bluuebunny/crossref_metadata_2025_split huggingface dataset:
High-Fidelity Hybrid Simulation Not Only Optimizes Skills Acquisition But Improves Non-Technical Skills
Authors: Ruz Cristián , Besa Pablo , Irarrázaval Sebastián , Vidal Catalina , Nazar Claudio , Varas Julián , Villagrán Ignacio , Fuentes-López Eduardo , Riquelme Arnoldo 
Published: December 2020

Abstract
Introduction Knee arthrocentesis is frequently performed as a diagnostic or therapeutic procedure. Although considered a key competency for medical doctors, most students never execute the procedure during their training. We aimed to assess technical and nontechnical skills for knee arthrocentesis through high-fidelity hybrid simulation Methods Medical students and general physicians were recruited for training; orthopedic surgeons were recruited as experts. Trainees received educational documentation prior to training. Trainees took a medical history and obtained informed consent from a patient-actor, then encountered a simulated knee to execute the procedure. We adapted a direct observation scale to assess technical and nontechnical skill performance. Personalized feedback was received after each session. Performance among trainees (learning curves) and between trainees and experts was compared using a mixed-effects model. Results Trainees significantly improved from the first session to the second and third. The third session was the learning curve plateau. Performance obtained in the third and fourth sessions were similar to expert performance. The assessment tool evaluated technical and nontechnical skills with high internal consistency and showed high interobserver reliability. Discussion Learning curve analysis showed that high-fidelity simulation allowed trainees to become proficient in technical and nontechnical skills required to perform a safe knee arthrocentesis.Level of Evidence: Level II (Prospective Cohort Study)
Lessons from the Effective Implementation of a Hybrid Virtual Clinical Model for Surgical Clerkships during the Covid Pandemic: Impact on Academic Performance, Burnout and Surgical Interest
Authors: Hinojosa-Gonzalez David Eugenio , Roblesgil-Medrano Andres , Segura-Ibarra Victor , Tellez Armando , Diaz-Elizondo Jose , Flores-Villalba Eduardo 
Published: December 2020

Abstract
Objective: Determine the academic and psychosocial impact of a hybrid-virtual surgical clerkship in medical students during the Covid Pandemic.Background: The Covid-19 pandemic has forced universities to modify their academic curriculum to adapt and overcome never before seen adversities. Herein we present the implementation of a Hybrid Virtual Clinical Model for Surgical Clerkships and its comparison against traditional face-to-face learning.Methods: We surveyed 47 medical students prior to their first-ever clerkship using Maslach’s Burnout Inventory and a questionnaire regarding their interest in surgery as a career path before and after their clerkship. Burnout rates, clinical exposure, academic performance, and surgical interest were analyzed and compared against results from prior year students on a traditional program.Results: Baseline burnout was significantly lower in the hybrid model (15.4% vs. 2.6%, p=0.048). The same was seen on alternate burnout rates (33.3% vs. 10.3%, p=0.02), differences remained after three months of clerkship (23.1% vs. 5.1%, p=0.023). When comparing different domains such as professional fulfillment, depersonalization, and fatigue, the hybrid model did overall better. Clinical exposure hours were statistically significant between both groups (954.32 vs. 276.33, p=0.001), however, when considering virtual clinical hours, no significant differences were found. Despite the hybrid group having a lower midterm exam score (68 vs. 77.49, p=0.001), final exam scores were similar between groups (74.97 vs. 75.89, p=0.662).Conclusion: We believe our model may be useful for other programs to maximize clinical exposure while minimizing the risk of exposure, maintaining maximum academic performance, and preserving the surgical interest of rotating alumni.ACGME Competencies: Practice-Based Learning and Improvement
Risk Prediction of Radiation-Induced Hepatic Toxicity Complications in Patients With Hepatocellular Carcinoma
Authors: Shieh Chin-Shiuh , Chou Chi-Ming , Huang Tai-Lin , Lin Chin-Hsueh , Chao Pei-Ju , Wu Jia-Ming , Liu Chao-Hong , Leung Stephen W , Tseng Chin-Dar , Hsu Hsuan-Chih , Lee Tsair-Fwu 
Published: December 2020

