bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prescribing antidepressants and anxiolytic medications to pregnant women: Comparing perception of risk of foetal teratogenicity between Australian Obstetricians and Gynaecologists, Speciality trainees and upskilled General Practitioners
Authors: Williams Summer , Bruxner George , Ballard Emma , Kothari Alka 
Published: October 2020

Abstract
Background: The decision of whether to prescribe antidepressants (AD) and anxiolytics (AX) to pregnant women is complex, with serious potential ramifications. Clinicians’ perception of the risk of teratogenicity significantly influences their prescribing decisions and in turn impacts maternal decision making. Our cross-sectional study sought to discern differences in perceived risk between Obstetricians and Gynaecologists (O&Gs) and General Practitioners (GPs) when prescribing these medications in pregnancy. Furthermore, we investigated factors impacting perception, clinicians’ willingness to prescribe and their approach to provision of patient information. Methods: This cross-sectional study was conducted via a nation-wide online SurveyMonkey extended to Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) database-derived affiliates: GP diplomates, fellows and trainees (5409 survey invitations: 545 respondents). O&Gs and GPs were compared using Pearson Chi-squared test for categorical variables and the Student t-test for continuous variables. Results: GPs reported higher rates of being aware of up-to-date medication prescription recommendations (57.6%) compared with O&Gs (44.2%). GPs also reported higher rates of training adequacy in psychotropic prescription (56.1% versus 29.0%). There was evidence to suggest GPs level of confidence in knowledge base, initiation and prescription of AD and AX was higher than those of O&Gs. The mean perception of patient non-compliance was similar between clinician groups (approximately 35%), but GPs perceived the extent of patient anxiety as higher compared to O&Gs (mean 73.7% (SD 21.3) versus 63.1% (SD 24.1), p<0.001). Both groups showed a strong preference for improved training rather than patient-focused technology (above 70% for both groups). Conclusion: Further development of clinician training in perinatal psychotropic prescription is warranted. Keywords : psychotropics, teratogenicity, pregnant, prescribing, foetal, perception
Disinfectant Wipes Transfer Clostridioides difficile Spores from Contaminated Surfaces to Uncontaminated Surfaces during the Disinfection Process
Authors: Nkemngong Carine A. , Chaggar Gurpreet K. , Li Xiaobao , Teska Peter J. , Oliver Haley F 
Published: October 2020

Abstract
Background: Pre-wetted disinfectant wipes are increasingly being used in healthcare facilities to help address the risk of healthcare associated infections (HAI). However, HAIs are still a major problem in the US with Clostridioides difficile being the most common cause, leading to approximately 12,800 deaths annually in the US. An underexplored risk when using disinfectant wipes is that they may cross-contaminate uncontaminated surfaces during the wiping process. The objective of this study was to determine the cross-contamination risk that pre-wetted disinfectant towelettes may pose when challenged with C. difficile spores. We hypothesized that although the tested disinfectant wipes had no sporicidal claims, they will reduce spore loads. We also hypothesized that hydrogen peroxide disinfectant towelettes would present a lower cross-contamination risk than quaternary ammonium products. Methods: We evaluated the risk of cross-contamination when disinfectant wipes are challenged with C. difficile ATCC 43598 spores on Formica surfaces. A disinfectant wipe was used to wipe a Formica sheet inoculated with C. difficile. After the wiping process, we determined log10 CFU on previously uncontaminated pre-determined distances from the inoculation point and on the used wipes. Results: We found that the disinfectant wipes transferred C. difficile spores from inoculated surfaces to previously uncontaminated surfaces. We also found that wipes physically removed C. difficile spores and that hydrogen peroxide disinfectants were more sporicidal than the quaternary ammonium disinfectants. Conclusion: Regardless of the product type, all disinfectant wipes had some sporicidal effect but transferred C. difficile spores from contaminated to otherwise previously uncontaminated surfaces. Disinfectant wipes retain C. difficile spores during and after the wiping process.
Seroepidemiology of Respiratory Syncytial Virus infection in rural and semi-rural areas of the Littoral Region of Cameroon
Authors: Mandi Henshaw Eyambe , Yimer Solomon Abebe , Bekolo Cavin Epie , Eyoh Agnes , Jan Sindhiya , Clemens Ralf 
Published: October 2020

