bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral Metronidazole and Cefixime as Prophylaxis on Wound Complications of Uncomplicated Appendicitis Following Appendectomy: A Randomized Clinical Trial
Authors: Ayazi Khosro , Tofigh Arash Mohammadi , Qaderi Shohra , Tarki Farzad Esmaeili , Samsami Majid , Nematihonar Behzad , Tahmasbi Hamed , Bagherpour Javad Zebarjadi 
Published: July 2021

Abstract
Backgrounds

Without proper use of prophylactic antibiotics, the chance of infection at the site of surgery after appendectomy is around 10 to 30%. Although, in the case of nonperforated appendicitis, the therapeutic use of antibiotic prophylaxis is still contentious. Cephalosporins and Metronidazole has been shown to be effective against anaerobe micro-organisms, and its bioavailability after oral and parenteral administration is comparable. The aim of this research is to compare the incidence of infection-related complications following open appendectomy for nonperforated appendicitis in patients who were given prophylactic antibiotics (Metronidazole and Cephalosporins) either intravenously or orally.
Materials & Methods

In this randomized clinical trial, the open appendectomy was performed on 200 non-perforated appendicitis cases; 87 females and 113 males, with a mean age of 26 years. Of all the enrolled, 100 cases were given single-dose metronidazole and Cefixime orally (study group), and 100 cases were given single-dose intravenous metronidazole and Ceftriaxone (control group).
Results

The wound infection incidence did not vary substantially between the two groups. (5% and 7% in the control and case group, respectively, P = 0.552). In addition, the length of hospitalization was also similar between both groups (2.4 and 2.6 days in the in the case and control group, respectively, P = 168).
Conclusion

All in all, it has been concluded that a single-dose metronidazole and Cefixime taken orally before surgery could bestow impactful prophylactic effects for nonperforated appendicitis cases. Therefore, it could be used instead of the parenteral antibiotics (Intravenous Metronidazole and Ceftriaxone).
Hyperuricemia Resistant to a Xanthine Oxidase Inhibitor, Topiroxostat: a Case Report
Authors: Kimura Takahide , Yamada Seiki , Tanemoto Masayuki 
Published: July 2021

Abstract
Hyperuricemia is a common complication of chronic kidney disease. Gout is a clinical symptom of hyperuricemia, and lowering serum uric acid concentration has been recommended to prevent its recurrence. We present a case whose hyperuricemia was resistant to a xanthine oxidase inhibitor, febuxostat, but not another inhibitor, topiroxostat, while both are presumed to inhibit the same enzymatic center of this rate-limiting enzyme for uric acid production. The different efficacy indicates that xanthine oxidase inhibitors are not interchangeable even among those acting on the same site of the enzyme.
The Study of Clinical Pharmacist Participating in the Pain Management of Outpatients with Cancer in A Prescription Period
Authors: Ren Xiayang , Yang Jun , Li Guohui , Cong Minghua 
Published: July 2021

Abstract
Purpose. The management of outpatients with cancer painis very important for medication safety. Medical interviews by CP is conducive to pain management. Our objective was to describe the contribution of the clinical pharmacist (CP) to outpatients in pain-relief clinic.Methods. This was a prospective, case-by-case self-control study. One clinical pharmacist conducted three questionnaire surveys. The first happened in the clinic face to face, the second by telephone one week later after the visit and the third by telephone two weeks later. The interventions by CP and comprehensive pain assessment (scored by NRS, sleep, mood and general activities) were both recorded. Analgesic-related knowledge were delivered by CP and were measured both before and after therapy. 1.Department of Pharmacy ,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China E-mail: erxia100@163.com2.Department of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China E-mail: doccong@vip.163.comResults. 51 patients were enrolled. The top 5 interventions in the first telephone interview(second survey) was suggestions for treating adverse drug reactions(47%), correcting the wrong usage(35%), medication education(26%), recommendations for dosage adjustment(18%) and suggestions for further treatment(15%). While in the second telephone interview (third survey), the rankings were totally inverted. Comprehensive pain assessment showed better in the first interview and then worse in the second. Analgesic-related knowledge increased significantly after the education by CP.Conclusions. CP made a totally different interventions at the different stages of medication in the outpatients with cancer pain,which may be related to the pain control. Patients’ knowledge regarding analgesics significantly increased after education by CP.
A Five Collagen-related Gene Signature to Estimate the Prognosis and Immune Microenvironment in Clear Cell Renal Cell Cancer
Authors: Shi Xiaokai , Zhou Xiao , Yue Chuang , Lu Chao , Gao Shenglin , Zuo Li , Sun Zhiqin , Zhang Lifeng 
Published: July 2021