Abstract
We use dose-volume factors to predict the risk of radiation-induced hepatic toxicity (RIHT) complications in patients with hepatocellular carcinoma (HCC) for controlling the low tolerance of liver organs to radiation and reducing the incidence of radiation-induced hepatic toxicity complications. This study retrospectively collected 114 patients who underwent Intensity Modulation Radiation Therapy (IMRT) for hepatocellular carcinoma between 2014 and 2017. The total number of patients was 69 after excluding normal liver organs whose volume did not reach 700 cc and extreme data. A total of 138 experimental samples were generated using the bootstrap method. All patients were evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) during treatment to determine the degree of increase in blood draws and to judge for radiation-induced hepatic toxicity complications. The patient received dose-volume parameters were uniformly adjusted using a bioequivalent dose conversion of 2 Gy/fraction. The study data were divided into normal and total liver received dose-volume. Least absolute shrinkage and selection operator (LASSO) was used to select predictors and logistic regression (LR) was used to establish the performance model. LASSO was used to select the patient dose-volume parameter predictor. The risk factors of normal liver received dose-volume were age and NLV30 Gy. The risk factors of total liver received dose-volume were age and TLV35 Gy. For patients with hepatocellular carcinoma receiving radiation therapy (RT), this study recommends that a normal liver receiving a dose volume of 30 Gy should be less than 54.75%, so that the probability of RIHT can be less than 50%. A total liver receiving a dose volume of 35 Gy should be less than 54.75% so that the probability of RIHT can be less than 50%. It can control the low tolerance of liver organs to radiation and reduce the incidence of hepatotoxic complications induced by radiotherapy techniques.
Hunger Pandemic: Urban Rodents' Boom and Bust During COVID-19
Authors: Bedoya-Pérez Miguel , Ward Michael , Loomes Max , Crowther Mathew 
Published: December 2020

Abstract
Shortly after the enactment of restrictions aimed at limiting the spread of COVID-19, local governments and public health authorities around the world reported an increased sighting of rats. We combined multi-catch rodent station data, rodent bait stations data, and rodent-related residents’ complaints data to explore the effects that social distancing and lockdown measures might have had on the rodent population within the City of Sydney, Australia. We found that rodent captures, activity, and rodent related residents’ complaints increased during the COVID-19 related lockdown period, followed by a steep decline post-lockdown. We found no changes in the geographical distribution of any of our indices of rodent abundance. We hypothesize that lockdown measures resulted in an increase in rodent activity driven by a reduction in human-derived food resources. This might have increased the mortality rate, triggering a population crash. There is a high chance that the surviving individuals might be rodenticide resistant. It is possible that the onset of COVID-19 might have disrupted commensal rodent populations, with profound implications for the future management of these ubiquitous urban indicator species.
Chemical Constituents with Inhibitory Activities on Proprotein Convertase Subtilisin/kexin Type 9 Expression from the Aerial Parts of Penthorum chinense
Authors: Pel Pisey , Chae Hee-Sung , Cho Jinwoo , Kim Young-Mi , Huh Jungmoo , Choi Young Hee , Kim Jinwoong , Chin Young-Won 
Published: December 2020

Abstract
Background: Penthorum chinense has been used in East Asia for the treatment of cholecystitis, infectious hepatitis, and jaundice. So far there is no report regarding proprotein convertase subtilisin/kexin type 9 inhibitory constituents from this plant. The aim of the present study was to discover new active constituents with PCSK9 expression inhibitory activities from P. chinenseMethods: All structures were established by interpreting NMR spectroscopic data and MS data. Further experimental and calculated ECD data were used to determine the absolute configuration of the two new neolignans. To monitor the inhibitory activity on proprotein convertase subtilisin/kexin type 9 (PCSK9) mRNA expression and PCSK9-low density lipoprotein receptor (LDLR) interaction, quantitative real time-PCR, Western blot analysis, and an enzyme-linked immunosorbent assay (ELISA) method by a PCSK9-biotinylated-LDLR binding assay were performed.Results: 39 compounds were isolated and identified including two new oxepine-type neolignans, penthorinols A (1) and B (2) and a naturally occurring chalcone, 6'-hydroxy-2'-methoxychalcone-4'-O-β-D-glucopyranoside (20). Of all tested compounds, penthorin A (4) and methyl gallate (25) were found to suppress PCSK9 mRNA expression with IC50 values of 15.56 and 11.66 µM, respectively. Furthermore, penthorin A (4) and methyl gallate (25) downregulated PCSK9 protein expression. However, all compounds seemed to be inactive in PCSK9-LDLR interaction.Conclusion: In the present study, two new compounds was discovered from this plant and active constituents with PCSK9 expression inhibitory activities were suggested.
Aneurysm and Artery Dissection Following the use of Vascular Endothelial Growth Factor Inhibitor: A Real-World Analysis Using a Spontaneous Reporting System
Authors: Gong Jian , Shuyue WANG , Mingzhu CHEN , Xinghui ZHANG , Lingjian ZHANG , Min JIA , Zhiwen SHEN , Junyan WANG , Jing XU , Zheng ZHENG , Mengmeng WANG , Xuanrui LV , Xiaoyu ZONG , Hui LI , Jin ZHOU , Tong MENG , Zhao Bin , Jian GONG 
Published: December 2020

