bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Spinal Alignment Changes on Low Back Pain in Patients Treated with Total Hip Arthroplasty for Hip Osteoarthritis
Authors: Saiki Fumiko , Tanaka Takeyuki , Tachibana Naohiro , Oshima Hirofumi , Kaneko Taizo , Horii Chiaki , Nakamoto Hideki , Kato So , Doi Toru , Matsubayashi Yoshitaka , Taniguchi Yuki , Tanaka Sakae , Oshima Yasushi 
Published: August 2020

Abstract
BackgroundTotal hip arthroplasty (THA) is an established procedure for patients with osteoarthritis (OA) of the hip joint that effectively relieves pain and restores function. Because contracture of the hip joint as well as preoperative leg length discrepancy is expected to improve by the surgery, it would be reasonable to speculate that spinal sagittal alignment will also change. However, the influence of spinal alignment changes on clinical symptoms, such as low back pain (LBP), remains controversial. In this study, we aimed to evaluate the associations between spinal alignment changes and improvement in preoperative LBP after THA.MethodsFrom November 2015 to January 2017, 104 consecutive patients who underwent THA were prospectively enrolled. Whole spine X-rays were obtained preoperatively and 12 months postoperatively. The patient-reported outcomes (PROs) used were the Numerical Rating Scale (NRS) for back pain, EuroQol 5 Dimension, and Short Form-12. The presence of LBP was defined as an NRS of ≥4. Changes in spinal alignment and PROs before and after surgery were evaluated.ResultsSeventy-four (71%) patients were included in the study. The sagittal spinal parameters changed slightly but significantly; pelvic incidence (PI) decreased, pelvic tilt (PT) increased, and sacral slope decreased. Coronal spinal alignment significantly improved after surgery. Twenty-six (37%) patients had LBP preoperatively. The patients with preoperative LBP had smaller lumbar lordosis (LL), larger PT, and larger PI minus LL than those in the patients without. Fourteen (54%) of the 26 patients with preoperative LBP showed improvement, but there were no significant differences in the pre- and postoperative radiographic parameters.ConclusionAlthough preoperative LBP was likely to resolve after THR, there were no significant correlations between alignment changes and LBP improvement. The cause of LBP in patients with hip OA patients might be multifactorial.
COVID-19 and Guillain-Barre Syndrome - a Case report
Authors: Sidig Amira , Abbasher Khabab , Digna Mutaz F. , Elsayed Mohamed , Abbasher Hussien , Abbasher Mohammed , Hussien Abbasher 
Published: August 2020

Abstract
Coronaviruses are a family of related viruses that cause diseases in mammals and avians. Guillain-Barre syndrome is a rare disorder in which the body's immune system attacks peripheral nerves.The case:A 65 years old Sudanese male with no diabetes mellitus or hypertension present to the clinic; On examination, he has upper and lower limb weakness (quadriplegia). The condition was preceded by upper respiratory tract infection. Chest X-ray showed features of pneumonia Chest CT scan showed multiple bilateral ground-glass opacities and consolidation typical of COVID-19 pneumonia. Brain MRI was normal. The COVID-19 nasal swab test was positive. Nerve conduction study showed evidence of polyradiculopathies with dominant demyelination supporting the diagnosis of Guillain-Barre syndrome. The patients died after seven days; because of progressive respiratory failure.
Muscles Adaptation to Aging and Training: Architectural Changes – A Randomised Trial
Authors: LÉTOCART Adrien J. , Mabesoone Franck , Charleux Fabrice , Couppé Christian , Svensson Rene B. , Marin Frédéric , Magnusson S. Peter , Grosset Jean-François 
Published: August 2020