Abstract
Background: Collagen is the main component of Extracellular matrix (ECM) and might play an important role in tumor microenvironment. However, the relationship between collagen and clear cell renal cell cancer (ccRCC) still not fully clarified. Hence, we aimed to establish a collagen-related signature to predict the prognosis and estimate the tumor immune microenvironment in ccRCC patients. Results: In this study, we established a five collagen-related gene signature to estimate the immune microenvironment and predict the prognosis of ccRCC patients. Patients with high-risk score were often correlated with unfavorable overall survival (OS) and immunosuppressive microenvironment. In addition, the collagen-related genetic signature was highly correlated with clinical pathological features and can be considered as independent prognostic factors in ccRCC patients. Besides, GSEA results also show that patients with high-risk grade tend to be associated with epithelial-mesenchymal junctions (EMT) and immune responses.Conclusion: In this study, we developed a collagen-related gene signature, which might possess the potential to predict the prognosis and immune microenvironment of ccRCC patients and function as an independent prognostic factor in ccRCC.
Title: Clinical Manifestations and Outcome of Viral Acute Lower Respiratory Infection in Hospitalised Children in Myanmar
Authors: Kamata Kazuhiro , Thein Khin Nyo , Ja Lasham Di , Win Nay Chi , Win Su Mon Kyaw , Suzuki Yuko , Ito Ai , Osada Hidekazu , Chon Irina , Phyu Wint Wint , Aizawa Yuta , Ikuse Tatsuki , Ota Tomomi , Kyaw Yadanar , Tin Htay Htay , Shobugawa Yugo , Watanabe Hisami , Saito Reiko , Saitoh Akihiko 
Published: July 2021

Abstract
Background
Acute lower respiratory infection (ALRI) remains the leading cause of death in children worldwide, and viruses have been the major causative factors of ALRI after the introduction of bacterial conjugate vaccines. In Myanmar, ALRI is associated with high morbidity and mortality in children. However, detailed information on ALRI is currently lacking.
Methods
We conducted a prospective study to investigate the viral aetiologies, clinical manifestations, and outcomes of ALRI in hospitalised children at the Yankin Children Hospital, Yangon, Myanmar from May 2017 to April 2019. The World Health Organization’s definitions of ALRI and severe ALRI were used with minor modifications. For the patients with suspected viral ALRI, a nasopharyngeal swab was obtained, and rapid tests for influenza and respiratory syncytial virus (RSV) were performed, followed by real-time PCR for the 16 respiratory viruses causing ALRI. Clinical information was extracted from the medical records.
Results
Among the 5463 patients admitted with a diagnosis of ALRI, 570 (10.4%) were randomly enrolled in the study. The median age of the patients was 8 months (interquartile range, 4–15 months). The most common symptoms were cough (93%) and difficulty of breathing (73%), while the most common signs were tachypnoea (78%) and chest indrawing (67%). Sixteen potentially causative viruses were detected in 502 (88%) patients, with RSV B (36%) and rhinovirus (28%) being the most commonly detected. Multiple viruses were detected simultaneously in 221 patients (37%). Severe ALRI was diagnosed in 107 patients (19%). The mortality rate was 5%; influenza virus A (29%) and RSV B (21%) were commonly detected in such cases.
Conclusions
Viral ALRI in children has significant morbidity and mortality rates in Myanmar. RSV and rhinovirus were the most commonly detected, while influenza virus and RSV were the most common causes of mortality.
Transcriptome and whole genome sequencing profiles in Leber’s Hereditary Optic Neuropathy 14484T&gt;C mutation carrying monozygotic twins reveal that prostanoid receptor is a possible modifier for LHON manifestation
Authors: Tun Khin Kay Zin , Toosaranont Jarichad , Kaewsutthi Supannee , Grove Harald , Ruchadaariyachat Sukanya , Suthammarak Wichit , Chuenkongkaew Wanicha , Lertrit Patcharee , Suktitipat Bhoom , Mitrpant Chalermchai 
Published: July 2021

Abstract
Background

Leber’s inherited optic neuropathy (LHON) is well known for incomplete penetrance. A pair of monozygotic twins carrying 14484T > C LHON mutation: one displayed LHON characteristics (affected LHON) and the other twin was an unaffected LHON carrier, were studied to identify possible modifier(s) for LHON manifestation.
Methods