Abstract
Background: There are few real-world studies comparing the incidence, clinical features, and prognosis of aneurysm and artery dissection related to various vascular endothelial growth factor inhibitor (VPI) regimens. This study evaluated the recent evidence of aneurysm and artery dissection after VPI therapy. The purpose was to evaluate and compare the links between different VPIs and aneurysm and artery dissection by investigating the Food and Drug Administration Adverse Event Reporting System (FAERS).Methods: Using FAERS data from January 2004 to March 2020, disproportionality analysis was used for data mining to screen suspected aneurysm and artery dissection cases after different VPI treatments. The times to onset and fatality rates of suspected drugs were also investigated to assess prognoses.Results: In total, there were 634 reports of aneurysm and artery dissection events after VPI. Ramucirumab appeared to have a stronger association than other VPIs, based on the reporting odds ratio (ROR = 3.68, 95% [2.18, 6.23]). The results showed a signiﬁcant difference in onset time (P < 0.001), and a quick onset occurred in 60.13% of cases. The median time to aneurysm and artery dissection was 79.5 (IQR: 19–273.5) days after VPI administration. The results also showed that men were more affected than women (59.68% vs. 40.32%), and patients older than 45 years were more affected than younger patients (68.12% vs. 3.93%). Finally, the suspected drugs generally led to a 19.98% fatality rate and a 29.81% hospitalization rate. The highest death rate was associated with Aflibercept (25.49%).Conclusions: We identified signals for aneurysm and artery dissection following various VPIs in real-world practice using the FAERS, which represents the first step for continued pharmacovigilance investigation.
Ergonomic Evaluation of Job Performance and Investigation of the Impact of Corrective Exercise Training on Reduction of Musculoskeletal Complaints Among Operating Room Nurses in Iran
Authors: jeihooni Ali khani , Gholami Tahereh , Omidi Sedighe , Taheri Omalbanin , Dehghan Azizollah 
Published: December 2020

Abstract
BackgroundOperating Room(OR) nurses are at risk of Musculoskeletal Disorders(MSDs) due to the nature of their job and performance of non-ergonomic activities. The present study aimed at ergonomic evaluation of the workplace and investigation of the impact of corrective exercise training on reduction of musculoskeletal complaints among OR nurses.Materials and MethodsThis educational intervention study was conducted on 46 OR nurses in an educational hospital in Fasa city in Iran. who were selected through census. Data were collected via demographic information form, body map, and Rapid Entire Body Assessment(REBA) method. After three months, the effects of ergonomic principles training and intensity of disorders were evaluated by the REBA method and body map respectively. After all, the data were analyzed using descriptive statistics, Wilcoxon test, and marginal homogeneity in SPSS20 software. Resultsmean age and mean job tenure of the nurses were 28.93(6.47) and 6.02(5.62) years, respectively. 78.3% of the participants were male, 38%, were single, and 91% were shift workers. a significant decline was observed in disorders in all body regions, except for the head and neck(p=0.293), three months after the educational intervention. The mean score of the REBA test was 5.58+1.146 after the intervention(p=0.000). Additionally, the mean level of risk was 2+1.89 after the intervention(p=0.000). the mean level of corrective priorities was 1.0+89.314 after the intervention(p=0.000). the corrective actions reached levels 1 and 2 after the intervention. Accordingly, the highest percentage of actions for reduction of injuries were at the necessary (soon) level before the intervention, but at the necessary level after that(89.1%).Discussion and ConclusionThe results indicated that training ergonomic principles, correct goods transfer methods, and corrective exercises has been recommended to be effective in decreasing the risk of MSDs in this profession.
Pyogenic Lung Abscess in an Infectious Disease Unit, a 20-year Retrospective Study
Authors: Maitre Thomas , OK Vichita , CALIN Ruxandra , LASSEL Ludovic , CANESTRI Ana , DENIS Michel , HAMIDI Mohammed , TAVOLARO Sebastian , VERDET Charlotte , PARROT Antoine , CADRANEL Jacques , PIALOUX Gilles 
Published: December 2020