Abstract
Background: To investigate how anatomical cross-sectional area and volume of quadriceps and triceps surae muscles were affected by ageing, and by resistance training in older and younger men, in vivo. Methods: The old participants were randomly assigned to moderate (O55, n=13) or high-load (O80, n=14) training intervention (12 weeks; 3 times/week) corresponding to 55% or 80% of one repetition maximum, respectively. Young men (Y55, n=11) were assigned to the moderate-load training program. Each groups received the exact same training volume on triceps surae and quadriceps group (Reps x Sets x Intensity). The fitting polynomial regression equations for each of anatomical cross-sectional area-muscle length curves were used to calculate muscle volume (contractile content) before and after 12 weeks using magnetic resonance imaging scans.Results: Only Rectus femoris and medial gastrocnemius muscle showed a higher relative anatomical cross-sectional area in the young than the elderly on the proximal end. The old group displayed a higher absolute volume of non-contractile material than young men in triceps surae (+96%). After training, Y55, O55 and O80 showed an increase in total quadriceps (+4.3%; +6.7%; 4.2% respectively) and triceps surae (+2.8%; +7.5%; 4.3% respectively) volume. O55 demonstrated a greater increase on average gains compared to Y55, while no difference between O55 and O80 was observed.Conclusions: Muscle loss with aging is region-specific for some muscles and uniform for others. Equivalent training volume at moderate or high intensities induced no additional muscle volume gains for old men. These data suggest that physical exercise at moderate intensity (55 to 60% of one repetition maximum) can retain the aging related loss of muscle mass.Trial registration: CPP-2016/52 (France) and on Clinical Trials.gov (2016-A00534-47)
Fatal Sickling Associated Microvascular Occlusive Crisis in a Young Military Recruit with Sickle Cell Trait: A Case Report
Authors: Mutreja Deepti , K Benjith Paul , K Tilak T V S V G , Tewari Vanmalini 
Published: August 2020

Abstract
Background.

Sickle cell trait(SCT), a heterozygous state characterized by the presence of hemoglobin AS, occurs in varied frequency in the Indian population with highest prevalence in Central and southern India. SCT is compatible with a normal lifespan and not commonly regarded as a cause of morbid illness or death in contrast to sickle cell disease, its homozygous counterpart.
Case Presentation.

We describe a case of fatal sickling associated microvascular crisis, identified on post mortem evaluation in a previously undiagnosed 20-year-old military recruit with sickle cell trait. The individual presented with repeated episodes of presyncope during his training and was evaluated for cardiac anomalies and heat syncope. During the terminal episode, he collapsed and died of severe metabolic complications as he struggled to complete an organised run during routine training activities.
Conclusion.

To our knowledge, this is the first report of fatal sickling associated crisis in a military recruit with sickle cell trait from India. This case serves to remind all medical officers of the armed forces of the importance of screening a recruit who is unable to complete exertional physical training for the presence of sickle cell trait.
Predictive performance of PiCCO system and blood gas parameters for early prognosis of patients with sepsis
Authors: YUAN JING , Qin XueMei , Wang Tao , Wang Tong , Wu Jinyi , Shen Guanggui , Cao Yinya , Lu Weihua , Wang Zhen 
Published: August 2020

Abstract
Purpose: Invasive hemodynamics monitor directed fluids resuscitation remains misgiving issues. This study aims to explore the predictive value of the PiCCO system (pulse indicator continuous cardiac output device) and blood gas parameters on the early prognosis of patients with sepsis.Methods: 42 patients with sepsis were included from January 2013 to January 2015. All patients were stratified into survivor group (n=29) and nonsurvivor group (n=13) based on seven day-mortality. The PiCCO and blood gas parameters at enrollment and 24 hours were compared between two groups. The predictive performance of these parameters was distinguished with Area Under the Receiver Operating Characteristic Curve (AUC). Results: At 24 hours after enrollment, the HR (97.27±22.07 vs. 120.20±20.56), extravascular lung water index (EVLWI) (7.32±2.96 vs. 15.9±11.2), and lactic acid (Lac) (1.62±0.92 vs. 6.33±5.83) level were significantly lower in survivor group (P < 0.05), whereas the cardiac index (CI) (3.67±0.85 vs. 2.98±0.73) and PaO2/FiO2 (242.8±89.68 vs.136.07±78.01) increased significantly. Meanwhile PaO2/FiO2 was negatively correlated with EVLWI (r= -0.673, P < 0.01). The AUC of the combination of Lac with PaO2/FiO2, HR, EVLWI, pulmonary vascular permeability index (PVPI) and Lac at 24 hours were 0.853, 0.739, 0.776, 0.764, and 0.794.Conclusions: The PiCCO and blood gas parameters exhibit superior predictive capability for early prognosis in patients with sepsis, and the combination Lac with PaO2/FiO2 was noninferior under the circumstance of unavailability with PiCCO.
Spontaneous Pneumothorax as Unusual Presenting Symptom of Covid-19 Pneumonia: Surgical Management and Pathological Findings
Authors: Bellini Roberto , SALANDINI MARIA CHIARA , Cuttin Serena , Mauro Stefania , Scarpazza Paolo , Cotsoglou Christian 
Published: August 2020

