bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safely reducing haemodialysis frequency during the COVID-19 pandemic
Authors: Lodge Michelle da Silva , Abeygunaratne Thilini , Alderson Helen , Ali Ibrahim , Brown Nina , Chrysochou Constantina , Donne Rosie , Erekosima Ibi , Evans Philip , Flanagan Emma , Gray Simon , Green Darren , Hegarty Janet , Hyde Audrey , Kalra Philip A , Lamerton Elizabeth , Lewis David , Middleton Rachel , New David , Nipah Robert , O’Donoghue Donal , O’Riordan Edmond , Poulikakos Dimitrios , Rainone Francesco , Raman Maharajan , Ritchie James , Sinha Smeeta , Wood Grahame , Tollitt James 
Published: August 2020

Abstract
Background: Patients undergoing haemodialysis (HD) are at higher risk of developing worse outcomes if they contract COVID-19. In our renal service we reduced HD frequency from thrice to twice-weekly in selected patients with the primary aim of reducing COVID 19 exposure and transmission between HD patients.Methods: Dialysis unit nephrologists identified 166 suitable patients (38.4% of our HD population) to temporarily convert to twice-weekly haemodialysis immediately prior to the peak of the COVID-19 pandemic in our area. Changes in pre-dialysis weight, systolic blood pressure (SBP) and biochemistry were recorded weekly throughout the 4-week project. Hyperkalaemic patients (serum potassium > 6.0mmol/L) were treated with a potassium binder, sodium bicarbonate and received responsive dietary advice.Results: There were 12 deaths (5 due to COVID-19) in the HD population, 6 of which were in the twice weekly HD group; no deaths were associated with change of dialysis protocol. A further 19 patients were either hospitalised and/or developed COVID-19 and thus transferred back to thrice weekly dialysis as per protocol. Of 141 eligible patients 113 (80.1%) were still receiving twice-weekly HD by the end of the 4-week project. Indications for transfer back to thrice weekly were; fluid overload (19), persistent hyperkalaemia (4), patient request (4) and compliance (1). There were statistically significant increases in SBP and pre-dialysis potassium during the project. Conclusions: Short term conversion of a large but selected HD population to twice-weekly dialysis sessions was possible and safe. This approach could help mitigate COVID-19 transmission amongst dialysis patients in centres with similar organisational pressures.
Sphinx Modified Position For Scaphocephalic And Complex Craniofacial Patients. Technical Note
Authors: Mayorga-Buiza Maria Jose , Rivero-Garvia Monica , Vargas Maria Luisa Tosca , Gonzalez Emilio Gomez , Rivas Javier Marquez 
Published: August 2020

Abstract
Background

The development of less invasive surgical techniques means that surgical remodelling techniques can be performed at younger ages in more complex situations and at lower cost.
Methods
Descriptive study
Results

We describe the technique of positioning and reviews our experience with the partially-modified sphinx position (MSP) in a serie of 234 patients, 96 of these endoscopic procedures (EP). Patient position on the operating table with regard to the treatment area, as well as the position of the treatment area in regard to the floor plane, is paramount for their anaesthetic and surgical management.
Conclusions

We consider that MSP is safe, facilitates access to the operative field, shortens surgery time, reduces bleeding and offers maximum airway and cranio cervical safety in patients undergoing surgery to correct cranial vault pathologies.
Single Arm Prospective Multicenter Case Series on the Use of Burst Stimulation to Improve Pain and Motor Symptoms in Parkinson’s Disease
Authors: Chakravarthy Krishnan V. , Chaturvedi Rahul , Agari Takashi , Iwamuro Hirokazu , Reddy Rajiv , Matsui Ayano 
Published: August 2020

