-based Combination Therapy
Authors: Mukhi Benudhar , Anvikar Anupkumar R. , Srivast Bina , Gupta Himanshu , Ghosh Susanta Kumar 
Published: November 2020

Abstract
BackgroundHyperparasitaemia is an important event in a cascade of Plasmodium falciparum severe malaria (SM) but requires host responses to cause cerebral malaria (CM) leading to death, if left untreated. Here, we report two hyperparasitaemic patients with no CM.MethodsMalaria diagnosis was performed based on thick and thin smears examination, and immunochromatographic-based rapid diagnostic test assay. Parasitaemia was calculated following World Health Organization (WHO) protocol. Haematological and biochemical investigations were also performed. ResultsThe first patient had 42% parasitaemia (100% asexual parasites). The second one had 9.5% parasitaemia comprising 46% asexual, and 54% sexual stages with 1:1 male to female ratio. On the day of admission, both had presented abnormal haematological and biochemical parameters compared to the reference ranges. Remarkably, both the patients recovered successfully with oral artemisinin-based combination therapy (ACT) and a single dose of primaquine.ConclusionThe presence of hypergametocytaemia may hinder the elimination efforts, if not treated immediately. This report also signifies the need of accurately estimating the parasitaemia in malaria patients and their timely management to prevent complications and mortality.
Correlation Between Small and Dense Low Density Lipoprotein Cholesterol and Cardiovascular Events in Beijing Community Population
Authors: Wang Xiaona , wang Liang , Cao Ruihua , Yang Xu , Xiao Wenkai , Zhang Yun , Ye Ping 
Published: November 2020

Abstract
BackgroundThe relationship between small dense low-density lipoprotein cholesterol (sdLDL-C) and different cardiovascular events has been observed in several large community studies, and the results have been controversial. However, there is currently no cross-sectional or longitudinal follow-up study on sdLDL-C in the Chinese hypertension population.MethodsWe analyzed the association of plasma sdLDL-C levels with major adverse cardiovascular events in 1325 subjects from a longitudinal follow-up community-based population in Beijing, China.ResultsDuring the follow-up period, a total of 191 subjects had MACEs. Cox regression analysis showed that sdLDL-C is a major risk factor for MACEs independent of sex, age, BMI, hypertension, diabetes, smoking, SBP, DBP, FBG, eGFR in the general community population (1.013 (1.001 -1.025, P <0.05)), but the correlation disappeared after adjusting for TC and HDL-C in Model 3. Cox analysis showed that hypertension combined with high level of sdLDL-C was still the risk factor for MACEs ((2.079 (1.039-4.148)).ConclusionsOur findings in the Chinese cohort support that sdLDL-C is a risk factor for major adverse cardiovascular events in hypertension subjects.
The Effects of Sub-Faults Strike Direction and Landslide Energy on the Propagation of the 2011 Tohoku Earthquake and Tsunami
Authors: Setyonegoro Wiko , Febriani Febty , Muzli Muzli , Supendi Pepen , Yuliatmoko Rahmat Setyo , Rohadi Supriyanto , Riama Nelly Florida , Karnawati Dwikorita 
Published: November 2020

Abstract
We carried out a tsunami simulation of the 2011 (Mw 9.0) Tohoku earthquake. We analyze the tsunami run-up modeling by applying additional variables to seismic moment and moment magnitude equation to find out what extent it affects of sub-faults strike direction and landslide energy to tsunami propagation. To investigate the accuracy of run-up and inundation of the tsunami, we processed and analyzed the mainshock and aftershocks by applying scaling law method and inundation equation. We applied the aftershocks data to determine the wide area of the fault. The fault is divided into several sub-faults to make simulation design and scaling formulation adjustment. Each of sub-faults strike direction on simulation design has a different energy one another, which is determined by the strike direction of each fault position. Furthermore, we calculated the affects of submarine landslides on tsunami propagation. To obtain the variable of resultant energy of earthquake and landslide it performed by using the law of mechanical energy conservation. We applied both L-2008 and ComMIT tools for processing tsunami simulation modeling. The result presents that the sub-fault strike direction and landslide energy can increase the propagation energy of the tsunami waves.
Supporting the Classification of Patients in Public Hospitals in Chile by Designing, Deploying and Validating a System Based on Natural Language Processing
Authors: Villena Fabián , Perez Jorge , Lagos René , Dunstan Jocelyn 
Published: November 2020