Abstract
Background: The respiratory syncytial virus (RSV) has been established as a leading cause of acute lower respiratory illness (ALRI) in infants and children. In 2015, the global disease burden (GBD) study estimated that the overall RSV-ALRI mortality could be as high as 118200, with most death occurring in low- and middle-incomes countries (LMICs). This study aimed to assess the burden of RSV infection among children less than two years with acute respiratory infections (ARI) in the littoral region of Cameroon.Methods: We carried out a cross-sectional study in seven health in the littoral region of Cameroon. Venous blood was collected using serum separation tubes from eligible children who visited these healthcare facilities with acute respiratory infections. ELISA testing was used to assess the seroprevalence of anti-IgM RSV for the total population and by selected demographic and health parameters and potential risk factors. Results: The overall RSV-associated ARI seroprevalence was 33% (95%CI:23.6-42.3; 33/100 children). The only demographic factor significantly associated with RSV acquisition was age of six months and below (odds ratio: 7.54 (2.62, 23.36); p=0.000). Children who were concomitantly infected with malaria had a lower risk of RSV infection (odds ratio: 0.38 (0.14, 0.95; P = 0.03). Conclusions: The RSV burden is high among children less than two years with ARI in the littoral region of Cameroon. There is a need for an effective public health RSV surveillance system with standard laboratory techniques and equipment to better understand the RSV disease age-specific incidence, seasonality, risk factors and RSV burden among patients in communities in Cameroon.
Biomechanical Control of Paretic Lower Limb During Imposed Weight Transfer in Individuals Post-Stroke
Authors: Hsiao Hao-Yuan , Gray Vicki L , Borrelli James , Rogers Mark W 
Published: October 2020

Abstract
Background: stroke is a leading cause of disability with associated hemiparesis resulting in difficulty bearing and transferring weight on to the paretic limb. Difficulties in weight bearing and weight transfer may result in impaired mobility and balance, increased fall risk, and decreased community engagement. Despite considerable efforts aimed at improving weight transfer after stroke, impairments in its neuromotor and biomechanical control remain poorly understood. In the present study, a novel experimental paradigm was used to characterize differences in weight transfer biomechanics in individuals with chronic stroke versus able-bodied controls. Methods: fifteen participants with stroke and fifteen age-matched able-bodied controls participated in the study. Participants stood with one foot on each of two custom built platforms. One of the platforms dropped 4.3 cm vertically to induce lateral weight transfer and weight bearing. Trials involving a drop of the platform beneath the paretic lower extremity (non-dominant limb for control) were included in the analyses. Paretic lower extremity joint kinematics, vertical ground reaction forces, and center of pressure velocity were measured. All participants completed the clinical Step Test and Four-Square Step Test. Results: reduced paretic ankle, knee, and hip joint angular displacement and velocity, delayed ankle and knee inter-joint timing, increased downward displacement of center of mass, and increased center of pressure (COP) velocity stabilization time were exhibited in the stroke group compared to the control group. In addition, paretic COP velocity stabilization time during induced weight transfer predicted Four-Square Step Test scores in individuals post-stroke. Conclusions: the induced weight transfer approach identified stroke-related abnormalities in the control of weight transfer towards the paretic limb side compared to controls. Decreased joint flexion of the paretic ankle and knee, altered inter-joint timing, and increased COP stabilization times may reflect difficulties in neuromuscular control during weight transfer following stroke. Future work will investigate the potential of improving functional weight transfer through induced weight transfer training exercise.
Biomechanical analysis of canine medial patellar luxation with femoral varus deformity using a computer model
Authors: Lee Jiyun , Sim Heedong , Jeong Jaemin , DVM Sun-Young Kim , Yang Seokjo , Jeong SeongMok , Lee Haebeom 
Published: October 2020