Abstract
Spontaneous pneumothorax has been reported as a possibile complication of novel coronavirus associated pneumonia (COVID-19). We report two cases of COVID-19 patients who developed spontaeous and recurrent pneumothorax as a presenting symptom, treated with surgical procedure. Intraoperative findings of COVID-19 pneumonia were parenchymal atelectasis and vascular congestion. Lung tissue was very frail and prone to bleeding. Histological examination showed interstitial infiltration of lymphocytes and plasma cells, as seen in non specific interstitial pneumonia, together with myo-intimal thicknening of vessels with blood extravasation and microthrombi. Lung surgery for pneumothorax in COVID-19 patients can be safely and effectively performed when necessary.
Understanding the Causes of Errors in Eukaryotic Protein-coding Gene Prediction: A Case Study of Primate Proteomes
Authors: Meyer Corentin , Scalzitti Nicolas , Jeannin-Girardon Anne , Collet Pierre , Poch Olivier , Thompson Julie 
Published: August 2020

Abstract
Background. Recent advances in sequencing technologies have led to an explosion in the number of genomes available, but accurate genome annotation remains a major challenge. The prediction of protein-coding genes in eukaryotic genomes is especially problematic, due to their complex exon-intron structures. Even the best eukaryotic gene prediction algorithms can make serious errors that will significantly affect subsequent analyses. Results. We first investigated the prevalence of gene prediction errors in a large set of 176,478 proteins from ten primate proteomes available in public databases. Using the well-studied human proteins as a reference, a total of 82,305 potential errors were detected, including 44,001 deletions, 27,289 insertions and 11,015 mismatched segments where part of the correct protein sequence is replaced with an alternative erroneous sequence. We then focused on the mismatched sequence errors that cause particular problems for downstream applications. A detailed characterization allowed us to identify the potential causes for the gene misprediction in approximately half (5446) of these cases. As a proof-of-concept, we also developed a simple method which allowed us to propose improved sequences for 603 primate proteins. Conclusions. Gene prediction errors in primate proteomes affect up to 50% of the sequences. Major causes of errors include undetermined genome regions, genome sequencing or assembly issues, and limitations in the models used to represent gene exon-intron structures. Nevertheless, existing genome sequences can still be exploited to improve protein sequence quality. Perspectives of the work include the characterization of other types of gene prediction errors, as well as the development of a more comprehensive algorithm for protein sequence error correction.
Metagenomic survey and whole genome sequencing of antimicrobial resistant bacteria in the sewage of a Japanese hospital
Authors: Katagiri Miwa , Kuroda Makoto , Sekizuka Tsuyoshi , Nakada Norihide , Ito Yukitaka , Otsuka Masanobu , Watanabe Manabu , Kusachi Shinya 
Published: August 2020

Abstract
Background The dissemination of antimicrobial-resistant bacteria (ARB) and the transfer of antimicrobial resistance genes (ARGs) are a threat to public health. Antibiotics are indispensable therapeutic agents essential for the treatment of infectious diseases; however, inappropriate use of antibiotics leads to the emergence of ARB. It is established that hospitals are closely involved in the spread of antimicrobial resistance (AMR), which impedes antibiotic treatment and subsequently increases mortality. In addition, excrement of patients or healthy carriers of ARB are discharged from the hospital sewage through the wastewater treatment plant (WWTP) into the rivers, causing an AMR burden on the environment.Method Metagenomic analysis was performed on the hospital sewage samples, followed by whole genome sequencing of the extended spectrum β-lactamase (ESBL)-producing organisms (EPOs). A comparative genome analysis was also performed between EPO isolates from sewage and clinical isolates.Results Metagenomic analysis showed that the hospital sewage tanks had bacterial flora corresponding to the human gut. During the study period, the hospital was relocated to a newly constructed building with new sewage tanks; however, the presence of ARB/ARGs in the new hospital sewage tanks became markedly equivalent to that of the old hospital within one month. The ESBL blaCTX−M and carbapenemase blaIMP genes were not much detected in the original hospital sewage samples by metagenome analysis, but selection on CHROMagar ESBL increased the sensitivity to detect those β-lactamase genes. Comparative genome analysis between sewage and clinical EPO isolates revealed partial similarity; however, most EPO isolates exhibited a notable difference (≥ 50) in single nucleotide variations based on core-genome phylogeny. This result suggests that only some of the sewage EPO isolates were originated from the clinical patient. Therapeutic agents in the hospital sewage were analyzed and the concentration of levofloxacin and clarithromycin was 0.0325 and 0.0135 µg/mL, respectively.Conclusions Whole genome analysis between sewage and clinical isolates suggested that healthy or asymptomatic carriers may be involved in the contamination of hospital sewage. Moreover, the hospital sewage tank may serve as a hotspot for the horizontal transfer of ARGs under the selective pressure of antimicrobial agents. Therefore, ARB monitoring in hospital sewage is expected to detect the presence of carriers prior to nosocomial ARB outbreaks. In addition, hospital wastewater should be treated suitably to bring ARB below detectable levels to reduce the environmental AMR burden.
Identification of mammalian-adapting mutations involved into antigenic change of H1N1 influenza virus
Authors: Yu Zhijun , Cheng Kaihui , Sun Weiyang , Zhang Xinghai , Wang Tiecheng , Zhao Yongkun , Wu Jiaqiang , Gao Yuwei , Xia Xianzhu 
Published: August 2020