Abstract
BackgroundIn Chile, a patient needing a specialty consultation or surgery has to first be referred by a general practitioner, then placed on a waiting list. The Explicit Health Guarantees (GES in Spanish) ensure, by law, the maximum time to solve an important set of health problems. Usually, a health professional manually verifies if each referral, written in natural language, corresponds or not to a GES-covered disease. An error in this classification is catastrophic for patients, as it puts them on a non-prioritized waiting list, characterized by prolonged waiting times. MethodsTo support the manual process, we developed and deployed a system that automatically classifies referrals as GES-covered or not using historical data. Our system is based on word embeddings specially trained for clinical text produced in Chile. We used a vector representation of the reason for referral and patient's age as features for training machine learning models using human-labeled historical data. We constructed a ground truth dataset combining classifications made by three healthcare experts, which was used to validate our results.ResultsThe best performing model over ground truth reached an AUC score of 0.94. During seven months of continuous and voluntary use, the system has amended 87 patient misclassifications.ConclusionThis system is a result of a collaboration between technical and clinical experts, and the design of the classifier was custom-tailored for a hospital's clinical workflow, which encouraged the voluntary use of the platform. Our solution can be easily expanded across other hospitals since the registry is uniform in Chile.
Passive Biaxial Ankle Movement Training with Electrical Stimulation for Ankle Sensorimotor Function in Chronic Stroke
Authors: Cho Ji-Eun , Shin Joon-Ho , Kim Hogene 
Published: November 2020

Abstract
BackgroundPost stroke had both ankle sensory and motor impairments that affect ankle motor control. The purpose of this study was to investigate the effect of passive biaxial ankle movement training coupled with electrical stimulation (AMT-EST) on ankle proprioception, ankle strength, balance, and gait in chronic stroke. MethodsThirty-five stroke subjects were randomized to an experimental or control group, and 30 subjects completed the trials. The experimental group received AMT-EST on the affected ankle for 30 minutes a day, 5 times a week for 4 weeks, for a total of 20 sessions. The control group received electrical stimulation therapy on the affected ankle. The primary outcome measures were ankle proprioception, passive range of motion, and strength. The secondary outcome measures were balance and gait-related functional abilities. ResultsThe experimental group showed significant post-training improvement in ankle proprioception of eversion, the ankle passive range of motion (inversion and eversion), ankle strength (dorsiflexion, plantarflexion, inversion, and eversion) Fugl–Meyer Assessment (FM-A), Berg Balance Scale (BBS), Timed Up and Go test, Fall Efficacy Scale, and walking speed (p < 0.05). Significant group×time interactions were observed in ankle passive range of motion (inversion and eversion), ankle strength (dorsiflexion), and FM-A (p < 0.05). All ankle proprioception moderately correlated with ankle passive range of motion (eversion), ankle strength (dorsiflexion and eversion), the BBS, and FM-A (p < 0.05). ConclusionsThe findings suggest that AMT-EST can be proposed as an ankle rehabilitation program for people with chronic stroke with ankle sensorimotor impairment.Trial Registration﻿KCT0004688. Registered 01 Jan 2020
Use of long-lasting insecticidal nets among women attending antenatal clinic at a tertiary hospital in Bayelsa State, Nigeria 2019
Authors: Ibegu Maria Imaobong , Hamza Khadeejah Liman , Umeokonkwo Chukwuma David , Numbere Tamuno-Wari , Ndoreraho Adolphe , Dahiru Tukur 
Published: November 2020