Abstract
Background Femoral varus deformities complicating the realignment of the quadriceps muscles are frequently associated with medial patellar luxation (MPL) in dogs. Therefore, distal femoral osteotomy (DFO) is recommended in dogs affected with severe MPL and a distal femoral varus deformity. The presence of an anatomic lateral distal femoral angle (aLDFA) of ≥ 102° has been anecdotally recommended as an indication for performing corrective DFO in large-breed dogs. However, the effect of a femoral varus deformity on MPL has not been scientifically evaluated. We aimed to evaluate the influence of a femoral varus deformity on MPL using a finite element method based computer model. Three-dimensionally reconstructed computed tomographic images of a normal femur from a Beagle dog were deformed using meshing software to create distal varus deformities. A total of thirteen aLDFAs, including 95°, 98° and 100°–110°, were simulated. The patellar positions and reaction force between the patella and trochlear grooves were calculated for all finite element models under constant rectus femoris muscle activation.Results: The patella was displaced medially from the trochlear groove at an aLDFA of ≥103°. With an aLDFA of 103° to 110°, the reaction force was equal to zero and then decreased to negative values during the simulation, while other models with aLDFAs of 95°, 98°, and 100°-102° had positive reaction force values. The patella began to luxate at 24.90 seconds (sec) with an aLDFA of 103°, 19.80 sec with an aLDFA of 104°, 21.40 sec with an aLDFA of 105°, 20.10 sec with an aLDFA of 106°, 18.60 sec with an aLDFA of 107°, 15.30 sec with an aLDFA of 108°, 16.60 sec with an aLDFA of 109°, and 11.90 sec with an aLDFA of 110°.Conclusion: Severe distal femoral varus with an aLDFA of ≥103° caused MPL when other anatomical factors were controlled. This simplified computer model provides complementary information to anecdotal cutoffs for DFO, hence it should be applied to clinical patients with caution.
Why do pregnant women prefer cesarean birth? : a qualitative study in a tertiary care center in Southern Thailand
Authors: Suwanrath Chitkasaem , Chunuan Sopen , Matemanosak Phawat , Pinjaroen Sutham 
Published: October 2020

Abstract
Background: The increasing worldwide rate of cesarean sections is of global concern. In recent years, cesarean births upon maternal request have become both a hotly debated issue. Hence, this study aimed to explore maternal reasons for cesarean preference without medical indications.Methods: A descriptive qualitative study was conducted, using in-depth interviews with 27 pregnant women, attending antenatal care in Songklanagarind Hospital from September 2018 to June 2019, who preferred cesarean birth. Data were analyzed using content analysis.Results: Maternal reasons for cesarean preference were classified into six main categories including: fear of childbirth, safety concerns related to health risk perception, negative previous birth experience, positive attitude toward cesarean birth, access to biased information and superstitious belief in auspicious birth dates. Most women had more than one reason for opting cesarean birth. Conclusion: Several reasons for cesarean birth preference have been elucidated. One striking reason was a superstitious belief in auspicious birth dates, which is challengable for obstetricians to deal with. Obstetricians should explore the exact reasons why women request cesarean birth, so as to prevent or diminish unnecessary cesarean births.
Neuroprotective effect of Indobufen against pyroptosis following cerebral ischemia-reperfusion injury both in vivo and in vitro
Authors: Zhang Tian , Xu Dan , Li Fengyang , Liu Rui , Hou Kai , Gou Xue , Liu Jia , Fang Weirong , Li Yunman 
Published: October 2020

Abstract
Background: Indobufen is a new generation of antiplatelet agents and has been shown to have antithrombotic effects in animal models. However, the efficacy of Indobufen on cerebral ischemia/reperfusion (I/R) injury and its mechanisms remain to be investigated. Methods: In this study, the efficacy of Indobufen with both pre- (5days) and post- (15days) treatment on rats suffering middle cerebral artery occlusion/reperfusion (MCAO/R, 2h of ischemia and 24h/15days of reperfusion) was investigated. Furthermore, human umbilical vein endothelial cells (HUVECs) were cultured and underwent oxygen glucose deprivation/reoxygenation (OGD/R) injury for in vitro studies. Relationship between Indobufen and pyroptosis associated NF-κB/Caspase-1/GSDMD pathway was preliminarily discussed.Results: The pharmacodynamic tests revealed that Indobufen ameliorated I/R injury by decreasing the platelet aggregation, infarct size, brain edema and neurologic impairment in rats and rescuing cell apoptosis/pyroptosis in HUVECs. The underlying mechanisms were probably related to pyroptosis suppression by platelet inhibition induced regulation of the NF-κB/Caspase-1/GSDMD pathway. Conclusion: Overall, these studies indicates that Indobufen exerts protective and therapeutic effects against I/R injury by pyroptosis suppression via downregulating NF-κB/Caspase-1/GSDMD pathway.
Assessing the Effectiveness of Chagas Disease Education for Healthcare Providers in the United States
Authors: Granados Paula Stigler , Pacheco Gerardo J , Patlán Evangelina Núñez , Betancourt Jose , Fulton Lawrence 
Published: October 2020