Abstract
Though the 2009 pandemic H1N1 virus has become a seasonal influenza A virus, continued host adaptation and antigenic drift may limit the effectiveness of current vaccines. Here, we assess viral antigenic change of a 2009 pandemic H1N1 virus (A/Changchun/01/2009) in the absence and presence of immune-mediated selective pressures and further identify the key amino acid substitutions involved into the antigenic change of the 2009 pandemic H1N1 virus. We found that serial passage of the 2009 pandemic H1N1 virus in both naïve and previously immunized mice generated antigenically distinct variants and that serial passage in previously immunized mice generated viruses with lower overall antigenic relatedness to the parental virus when compared to variants generated by serial passage in naïve mice, suggesting that antibody pressure may accelerate the antigenic variation rate of the 2009 pandemic H1N1 virus. Furthermore, we found that three amino acid substitutions in the viral HA protein (N159D, S186P, and D225G), both alone and in combination, affected viral antigenicity. It is noted that all three mutations (N159D, S186P, and D225G) in the viral HA protein have been found in the natural 2009 pandemic H1N1 virus isolates and can also enhance the pathogenicity of the 2009 pandemic H1N1 virus to mammals, suggesting that these mutations in the viral HA protein may pose a potential threat to public health and should be paid more attention. Taken together, our work defines some novel molecular determinants of the pandemic H1N1 virus antigenicity and has important implications for ongoing human influenza virus surveillance efforts.
Developing a New Tool for Determining the Difficulty of Laparoscopic Bariatric Surgery
Authors: Kabir Ali , Abbas Syed Imran , Moradi Marziyeh , Pazouki Abdolreza 
Published: August 2020

Abstract
Background: Recommendations for candidates of bariatric surgery are available but they seldom give guidance to help a specific patient. The purpose of this study is to develop a new tool for determining the difficulty of laparoscopic bariatric surgery before surgery. Methods: This was a mixed method study. After a comprehensive search, semi structure interview and focus group discussions (FGD) with surgeons, and operating room personnel and department, initial draft of the questionnaire was prepared. We used Delphi method to achieve a group consensus of national and international surgeons. Finally, after several times of review and modification of the designed questions, a final questionnaire was prepared. Content and face validity, reliability and internal consistency (using Cronbach’s alpha) were determined.Results: Final questionnaire has 31 questions consist of I. Factors related to surgeon: experience(four questions), and exposure(one question), II. Factors related to patient: anatomy(eleven questions), and comorbidities(two questions), patient’s position(one question), and others(one question), III. Factors related to instruments and operation room, quantity(two questions), and quality(one question), IV. Factors related to other personnel: anesthesia team(six questions), and other personnel(two questions). Cronbach’s alpha was 0.98 for the whole questionnaire and between 0.86 and 0.97 for the four subscales. Conclusions: The psychometrics analysis indicated that it is valid and reliable for determining the difficulty of laparoscopic bariatric surgery. We recommend using this questionnaire for different settings either need to know difficulty of a bariatric surgery before a surgery or as an independent variable in various research projects.
Investigating Association Between Participation in Co-curricular Activities and Student’s Academic Output at Secondary Level
Authors: Sarwat Yusra , Nadeem Hamid Ali , Sahar Namood-e 
Published: August 2020