Abstract
Background: Malaria in pregnancy remains a major contributor to maternal and infant morbidity and mortality despite scale up in interventions. Its prevention is one of the major interventions in reducing maternal and infant morbidity and mortality. We assessed the ownership, utilization and predictors of use of long-lasting insecticide treated nets (LLINs) for malaria prevention among women attending antenatal clinic (ANC) at a tertiary hospital in Bayelsa State Nigeria. Methods: We conducted a cross-sectional study of 297 women recruited through systematic sampling. Information on sociodemographic characteristics, ownership, source and utilization of LLINs, were collected with a pre-tested structured interviewer-administered questionnaire. We examined the relationship between use of LLIN and sociodemographic characteristics using chi square and logistic regression at 5% level of significance. Results: The mean age of respondents was 28.8 ± 2.6 years. Most (59.2%) had tertiary education and were mainly (88.2%) urban dwellers. Two hundred and fifty (84.2%) owned LLINs, and 196 (78%) used LLIN the night prior to the interview. Almost half of the respondents purchased their LLINs. Those who purchased LLINs were 3 times more likely to have used it (OR: 3.13, 95% CI: 1.62-6.04) compared to those that got it free. Those who were gainfully employed (OR: 3.16, 95% CI: 1.59-6.29) and those who earned above the minimum wage (OR: 2.88, 95% CI: 1.45-5.72) were 3 times more likely to have used LLIN in their index pregnancy. Conclusion: The use of LLIN as a preventive measure against malaria was relatively high among the participants in this study, though still below national target. The major factors determining the use of LLIN among these women were purchase of LLINs and being gainfully employed. We recommend that efforts should be made to enforce the policy of free LLINs at ANC registration at the tertiary hospitals, as this would further drive up ownership and utilization rates.
Gender differences in the efficacy of pioglitazone treatment in nonalcoholic fatty liver disease patients with abnormal glucose metabolism
Authors: Yan Hongmei , Wu Weiyun , Chang Xinxia , Xia Mingfeng , Ma Sicheng , Wang Liu , Gao Jian 
Published: November 2020

Abstract
Background: Pioglitazone is a promising therapeutic method for nonalcoholic fatty liver disease (NAFLD) patients with or without type 2 diabetes. However, there is remarkable variability in treatment response. We analyzed our previous randomized controlled trial to examine the effects of gender and other factors on the efficacy of pioglitazone in treating Chinese nonalcoholic fatty liver disease (NAFLD) patients with abnormal glucose metabolism.Methods: This is a post hoc analysis of a previous randomized, parallel controlled, open-label clinical trial (RCT)* with an original purpose of evaluating the efficacy of berberine and pioglitazone on NAFLD. The total population (n= 185) was randomly divided into three groups: lifestyle intervention (LSI), LSI + pioglitazone (PGZ) 15 mg qd, and LSI + berberine (BBR) 0.5 g tid, respectively, for 16 weeks. The study used proton magnetic resonance spectroscopy (1H- MRS) to assess liver fat content. Results: As compared with LSI, PGZ + LSI treatment further decreased liver fat content in women (-15.24% ± 14.54% vs. -8.76% ± 13.49%, p = 0.025), but less decreased liver fat content in men (-9.95% ± 15.18% vs. -12.64% ± 17.78%, p = 0.046). There was a significant interaction between gender and efficacy of pioglitazone before and after adjustment for age, smoking, drinking, baseline BMI, BMI change, treatment adherence, baseline liver fat content, and glucose metabolism.Conclusion: The study recommends pioglitazone plus lifestyle intervention for Chinese NAFLD female patients with abnormal glucose metabolism.* Trial registration: Role of Pioglitazone and Berberine in Treatment of Non-Alcoholic Fatty Liver Disease, NCT00633282. Registered 3 March 2008, https://register.clinicaltrials.gov.
Low Arterial Oxygen Partial Pressure Induces Pulmonary Thrombocytopenia in Patients and a Mouse Model.
Authors: Wu Limeng , Guo Ninghong , Xu Zhenyan , Wang Wei , Xiong Qinmei , Hu Jinzhu , Wan Rong , Hong Kui 
Published: November 2020