Abstract
Background: Chagas disease is a zoonotic infection caused by the parasite Trypanosoma cruzi, which affects an estimated 8-11 million people globally. Chagas disease is almost always associated with poverty in rural areas and disproportionately impacts immigrants from Latin America living in the United States. Approximately 20-30% of people who are infected with Chagas disease will develop a chronic form of the infection that can be fatal if left untreated. Chagas disease is vastly underestimated in the United States, often goes undiagnosed and is not well understood by most U.S. healthcare providers. One of the most important ways at reducing barriers to improving diagnostics of Chagas disease in the U.S. is giving healthcare providers the most up-to-date information and access to leading experts. Methods: An online webinar was conducted for healthcare providers, veterinarians and public health professionals using Chagas disease expert panelists. Pre and post tests were administered to participants (n=57) to determine the efficacy in raising awareness and to determine key focus areas for improving knowledge. A Wilcoxon rank-sum was used for non-parametric variables equivalent and for questions that assessed knowledge the McNemar’s Chi-Square test was used.Results: There were statistically significant learning increases in multiple categories including transmission (p=<.001), clinical presentation (p= 0.016), diagnostics (p=<.001), and treatment (p=<.001). Conclusion: Providing easily accessible learning opportunities using validated testing and evaluations should be further developed for rural healthcare providers in the U.S. as well as healthcare providers serving under represented populations such as immigrants. There is a clear lack of knowledge and awareness surrounding Chagas disease in the United States and just by raising awareness and providing education on the topic, lives will be saved.
Prevalence and Clinical Phenotype of the Triplicated α-Globin Genes and its Ethnic and Geographical Distribution in Guizhou of China
Authors: Luo Xi , Chen Shi-ping , Zhang Xiang-mei , Wu Liu-song , Peng Zhi-yu , Chen Yan , Chen Jindong 
Published: October 2020

Abstract
Background: Thalassemia is relatively epidemic in Guizhou province of southwestern China. To predict the clinical manifestations of α-globin gene aberration for genetic counseling, we examined the prevalence of the α-globin triplication and the genotype-phenotype correlation in this subpopulationMethods: A cohort of 7644 subjects was collected from nine ethnicities covering four regions in Guizhou province of China. Peripheral blood was collected from each participant for routine blood testing and hemoglobin electrophoresis. PCR-DNA sequencing and Gap-PCR were used to identify the thalassemia gene mutations. Chi-square tests and one-way analysis of variance (ANOVA) were used to statistically analyze the data. ﻿Results: We found that the frequency of α-globin triplication in Guizhou province was 0.759% (58/7644). Genotypically, the αααanti4.2/αα accounted for 0.523% (40/7644), the αααanti3.7/αα for 0.235% (18/7644). The αααanti4.2/αα is more prevalent than the αααanti3.7/αα in Guizhou. In addition, the frequency of the αααanti4.2/-α3.7 (HK αα) was 0.235% (18/7644), and the αααanti3.7/--SEA was 0.013% (1/7644). Ethnically, the Tujia group presented the highest prevalence (2.47%) of α-globin triplication. Geographically, the highest frequency of the α-globin triplication was identified in Qiannan region (2.23%). Of the triplicated α-globin cases, 5 coinherited with heterozygote β-thalassemia and presented various clinical manifestations of anemia. Conclusions: These data will be used to update the triplicated α-globin thalassemia database and provide insights into the pathogenesis of thalassemia. These findings will be helpful for the diagnosis of thalassemia and future genetic counseling in those regions.
Effects of Tocilizumab in COVID-19 patients: a cohort study
Authors: Vu Christine , Deronde Kailynn J , Vega Ana D , Maxam Meshell , Holt Gregory , Natori Yoichiro , Zamora Jose Gonzales , Salazar Veronica , Boatwright Renata , Morris Stephen R , Corvino Daniela de Lima , Betances Anmary Fernandez , Colucci Leah , keegan James , Lopez Andy , Rezk Andrew Hany , Rodriguez Yvette , Doblecki Susanne , Zerda David De La , Abbo Lilian M 
Published: October 2020