Abstract
Background: In this study we analyze new clinical data in the use of spinal cord stimulation (SCS) for the treatment of pain and motor symptoms in patients with Parkinson’s Disease (PD), as both a singular bioelectric therapy and as a salvage therapy after deep brain stimulation (DBS).Methods: 15 patients were recruited and had percutaneous electrodes implanted at the level of the thoracic or cervical spine. Participants were set to one of three stimulation modes: continuous tonic stimulation, continuous Burst stimulation (40Hz, 500Hz, 1000μs), or cycle mode (on time of 10-15 sec, off time of 15-30 sec) with Burst (40Hz, 500Hz, 1000μs). Patients completed the Visual Analogue Scale (VAS), Unified Parkinson’s Disease Rating Scale, Self-Rating Depression Scale, Hamilton Depression Rating Scale, Profile of Mood State, 10-meter walking test, and the Timed Up and Go (TUG).Results: All patients experienced significant improvement in VAS scores with a mean reduction of 59% across all patients. Patients who chose the cycling burst stimulation parameter had an average 67% reduction in VAS scores, as compared to the continuous burst parameter group, which had an average 48% reduction in VAS scores. 73% of patients experienced improvement in the 10-meter walk, with an average improvement of 12%. 64% of patients experienced clinically relevant improvements in the TUG, with an average improvement of 21%. Conclusions: This study points to the potential utility of SCS to address both pain and certain aspects of motor symptoms in PD patients who have and have not received DBS therapy.
Young Key Populations Left Behind: The Necessity for a Targeted Response in Mozambique&nbsp;&nbsp;&nbsp;&nbsp;
Authors: Boothe Makini , Baltazar Cynthia Semá , Sathane Isabel , Raymond Henry F. , Fazito Erika , Temmermen Marleen , Luchters Stanley 
Published: August 2020

Abstract
Background: The first exposure to high-risk sexual and drug use behaviors often occurs during the period of youth (15-24 years old). These behaviors increase the risk of HIV infection, especially among young key populations (KP) – men how have sex with men (MSM), female sex workers (FSW), and people who inject drugs (PWID). We describe the characteristics of young KP participants in the first round of Biobehavioral Surveillance (BBS) surveys conducted in Mozambique and examine their risk behaviors compared to adult KP.Methods: Respondent-driven sampling (RDS) methodology was used to recruit KP in three major urban areas in Mozambique. RDS-weighted pooled estimates were calculated to estimate the proportion of young KP residing in each survey city. Unweighted pooled estimates of risk behaviors were calculated for each key population group and chi-square analysis assessed differences in proportions between youth (aged less than 24 years old) and older adult KP for each population group. Results: The majority of MSM and FSW participants were young 80.7% (95% CI: 71.5-89.9%) and 71.9% (95%CI: 71.9-79.5%), respectively, although not among PWID (18.2%, 95% CI: 13.2-23.2%). Young KP were single or never married, had a secondary education level or higher, and had lower employment rates. They reported lower perception of HIV risk (MSM: 72.3% vs 56.7%, p<0.001, FSW: 45.3% vs 24.4%, p<0.001), lower HIV testing uptake (MSM: 67.5 vs 72.3, p<0.001; FSW: 63.2 vs 80.6; p<0.001, PWID: 53.3 vs 31.2; p=0.001), greater underage sexual debut (MSM: 9.6 vs 4.8, p<0.001; FSW: 35.2 vs 22.9, p<0.001), and greater underage initiation of injection drug use (PWID: 31.9 vs 7.0, p<0.001). Young KP also had lower HIV prevalence compared to older KP: MSM: 3.3% vs 27.0%, p<0.001; FSW: 17.2% vs 53.7%, p<0.001; and PWID: 6.0% vs 55.0%, p<0.001. There was no significant difference in condom use across the populations. Conclusion: There is an immediate need for a targeted HIV response for young KP in Mozambique so that they are not left behind. Youth must be engaged in the design and implementation of interventions to ensure that low risk behaviors are sustained as they get older to prevent HIV infection.
Gastric Metastasis From Ovarian Carcinoma Revealed by Digestive Hemorrhage: Case Report
Authors: Erraichi¹ Hayat , RANDRIAMANOVONTSOA¹ Niaina Ezra , LITIQUE¹ valère , OUALLA² Karima , BENBRAHIM² Zineb , MELLAS² Nawfel , LIMACHER¹ Jean marc 
Published: August 2020