Abstract
Background: Recent basic studies demonstrate that the lung is a primary organ of platelet biogenesis. However, whether the pathophysiological state of the lung affect the platelets is little known. We aim to investigate the incidence of thrombocytopenia in patients with pulmonary infection (PIN) and risk factors associated with pulmonary thrombocytopenia. Methods: In total, 11941 patients with pulmonary infection (PIN) were enrolled, and patients with other three infectious diseases were collected as controls. The incidence of thrombocytopenia was compared, and the risk factors associated with thrombocytopenia in PIN patients were investigated by multivariate analysis. To explore the mechanism of thrombocytopenia, hypoxic model was constructed. Blood platelet counts from the angular vein (PLTs), left ventricle (PLTpost) and right ventricle (PLTpre) were determined. Megakaryocytes identified by anti-CD41 antibody were detected through flow cytometry and immunofluorescence. Results: The incidence of thrombocytopenia in PIN was higher than that in other three infectious diseases (9.8% vs 6.4%~5.0%, P<0.001). Low arterial oxygen partial pressure (PaO2) was an important risk factor for thrombocytopenia (OR=0.88; P<0.001). In a hypoxic mouse model, PLTs were decreased (518.38±127.92 vs 840.75±77.30, P<0.05), which showed that low PaO2 induce thrombocytopenia. The difference between the PLTpost and PLTpre (△PLTpost-pre), represent the production of platelets in the lungs, was significantly attenuated in hypoxic mice when compared with normoxic mice (F=25.47, P<0.05). Additionally, proportions of CD41-positive megakaryocytes in the lungs, marrow, spleen were all decreased in hypoxic mice. Conclusion: There is a high incidence for thrombocytopenia in PIN patients. Low PaO2-induced thrombocytopenia is associated with impaired generation of platelet in the lungs.
Astragaloside IV suppressed hippocampal GABAergic synaptic transmission and enhanced memory through EGR-1 mediated BDNF/TrkB signaling pathway in mice
Authors: Huang Fei , Xue Weixuan , Lan Yunyi , Tao Yanlin , Zhou Jin , Yang Liu , Guan Hao , Shi Hailian , Zhang Xiaoyang , Wu Xiaojun , Hu Zhibi 
Published: November 2020

Abstract
Background: Astragaloside IV (ASIV) is one of the saponins isolated from Astragalus membranaceus, a widely used traditional Chinese medicine and a health product sold all over the world. However, so far, the effect of ASIV on GABAergic synaptic transmission has not been elucidated yet. In the present study, the effect of ASIV on memory and hippocampal GABAergic synaptic transmission was investigated in wild type and early growth response protein 1 (EGR-1) knockout mice. Methods: Behavioral tests including radial-arm maze test and shuttle-box test, liquid chromatography-tandem mass spectrometry, western blotting analysis, quantitative PCR, electrophysiological recording, and electron microscopy were used in this study. Results: ASIV was shown to enhance the learning and memory of mice in behavioral tests, such as radial-arm maze test and shuttle-box test. It significantly reduced the concentration of GABA, the expression of glutamate decarboxylase 2 (GAD65) as well as the ratio of inhibitory synapses in mouse hippocampus, which was accompanied with a suppression of hippocampal spontaneous inhibitory postsynaptic currents. ASIV administration decreased the expression of EGR-1, brain-derived neurotrophic factor (BDNF) and tyrosine receptor kinase B (TrkB) in the hippocampus. Furthermore, blockage of BDNF/TrkB signaling with K-252a abrogated the effect of ASIV on GAD65 expression. When EGR-1 was knocked out, the promotive effects of ASIV on learning and memory, as well as the inhibitory effects on GABAergic synaptic transmission and GAD65, BDNF and TrkB expression, were abolished. In addition, ASIV was found to down-regulate the pre-existing EGR-1 baseline to better adapt to the learning stimuli. Conclusions: Together, these results demonstrated a novel role of ASIV in enhancing memory and reducing hippocampal GABAergic synaptic transmission through EGR-1 mediated BDNF/TrkB signaling pathway in mice.
Is It Still Possible to Reduce Population Salt Intake in Absence of Adequate National Policies and Regulations? A Randomized Field Trial, Social Marketing Intervention
Authors: Nejad Marzeyeh Soleymani , Keshavarz-Mohamadi Nastaran , Ramezankhani Ali , Omidvar Nasrin , Zayeri Farid 
Published: November 2020