Abstract
Background: Due to the lack of proven therapies, we evaluated the effects of early administration of tocilizumab for COVID-19. By inhibition of the IL-6 receptor, tocilizumab may help to mitigate the hyperinflammatory response associated with progressive respiratory failure caused by SARS-CoV-2. Methods: A retrospective, observational study was conducted on hospitalized adults who received intravenous tocilizumab for COVID-19 between March 23, 2020 and April 10, 2020. Results: Most patients were male (66.7%), Hispanic (63.3%) or Black (23.3%), with a median age of 54 years. Tocilizumab was administered at a median of 8 days (range 1-21) after initial symptoms and 2 days (range 0-12) after hospital admission. On the day of administration, the median PaO2/FiO2 was 166 (range 33-523) and 50 patients (83.3%) had ARDS. By day 30, 36 patients (60.0%) demonstrated clinical improvement, 9 (15.0%) died, 33 (55.0%) were discharged alive, and 18 (30.0%) remained hospitalized. Successful extubation occurred in 13 out of 29 patients (44.8%). Infectious complications occurred in 16 patients (26.7%) at a median of 10.5 days. There was an increase in PaO2/FiO2 and an initial reduction in CRP that was not sustained beyond day 10. Conclusions: Majority of patients demonstrated clinical improvement and were successfully discharged from the hospital alive after receiving tocilizumab. Similar to previous studies, infectious complications were not uncommon. We observed a rebound effect with CRP, which may suggest the need for higher or subsequent doses to adequately manage cytokine storm. Based on our findings, we believe that tocilizumab may have a role in the treatment of COVID-19, however randomized controlled studies are urgently needed.
Autologous peripheral blood-derived stem cells transplantation for treatment of no-option angiitis-induced critical limb ischemia: 10-year management experience
Authors: Fang Gang , Jiang Xiaolang , Fang Yuan , Pan Tianyue , Liu Hao , Wei Zheng , Gu Shiyang , Chen Bin , Jiang Junhao , Shi Yun , Guo Daqiao , Liu Peng , Dong Zhihui , Fu Weiguo 
Published: October 2020

Abstract
Background: Previous studies have demonstrated that no-option angiitis-induced critical limb ischemia (NO-AICLI) could be significantly improved by transplantation of peripheral blood-derived stem cells (PBDSCs). Additionally, a randomized controlled trial (RCT) recently conducted by us suggested that peripheral blood-derived purified CD34+ cells (PCCs) were not inferior to non-purified peripheral blood mononuclear cells (PBMNCs) at limb salvage in treatment of NO-AICLI. However, most of these clinical trials whether RCT or single-arm studies were characterized with a small sample size and absence of long-term outcomes. Methods: To analyze long-term clinical outcomes of PBDSCs transplantation for NO-AICLI, we reviewed clinical data of patients with NO-AICLI receiving PBDSCs transplantation at our center during the past decade. Meanwhile, we first compared the long-term safety and efficacy of intramuscular transplantation of PCCs versus PBMNCs in a sizable number of patients with NO-AICLI.Results: From May 2009 to December 2019, a total of 160 patients with NO-AICLI patients were treated by PBDSCs transplantation (82 with PCCs, 78 with PBMNCs) at our center. Baseline characteristics between two groups were similar. Up to June 2020, the mean follow-up period was 46.6±35.3 months. No critical adverse events were observed in either group. There was one death during the follow-up period. A total of eight major amputations occurred. The cumulative major amputation-free survival (MAFS) rate at 5 years after PBDSCs transplantation was 94.4%, without difference between two groups (P=.855). Wound healing, rest pain, pain-free walking time, ankle-brachial index, transcutaneous oxygen pressure, and quality of life (QoL) also significantly improved after PBDSCs transplantation. Conclusions: Autologous PBDSCs intramuscular transplantation could significantly decrease the major amputation rates and improve the QoL in patients with NO-AICLI. Long-term observation of a large sample of patients confirmed that the clinical benefits of PBDSCs transplantation were durable, without difference between the PCCs and PBMNCs groups.