Abstract
Background: Gastric metastases due to ovarian carcinoma are extremely rare and the patients' prognosis is poor. We report a case of gastric ovarian cancer metastases revealed by gastrosplenic perforation. The secondary gastric tumor appeared seven years after the diagnosis of primary cancer.Case presentation:The patient is a 71-year-old woman with a serous ovarian cancer hospitalized for asthenia with digestive hemorrhage. At esophagogastroduodenoscopy, a protruding mass was noted at the level of the gastric antrum. She underwent a hemostasis of an endoscopic hemostasis by argon plasma; with effective hemostasis. The final pathology revealed gastric metastases of serous ovarian adenocarcinoma. Weekly gemcitabine chemotherapy was adopted, but the disease progressed rapidly. The patient died 4 months later.Conclusion:We have reported a case of gastric metastasis of ovarian tumor origin revealed by digestive hemorrhage. This work reiterates that this secondary localization of this cancer is possible although extremely rare. Studies are still needed to elucidate much of this unclear situation.
Water, Sanitation, and Hygiene (WASH) and the Incidence and Prevalence of Children in Five Public Primary Schools in N'Zerekore, Guinea
Authors: Bah Alseny , Diallo Alhassanel , Bah Alhassane , Li Feihu 
Published: August 2020

Abstract
Background: In Guinea, the incidence and prevalence of children in public primary schools to common disease, e.g., diarrhoeal, malaria, fever, etc. remained pretty high mainly because of the poor water, sanitation, and hygiene (WASH) conditions and practices. We aimed to evaluate the impacts of WASH conditions in and out of school, health education programs, and the behavioral determinants of pupils on the incidence and prevalence of children. Methods: A questionnaire was designed to collect necessary information on current hygiene conditions of all the studied primary schools, the WASH practices in and out of schools, and the incidence and prevalence of these pupils. The data were collected via a survey of the pupils (n = 1048) from five public primary schools in the center of the city of N’Zerekore, Guinea between December 2018 and May 2019. Using a social survey (questionnaire survey), face-to-face interviews with the headmasters and the teachers of several selected schools, data collection was based on students' knowledge of hygiene practices associated with WASH, hand washing situations in and out of school.Results: It reveals that the WASH conditions in all five schools are inadequate. The water access and quality in four schools over all the five schools are greatly limited by the boreholes or unprotected dug wells. The scarcity of essential hygiene kits, especially in the latrines, disinclined the pupils to use the toilets in schools. The WASH and health educations are also invalid in all schools, and therefore the pupils were ineffectively influenced to change their unhealthy WASH behaviors. Our data indicated that 100% (n = 1048) of pupils don’t wash their hands with soap after defecation in school, and over 87.9% (n = 922) of students don’t wash hands before eating. All the above determinants result in a high incidence and prevalence of children among these pupils, including malaria, typhoid, diarrhea, etc.Conclusion: To improve the WASH conditions and to change the pupils’ unhealthy behaviors in the long term, some effective interventions including the provision of clean water and sanitation and hygiene infrastructure, as well as widespread and effective health education should be implemented.
Evaluating Scenarios for School Reopening Under COVID19
Authors: Baxter Arden , Oruc Buse Eylul , Keskinocak Pinar , Asplund John , Serban Nicoleta 
Published: August 2020