Abstract
Rationale: Pyogenic lung abscesses are rare and poorly described infections. This study aimed to describe their prognostic factors.Methods: We retrospectively included all patients hospitalized between January 1st, 1998 and June 1st, 2018, with a IDC-10 diagnosis of pyogenic lung abscess, from the Diamm ® based medical records (Micro6, Nancy; France). Parasitic, mycological, or mycobacterial lung abscesses were excluded.Results: A total of 64 patients were included. Abscesses were associated with immunosuppression in 28 patients, including HIV infection and immunosuppressive therapy for 8 and 12 patients, respectively. Bacterial identification was obtained for 36 patients. Nine patients (14%) developed lung abscesses after haematogenous dissemination. They differed from bronchogenic abscesses by their younger age (p=0.03), the absence of smoking or emphysema (p=0.05), S. aureus (p=0.001) or Streptococcus spp (p=0.05) isolation, and the smaller size of their abscess (p=0.02). Overall, evolution was marked by radiological sequelae, relapse, and death. Radiological sequelae occurred more frequently during the course of bronchogenic abscesses (p=0.02), particularly when they spontaneously discharged (p=0.04). Relapses were more frequent in patients with emphysema (p=0.04) and when H. influenzae was isolated (p=0.04). In multivariate analysis, poor outcomes, including death, sequelae, and relapse occurred more frequently in patients who had bronchogenic abscess (p=0.02), and in those who received antibiotics during less than 6 weeks (p=0.05). Conclusion: Duration of antibiotic treatment of less than six weeks and bronchogenic presentation were globally associated with poor outcome of pyogenic lung abscesses. These data should be considered when proposing guidelines for the care of pyogenic lung abscesses.
Prevalence and Associated Factors with Transfusion-Transmitted Infections among Blood Donors at the National Blood Transfusion and Research Center, Sana’a, Yemen
Authors: Ghaleb Yasser Ahmed , Alshahari Aymn Zaid , Ali Majdi Abdullhabeeb , Amad Mohammed Abdullah Al , Serouri Abdulwahed Abduljabbar Al 
Published: December 2020

Abstract
Background: Yemen is facing major challenges in ensuring the safety and availability of blood transfusion to meet the increased demand for blood transfusion due to the protracted conflict. However, Transfusion-transmissible infectious (TTIs) agents such as hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), syphilis and malaria remain the greatest threats for blood transfusion safety in such fragile, conflict-affected and vulnerable settings. This study aimed to determine the magnitude of TTIs among blood donors attending National Blood Transfusion and Research Center (NBTRC) and its associated factors. Methods: Cross- sectional study was conducted on 340 blood donors at the NBTRC during November and December 2017. Data was collected through face-to-face interview using a predesigned questionnaire that covered socio-demographic characteristics and possible TTIs associated factors. Blood samples were drawn and tested for HBV surface antigen (HBsAg), HCV antibodies, HIV1, 2 by using electrochemi-luminescence immunoassay technique and rapid immunochromato-graphic for screened syphilis and malaria antibodies. Result: The overall prevalence of TTIs was 8.8% where 2.5 %, 1.2%, 0.3%, 1.2%, 3.2% have HBV, HCV, HIV, syphilis and malaria respectively. HBV was significantly associated with history of jaundice and cupping. Furthermore, urethero-vaginal excretion was significantly associated with syphilis while malaria was significantly higher among donors from malaria endemic areas. Nearly three-fourth of donations were from replacement donors who had significantly higher TTIs prevalence than the voluntary donors: 10.4% vs. 3.3%, OR 3.4 (CI: 1.1-11.6). Conclusions: Although the prevalence of TTIs is low, it poses a serious risk for blood recipients especially in in fragile, conflict-affected and vulnerable settings where needs for blood transfusion are increasing and resources are limited. Therefore, using more sensitive screening methods and establishment of TTIs surveillance system should be considered. Efforts should be made to improve donor recruitment procedures and increase the proportion of regular and voluntary donation.
A Cross-National Comparison of Medicinal Plants used by the Miao, Yi and Lisu ethnic groups in Yanbian, China
Authors: Wang Ke-ru , Nan cuo , Ding Rong , Lin Jing , Hu Ding-jian , Zhong Shi-hong , Gu rui 
Published: December 2020