Primary fibroblasts from affected and unaffected monozygotic twins with 14484T > C LHON mutation were treated with different insults to differentiate cellular phenotype between the two fibroblasts. RNA sequencing of the fibroblasts indicated differentially expressed genes and whole genome sequencing was used to identify candidates for disease modifier.
Results

Our results suggested that fibroblast from unaffected carrier was able to adapt to galactose and hydrogen peroxide insult, while affected fibroblasts were not. We found reduced expression of total SOD2 with high proportion of inactive SOD2 (acetylated SOD2) in affected LHON fibroblast, while decreased expression of SIRT3 was detected in affected LHON fibroblasts treated with combination of insults. Differential expression indicated enrichment of a pathway relating to negative regulator of cell death pathway in unaffected carrier fibroblast. Expression of receptor for prostaglandin E receptor (PTGER3) was found to be affected by two SNPs. Unaffected LHON fibroblast possessed rs75523942 that indicates a positive effect on PTGER3 expression, while affected LHON fibroblast possessed rs496483 that indicates a negative effect on PTGER3 expression. Discordant SNPs on prostaglandin E receptor 3 (PTGER3) were identified as eQTL.
Conclusions

This study indicates that prostanoid receptor could be a possible modifier for LHON manifestation of these twins.
Risk Factor Analysis of Bone Cement Leakage for Polymethylmethacrylate-Augmented Cannulated Pedicle Screw Fixation in Spinal Degenerative Diseases
Authors: Liu Yaoyao , Xiao Jun , He Lei , Yin Xiang , Song Lei , Zhou Rui , Zeng Jing , Liu Peng , Dai Fei 
Published: July 2021

Abstract
Background
We investigated the risk factors of cement leakage (CL) for polymethylmethacrylate-augmented cannulated pedicle screw (CPS) in spinal degenerative diseases and provided technical guidance for clinical surgery.
Methods
This study enrolled 276 patients with spinal degenerative disease and osteoporosis who were augmented using CPSs (835 screws in total) from May 2011 to June 2018 in our hospital. The patients' age, sex, bone mineral density (BMD), diagnosis, augmented positions, number of CPS implanted, and CL during surgery were recorded. CL was observed by postoperative computed tomography (CT) and was classified by Yeom typing.
Results
A total of 74 (8.9%) CPSs in 64 patients leaked (23.2%), with 65 (87.83%), 3 (4.05%), and 6 (8.11%) screws showing Types S, B, and C leakage, respectively. CL was significantly correlated with the number and position of screws (P < 0.05), but not with sex, age, and BMD (P > 0.05). The position, number of CPSs, fracture, degenerative scoliosis, ankylosing spondylitis, and revision surgery were risk factors for CL (P < 0.05). Augmentation of the thoracic vertebral body, fracture, and ankylosing spondylitis were independent risk factors for Type S. Augmentation of the lumbar vertebral body, lumbar disc herniation, and lumbar spondylolisthesis were independent risk factors for Type B (P < 0.05).
Conclusions
CL has a high incidence in clinical practice. To avoid serious complications, high-risk factors for leakage should be addressed. Particularly, it is necessary to develop alternative solutions for the lack of holding force of internal fixation caused by CL during surgery.
An Evaluation of the Provision of Oncology Rehabilitation Services via Telemedicine Using a Participatory Design Approach
Authors: Brady Grainne Carmel , Ashforth Kate , Cowan-Dickie Siobhan , Dewhurst Sarah , Harris Natalie , Monteiro Alline , Sandsund Catherine , Roe Justin 
Published: July 2021