Abstract
Background: Thousands of school systems have been struggling with the decisions about how to safely and effectively deliver education during the fall semester of 2020, amid the COVID19 pandemic. This study evaluates the public health impact of various school reopening scenarios (when, and how to return in-person instruction) on the spread of COVID19.Methods: An agent-based simulation model was adapted and used to project the number of infections and deaths under multiple school reopening dates and scenarios, including different cohorts receiving in-person instruction on alternating days, only younger children returning to in-person instruction, regular schedule (all students receiving in-person instruction), and school closure (all students receiving online instruction). The study period was February 18th-November 24th, 2020 and the state of Georgia was used as a case study.Results: Across all scenarios, the number of COVID19-related deaths ranged from approximately 17 to 22 thousand during the study period, and on the peak day, the number of new infections ranged from 43 to 68 thousand. An alternating school day schedule performed: (i) almost as well as keeping schools closed, with the infection attack rate ranging from 38.5% to 39.8% compared to that of 37.7% under school closure; (ii) slightly better than only allowing children 10 years or younger to return to in-person instruction. Delaying the reopening of schools had a minimal impact on reducing infections and deaths under most scenarios.Conclusions: Reopening schools following a regular schedule, i.e., all children returning to school without strict public health measures, would have serious negative public health consequences. The alternating school day schedule, especially if offered as an option to families and teachers who prefer to opt in, provides a good balance in reducing the infection spread compared to the regular schedule, while ensuring access to in-person education.
Establishment of Functional Epithelial Organoid From Human Lacrimal Glands
Authors: Jeong Sang Yun , Choi Woo Hee , Lee Sookon , Park Jong-Moon , Park Mira , Lee Hoogeun , Lew Helen , Yoo Jongman 
Published: August 2020

Abstract
Background: Tear deficiency due to dysfunction of the lacrimal gland is one of the major causes of dry eye disease (DED). Artificial tears as conventional medicine often alleviate symptoms, however, they insufficient to prevent the progression of severe DED. Lacrimal gland stem cell-based therapies have been extensively reported to regenerate injured lacrimal tissue, but the number of stem cells in the lacrimal gland is pretty low, and 2D long-term cultivation results in the reduction of the differentiation capacity of stem cells. Therefore, 3D lacrimal gland organoids could be an alternative for a DED therapeutic method, which is capable of prolonged growth while maintaining the characteristics of the lacrimal gland tissue.Method: Digested cells from human lacrimal gland tissue were mixed with Matrigel and cultured in five different media modified from human prostate/salivary organoid culture media. After organoid formation, the growth, expression of specific markers and histological characters were analyzed to prove the lacrimal gland organoids. And then, the secretory function of lacrimal gland organoids was confirmed by calcium influx or proteomics after pilocarpine treatment.Result: Human lacrimal gland organoids were formed and cultured under a modified salivary organoid culture medium, and their histological features and gene expression pattern were similar to normal lacrimal gland tissue. After pilocarpine treatment, their secretory function was confirmed and the secretomes were analyzed by proteomics. More than 70% of the identified proteins were proven to exosome through GO analysis. Additionally, to explore the curability of developed organoids, mouse-derived lacrimal gland organoids were fabricated and transplanted into mouse lacrimal tissue with DED, and we confirmed that organoids were well engrafted in the lacrimal tissue.Conclusion: These results demonstrate that our established lacrimal gland organoids resemble characteristics of normal lacrimal gland tissue and could be used as cell therapy for patients with dry eye syndrome.
Executive Dysfunctions Mediate Between Altered Sensory Processing and Daily Activity Performance in Older Adults
Authors: Yeger Batya Engel , Rosenblum Sara 
Published: August 2020

Abstract
Background: Sensory processing is essential for the interaction with the environment and for adequate daily function. Sensory processing may be deteriorated in the elderly and restrict daily activity performance. Another factor impacted by aging which significantly affects daily activities is Executive functions (EF). Yet, most studies refer separately to the impacts of sensory processing or EF on daily activities and use clinical evaluations that do not necessarily reflect functional restrictions in real life. This study aims to describe the prevalence of altered sensory processing in the elderly as expressed in daily life scenarios and explore whether EF mediate between altered sensory processing and daily activity performance in older adults. Methods: This cross-sectional study included 167 healthy and independently functioning people living in the community and aged 65 years and older. Participants who had sufficient cognitive status and no symptoms of depression completed a demographic and health-status questionnaire, the Adolescent/Adult Sensory Profile, the Behavior Rating Inventory of Executive Function–Adult Version and the Daily Living Questionnaire. Results: Altered sensory processing, and mainly by the reduced ability to register and modulate sensory input from daily environment, are prevalent in older adults. Their impacts on daily activity performance are mediated by executive dysfunctions. Conclusions: Executive dysfunctions may worsen the negative effects of altered sensory processing on daily activity performance in older adults. The interaction between executive functions and sensory processing should receive growing attention in intervention and prevention programs for older adults, with the emphasis on their expressions in peoples’ real life context.
Midwives’ Integration of Post-Abortion Manual Vacuum Aspiration in the Democratic Republic of Congo: A Mixed Methods Case Study &amp; Positive Deviance Assessment
Authors: Bourret Kirsty Marie , Larocque Sylvie , Hien Amélie , Hogue Carol , Muray Kalum , Lukusa Aurélie Thethe , Ngabo Abel Minani 
Published: August 2020