Abstract
Background: Its backdrop of multiethnic living makes Yanbian County rich in national culture, and the unique climate and topography make this area rich in medicinal plants. The exchange, collision and integration of the medical cultures of ethnic groups in Yanbian County are of great research significance. The Miao, Yi and Lisu are the most populous ethnic groups in Yanbian. Therefore, in this study, we investigated, sorted and analyzed these three ethnic medical systems with the goal of providing a basis for the study of ethnic medicine in Southwest China.Methods: The medicinal plants of Miao medicine (MM), Yi medicine (YM) and Lisu medicine (LM) in Yanbian County were inventoried by identifying the collected plant specimens and interviewing the local ethnic doctors with a semistructured form. The inventory included scientific names, family names, Latin names, medicinal parts, diseases treated and other information on the medicinal plants. Finally, the Jaccard similarity index (JI), cluster analysis and functional equivalent species mining were used to preliminarily analyze the similarities and differences of the three ethnic medical systems.Results: A total of 345 medicinal plants (from 109 families and 299 genera) and 18 unreported special situations of medicinal plant use were recorded and documented in our ethnobotanical investigation of the three medical systems. There were 102 species of medicinal plants with shared uses in MM, YM and LM, among which the families with the most species were Compositae (14 species, 14%), Labiatae (6 species, 6%), Polygonaceae (4 species, 4%) and Rosaceae (4 species, 4%). In the three medical systems, these medicinal plants are used to treat 12 types of disease, and the most commonly used medicinal parts are whole plants, roots and rhizomes. The statistical data showed that the JI of MM and YM was the highest (47.6%), and the overall similarity of these medical systems was the highest among all comparisons (45.9%). The results showed that in Yanbian, MM and YM were more similar than LM.Conclusions: The Miao, Yi and Lisu groups in the study area have inherited a wealth of ethnic medicine knowledge but are in great danger of losing this knowledge. The results of this study fill the existing knowledge gaps concerning MM, YM and LM in Yanbian, and the almost complete dataset can allow us to preserve ethnic medicine knowledge and carry out a global analysis. The important shared-use medicinal plants in the three medical systems can be used as the basis for future research on new drug resources.
Val50Met Hereditary Transthyretin Amyloidosis: Not Just a Medical Problem, but a Psychosocial Burden
Authors: González-Moreno J , Losada-López I , Rodríguez A , Bosch-Rovira T , Barroso A Gaya , Ripoll-Vera T , Usón M , Figuerola A , Descals C , Montalà C , Ferrer-Nadal MA , Cisneros-Barroso E 
Published: December 2020

Abstract
Hereditary transthyretin (TTR) amyloidosis (ATTRv) is a heterogeneous disease with a clinical presentation that varies according to geographical area and TTR mutation. The symptoms of Val50Met-ATTRv are mainly neuropathic and progress to complete disability and death in most untreated patients within 10 to 15 years of diagnosis. The neurological effects may also be accompanied by gastrointestinal impairment, cardiomyopathy, nephropathy and/or ocular deposition. The disease is thus associated with a high degree of patient disability. Accordingly, we aimed to describe the psychosocial burden associated with ATTRv in a group of patients, asymptomatic Val50Met carriers, relatives and caregivers in the endemic focus of the disease in Majorca via a survey addressing various aspects related to psychosocial burden.Our study revealed that, although most of the population studied had had prior contact with ATTRv through affected relatives, there was still a lack of information regarding disease diagnosis. Fear of the genetic test result and psychological issues were common in our population. Moreover, the disease had a stronger impact on the daily life of our patients than that of our asymptomatic carriers. Autonomic symptoms were the main source of burden for relatives and caregivers. In conclusion, our survey results show high psychosocial burden associated with Val50Met-ATTRv in our area.