Abstract
Background
The COVID-19 pandemic has fundamentally impacted the delivery of healthcare services globally. In line with UK government guidelines on social distancing, the use of telemedicine was implemented to facilitate the ongoing provision of cancer rehabilitation.
Purpose
We sought to evaluate and co-design telemedicine services to meet the complex needs of our patients and carers at a tertiary cancer centre.
Methods
Experience based co-design (EBCD) methodology was adapted to include virtual methods. Staff members (n = 12) and patients (n = 11) who had delivered or received or delivered therapies services at our UK cancer centre since March 2020 were recruited to take part in one-to-one virtual interviews. Patient interviews were video recorded, analysed and edited to a 30-minute summary video. Patient and staff virtual events were undertaken thereafter. A joint virtual patient and staff event occurred, where staff could see the video and with patients as partners, agree areas for change and develop groups for service co-design.
Results
Positive aspects regarding telemedicine provision were highlighted including reduced financial and time burden on patients, and increased flexibility for both staff and patients. The key concerns included digital exclusion, safety, communication and patient choice. Four co-design groups have been established to enact changes in these priority areas.
Conclusion
Using a participatory design approach, we have worked in partnership with patients and staff to ensure the safe, acceptable and effective delivery of rehabilitation services with integrated telemedicine.
Within-patient Genetic Diversity of blaKPC Harboring K. pneumoniae Isolates in a Colombian High Complexity Hospital. Identification of a New Tn3-based NTEKPC-IIe Mobilization Platform.
Authors: Abril Deisy , Vergara Erika , Palacios Diana , Leal Aura Lucía , Marquez-Ortiz Ricaurte Alejandro , Madroñero Johana , Rozo Zayda Lorena Corredor , Rosa Zandra De La , Nieto Carlos A. , Vanegas Natasha , Cortés Jorge A. , Escobar-Perez Javier 
Published: July 2021

Abstract
Resistance to carbapenems in Klebsiella pneumoniae has been mostly related with the worldwide dissemination of KPC, largely due to the pandemic clones belonging to the complex clonal (CC) 258. To unravel blaKPC post-endemic clinical impact, here we describe clinical characteristics of 68 patients from a high complexity hospital, and the molecular and genetic characteristics of their 139 blaKPC - K. pneumoniae (KPC-Kp) isolates. Of the 26 patients that presented relapses or reinfections, 16 had changes in the resistance profiles of the isolates recovered from the recurrent episodes. In respect to the genetic diversity of KPC-Kp isolates, PFGE revealed 45 different clonal complexes (CC). MLST for 12 representative clones showed ST258 was present in the most frequent CC (23.0%), however, remaining 11 representative clones belonged to non-CC258 STs (77.0%). Interestingly, 16 patients presented within-patient genetic diversity of KPC-Kp clones. In one of these, three unrelated KPC-Kp clones (ST258, ST504, and ST846) and a blaKPC - K. variicola isolate (ST182) were identified. For this patient, complete genome sequence of one representative isolate of each clone was determined. In K. pneumoniae isolates blaKPC was mobilized by two Tn3-like unrelated platforms: Tn4401b (ST258) and Tn6454 (ST504 and ST846), a new NTEKPC-IIe transposon for first time characterized also determined in the K. variicola isolate of this study. Genome analysis showed these transposons were harbored in different unrelated but previously reported plasmids and in the chromosome of a K. pneumoniae (for Tn4401b). In conclusion, in the blaKPC post-endemic dissemination in Colombia, different KPC-Kp clones (mostly non-CC258) have emerged due to integration of the single blaKPC gene in new genetic platforms. This work also shows the intra-patient resistant and genetic diversity of KPC-Kp isolates. This circulation dynamic could impact the effectiveness of long-term treatments.
Impact of Climate Change on Rainfall Pattern in Upper Kumaon Himalaya Region
Authors: Singh A. , Singh R. B. , Anand S. , Mohanty A. , Dash S. S. 
Published: July 2021

Abstract
Every single aspect of environment is affected by climate change. Change in rainfall pattern is an immense important research area in climate-change based study. Rainfall pattern has direct impacts on food production and frequencies natural disasters (landslide, cloudburst, flood, drought etc.). Consequently, that appropriate and systemic consideration since it distresses the most of the human life. Situation in Himalayan region is worst. High altitude, less agricultural area, harsh climate with high fragility makes mountain region more vulnerable in term of climate change. The objective of this study is to identify yearly, seasonal, and monthly rainfall trends in the Upper Kumaon region (UKR). Long-term gridded daily rainfall data (1950–2018) were used. Rainfall data was processed and analyzed for a period of 68 years (1950–2018) at four places (four in each Kumaon division) in the surrounding area of Almora, Bageshwar, Pithoragarh, and Champawat. The regression analysis (parametric) method and variability analysis were used to examine historical trends in daily rainfall. The rising and falling trends in rainfall, as well as anomalies, have been studied using regression.The result shows that rainfall demonstrate statistically significant changes occurred in last 34 years. Rainfall variability is higher in low altitude region than high altitude region of Upper Kumaon region.
Acute Ophthalmic Manifestations in Mycoplasma Induced Rash and Mucositis
Authors: Rashad Ramy , Elhusseiny Abdelrahman M. , Shanbhag Swapna S. , Chodosh James , Saeed Hajirah N. 
Published: July 2021