Abstract
Background: This collaborative research with the Professional Association of Congolese midwives (SCOSAF) in the province of Kinshasa, Democratic Republic of Congo sought to understand how midwives have integrated manual vacuum aspiration (MVA) for post abortion care. Methods: A positive deviant approach to Creswell’s mixed method comparative case study design was used to identify midwives who have integrated MVA post training and to explore enabling factors. Case group comparisons of positive and non-positive deviant midwives provided further interpretations. Results: All 102 midwives invited to be surveyed were recruited. They included 34% who reported practicing MVA post training. No statistical significance was found between the two groups’ demographics and facility type. Overall, groups had positive attitudes regarding midwifery, MVA, and legalization of abortion. Positive deviant midwives demonstrated and described more confidence and competence to practice and teach MVA. They were more likely to identify as teachers and overcome interprofessional barriers by teaching MVA to physicians, medical students and other midwives and position themselves as experts during post abortion emergencies.Conclusion: Results provided important insight to midwives’ integration of post abortion care in Kinshasa. Strategies used by positive deviant midwives in emergencies allowed them to navigate challenging contexts in order to practice MVA, while simultaneously increasing the credibility of their profession and the dissemination of evidenced-based MVA practice. Programs designed to work with and promote positive deviant midwives as knowledge brokers could be tested for its overall impact on the diffusion of midwifery led MVA to improve access to safe respectful reproductive care.
Efficacy of Home-Based Fortified Diet in Rehabilitation of Malnourished Children in Resource Restrained Country: An Institution Based Retrospective Study
Authors: Shahid Saba , Mahesar Marvi , Rahim Anum , Sadiq Yumna 
Published: August 2020

Abstract
Background: Globally, it is estimated that 50 million children under five are wasted. National nutrition survey-2018 has shown that 23.3% and 45.5% of children are wasted and stunted in Pakistan. Many studies have shown that hospital-based management of malnutrition is not practical due to high cost and iatrogenic infections and currently WHO recommends community-based management of malnutrition with provision of therapeutic food. There is limited evidence of community rehabilitation of malnourished children by using home fortified diet in Pakistan. This study aims to evaluate effectiveness of using energy dense, home fortified diet in weight gain of malnourished children in Karachi, through a retrospective chart review.Methods: A retrospective chart review of pediatric patients (aged 6 month–5 years) seen in Indus Hospital between January 2017 to June 2018 was conducted. A pre-designed data abstraction form was used to record detailed information about demographic characteristics, feeding, anthropometric, micronutrient, and nutritional details at enrollment and on follow-up.Results: A total of 361 patients were included in the final analysis. The median age (IQR) of children was 15 (14) months. Forty eight percent (n= 172) children had diarrhea and 54% (n= 195) children had respiratory tract infection. The median length of stay in the program was 28 days. The median (IQR) for average weight gain was 4.8 (0-10.3) g/Kg/day, 64.6% (n=226) children defaulted, 29% (n=102) were cured and 3% (n=10) died.Conclusion: This study revealed adequate weight gain and recovery in malnourished children by using home fortified diet in real life situations without using therapeutic food or monetary support. Home fortified diets may serve as effective strategy in community-based rehabilitation of malnourished children.