Abstract
Educational experiences are necessary for ensuring student’s growth, skill development, and a successful life. The educational experiences are governed by the student’s learning outcomes. Co-curricular activities also form a significant part of student’s life and are found to play a vital role in the academic as well as personal growth and development of children. The present research studied the role of co-curricular activities in student’s learning outcomes at secondary level. The results support association between both variables as assessed by Murphy’s student survey questionnaire. Findings could help to provide evidence for importance of curricular activities to the policy makers so it can be made a part of student’s learning outcomes.﻿
Veno-venous-ECMO as a Platform to Evaluate Lung Lavage and Surfactant Replacement Therapy in an Animal Model of Severe ARDS
Authors: Qaqish Robert , Watanabe Yui , Galasso Marcos , Summers Cara , Ali Aadil , Takahashi Mamoru , Gazzalle Anajara , Liu Mingyao , Keshavjee Shaf , Cypel Marcelo , Sorbo Lorenzo Del 
Published: August 2020

Abstract
Background: There are limited therapeutic options directed at the underlying pathological processes in acute respiratory distress syndrome (ARDS). Experimental therapeutic strategies have targeted the protective systems that become deranged in ARDS such as surfactant. Although results of surfactant replacement therapy (SRT) in ARDS have been mixed, questions remain incompletely answered regarding timing and dosing strategies of surfactant. Furthermore, there are only few truly clinically relevant ARDS models in the literature. The primary aim of our study was to create a clinically relevant, reproducible model of severe ARDS requiring extracorporeal membrane oxygenation (ECMO). Secondly, we sought to use this model as a platform to evaluate a bronchoscopic intervention that involved saline lavage and SRT. Methods: Yorkshire pigs were tracheostomized and cannulated for veno-venous ECMO support, then subsequently given lung injury using gastric juice via bronchoscopy. Animals were randomized postinjury to either receive bronchoscopic saline lavage combined with SRT and recruitment maneuvers (treatment, n=5) or recruitment maneuvers alone (control, n=5) during ECMO.Results: PaO2/FiO2 after aspiration injury was 62.6 ±8 mmHg and 60.9 ±9.6 mmHg in the control and treatment group, respectively (p=0.95) satisfying criteria for severe ARDS. ECMO reversed the severe hypoxemia. After treatment with saline lavage and SRT during ECMO, lung physiologic and hemodynamic parameters were not significantly different between treatment and controls. Conclusions: A clinically relevant severe ARDS pig model requiring ECMO was established. Bronchoscopic saline lavage and SRT during ECMO did not provide a significant physiologic benefit compared to controls.
Implementing a mixed methods Human Factors approach to design and rehearse management of unplanned extubation in critically ill adult patients
Authors: Lang Alexandra Rosewall , Baxendale Bryn , Atkinson Sarah , Velzen Jeena , Blanks Thomas , Ansari Umair , Kane Mark , Miles Giulia , DeBeer Thearina , Gill Steven 
Published: August 2020

Abstract
Background: Unplanned extubation (UE), the unintentional dislodgement of a patient’s artificial airway; indwelling endotracheal tube or tracheostomy, occurs infrequently in the critical care setting but is a high risk incident and requires appropriately skilled staff and clear management plans to manage and ensure a positive outcome for the patient. Within the current guidance on management of UE, there is superficial consideration of the systems view and limited practical advice about the integration of systems thinking into management of these situations. Method: This paper reports the findings of a multidisciplinary Human Factors (HF) study to understand ‘work as done’ in being prepared and responding to UE in practice. Multiple methods were triangulated to take a systems perspective on these situations. The methods included development of a hierarchical task analysis (HTA), 21 expert interviews, 50 equipment familiarity audit surveys and three in situ simulation exercises. Results: The study identified key areas of focus for redesign of environment and accessibility of equipment and organisation of resources. It was established that difficulties in identifying individual competency and team skill mix appropriate to the scenario requirements undermined people’s non-technical skills and that decision making could be negatively impacted as a result. Conclusion: The HF approach has provided the critical care team with an improved understanding of the work involved in being prepared or responding to UE and a visual task breakdown which can be used for identifying and testing new ways of working, different environments, technological interventions and using simulation to rehearse for performance. The findings will inform future changes to practice, design of work and the development of a mastery learning programme to support individual and team capabilities in responding to UE so that staff are able to consider this infrequent scenario in context of the wider system.