Abstract
Background: High salt intake is one of the most important causes of some serious health problems. This study aims to evaluate the effects of a salt intake reduction intervention based on social marketing model in Ahwaz city, Iran.Methods: In this field trial experimental study, two similar residential complexes were selected using purposive sampling technique, and randomly assigned into intervention or control groups. In each residential complex, 130 women were selected using systematic random sampling. SMART model was applied as the social marketing planning tool. A formative research including audience, market, and channel analysis were conducted through two focus group discussions, a survey to identify cognitive and behavioral determinants of salt intake, and a salt intake assessment using 24-hour urine test for both groups. Based on the results of the formative research phase, an intervention plan was developed and implemented for 1 month in the intervention group. Post intervention assessment was conducted 1 month after the intervention by repeating the survey and the urine test. Statistical tests including independent T-Test and paired T-Test were used to compare the experimental and control groups. Results: Mean salt intake level before the intervention was 8574.41 mg/d in the intervention group and 8282.23 mg/d in the control group. Mean total scores of cognitive and behavioral factors was 25.32 and 26.41 out of 59 for the intervention and the control group respectively. After the intervention, daily salt intake decreased significantly by 1558.83 mg/d (16%) (P<0.001) and mean total scores of cognitive and behavioral factors increased significantly by 10.73 (p<0.001) in the intervention group.Conclusions: Despite the lack of public policies to decrease population salt intake, interventions based on social marketing can significantly reduce salt intake. However, long-term effect of such interventions will require further investigation.
Testicular Cancer Awareness among Men Residing in the Maltese Islands
Authors: Marmarà Vincent , Aquilina Reginald , Formosa Elyse , Hubbard Gill , Marmarà Danika 
Published: November 2020

Abstract
BackgroundTesticular cancer (TC) accounts for around one percent of all cancers in men. Early detection is of utmost importance for recovery and survivorship. Testicular self-examination (TSE) has been shown to be effective in preventing late-stage TC diagnosis. However, there is a lack of knowledge and awareness of both TC and TSE in men. Increasing such awareness may contribute towards earlier TC detection and positive outcomes. This study aims to assess the level of knowledge of a representative sample of the Maltese male population on TC and TSE. It also explores men’s willingness to learn about and perform TSE as well as their suggested approaches for TC and TSE information provision.MethodsA telephone interview approach was chosen using an interview schedule, developed based on established literature. Data were collected from a random sample of 400 male respondents aged 16 years or over and stratified according to all ages and districts of Malta. ResultsThe findings of this study indicate that Maltese males lack knowledge on TC and how to carry out TSE. Only 36.9% respondents had knowledge on how to perform TSE and 33.9% had practised TSE at least once in their lives. Higher educated, higher income and younger respondents scored better. This study also found that only 9.6% of respondents were informed by a doctor about TSE, indicating a notable gap in information provision. However, 87.3% of respondents knew that TC can be treated if identified at an early stage and 90.2% of males were ready to perform TSE on a regular basis if informed how to perform it. The majority of participants believed that increasing awareness of TC and TSE is important. ConclusionsKnowledge on TC and TSE is low in Malta. Health education campaigns are needed to inform the general population about the risks of TC and how to perform TSE. Such campaigns could improve early detection and hence a decrease in the number of advanced TC cases. The findings of this study are being used by the Ministry for Health and the Marigold Foundation to launch campaigns to raise awareness about TC and TSE.