Abstract
Background: The purpose of the current study is to demonstrate the prevalence of ocular complications in patients suffering with MIRM, an eruption clinically distinct from Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN).Methods: In this retrospective observational study, we identified all patients in our hospital database who were diagnosed with MIRM. Diagnosis was confirmed by clinical information and a positive Mycoplasma pneumoniae serology. Only patients with available records with formal ophthalmology consults were included. Clinical and laboratory data were collected from our electronic medical record system.Results: A total of 11 patients were included in our study. The average age was 22 ± 15.2 years, and the majority were male (63.6%). In all 22 eyes, the acute ocular findings were limited to conjunctival hyperemia (n=18, 81.8%), meibomitis (n=2, 9.1%), and conjunctival epithelial defects (n=1, 4.5%). None of the patients were treated with amniotic membrane transplantation in the acute phase. Three patients received follow-up eye examinations; none showed ocular complications.Conclusions: Ocular complications from MIRM appear to be milder in comparison to ocular complications found in other bullous and inflammatory conditions such as SJS/TEN. Understanding the ocular sequelae of MIRM is important to better inform acute and chronic management.
Oral Sucrose Improves Analgesia During Retinopathy of Prematurity Screening
Authors: Ramoutar Ryan R , Singh Anil J , Papandreou Charikleia 
Published: July 2021

Abstract
Purpose To determine whether sucrose provides significant analgesia during Retinopathy of Prematurity (ROP) screening Methods This was a prospective, randomized, sinlge masked audit. The examinations were performed by a single examiner. Forty-five (45) neonates were separated into two groups; Group 1 received oral sucrose while Group 2 received oral sucrose and non-nutritive suckling (NNS) at the discretion of the attending nurse. Pain was assessed using the Premature Infant Pain Profile (PIPP) score and recorded at baseline, immediately following lid speculum, at 3 minutes and 6 minutes following lid speculum insertion. Results The mean baseline PIPP score was 0.5. Fifteen (15) neonates (33%) received NNS. The mean PIPP scores at speculum insertion in both groups (Group 1: 7.24, Group 2: 5.50) were observed to be higher than at baseline and lower in Group 2 than in Group 1. In both groups, the scores at 3 minutes (Group 1: 4.70, Group 2: 4.20) and 6 minutes (Group 1 4.50, Group 2: 4.70) were observed to be higher than at baseline, lower than at speculum insertion, but not significantly different to each other. Conclusions Lid speculum insertion during ROP screening appears to be a significantly painful event. ROP examinations should be conducted with a combination of topical analgesia and sucrose and NNS for greatest pain-relieving effect.
Effective Coastal Adaptation Needs Accurate Hazard Assessment : A Case Study In Port Resolution, Tanna Island Vanuatu
Authors: Faivre Faivre , Tomlinson Rodger , Ware Daniel , Shaeri Saeed , Hadwen Wade , Buckwell Andrew , Mackey Brendan 
Published: July 2021

Abstract
Developing countries face risks from natural hazards that are being amplified by climate change. Selection of effective adaptation interventions to manage these risks requires a sufficiently accurate assessment of the coastal hazard at a given location. Yet challenges remain in terms of understanding local coastal risks given the coarseness of global wave models and the paucity of locally scaled data in most developing countries, including Small Island Developing States (SIDS) like Vanuatu. The aim of this paper was to examine the differences in hazard assessment and adaptation option selections arising from analyses using globally versus locally scaled data on coastal processes. As a case study, we focused on an eroding cliff face in Port Resolution on Tanna Island, Vanuatu, which is of concern to the local community and government authorities. The coastal process modelling revealed that the global wave data generated unrealistically high predictions of wave height within Port Resolution bay. Expensive engineering adaptations designed to provide coastal protection were therefore likely to fail in preventing ongoing cliff erosion. In this case, the best adaptation solution involves changing land use to revegetate and help stabilise the cliff top. Our case study highlights the importance of accurate hazard assessment, especially in data poor regions where extrapolation of global datasets and models in the absence of local data can result in poor adaptation decision making. Furthermore, the multidisciplinary approach applied here can be applied in other data-poor regions to strengthen analyses exploring the benefits of local adaptation interventions.