bluuebunny/crossref_metadata_2025_split huggingface dataset:
A new side-effect of sufentanil: increased monocyte-endothelial adhesion
Authors: Yuan Dongdong , Zou Zhaowei , Li Xianlong , Cheng Nan , Guo Na , Sun Guoliang , Liu Dezhao 
Published: November 2021

AbstractBackgroundOpioids have been identified by the World Health Organization to be ‘indispensable for the relief of pain and suffering’. Side-effects, such as nausea, vomiting, postoperative delirium, and effects on breathing, of opioids have been well investigated; however, the influence of opioids on monocyte-endothelial adherence has never been reported. Therefore, we explored the effects of representative opioids, fentanyl, sufentanil, and remifentanil, on monocyte-endothelial adherence and the underlying mechanisms.MethodsWe built a cell adhesion model with U937 monocytes and human umbilical vein endothelial cells (HUVECs). Two kinds of connexin43 (Cx43) channel inhibitors, 18-α-GA and Gap 27, were used to alter Cx43 channel function in U937 monocytes and HUVECs, respectively, to determine the effects of Cx43 channels on U937-HUVEC adhesion. Subsequently, the effects of fentanyl, sufentanil and remifentanil on Cx43 channel function and U937-HUVEC adhesion were explored.ResultsWhen fentanyl, sufentanil and remifentanil acted on monocytes or endothelial cells, their effects on monocyte-endothelial adherence differed. When acting on U937 monocytes, sufentanil significantly increased U937-HUVEC adhesion which was associated with reduced release of ATP from Cx43 channels, while fentanyl and remifentanil did not have these influences. Although sufentanil could also inhibit Cx43 channel function in HUVECs, it had no effect on ATP release from HUVECs or U937-HUVECs adhesion.ConclusionsWe demonstrated that sufentanil application increases monocyte-endothelial adherence which was associated with reduced release of ATP from Cx43 channels in monocytes. This side-effect of sufentanil should be considered seriously by clinicians.
Mortality and cardiovascular events in adults with kidney failure after major non-cardiac surgery: a population-based cohort study
Authors: Harrison Tyrone G. , Ronksley Paul E. , James Matthew T. , Ruzycki Shannon M. , Tonelli Marcello , Manns Braden J. , Zarnke Kelly B. , McCaughey Deirdre , Schneider Prism , Wick James , Hemmelgarn Brenda R. 
Published: November 2021

Abstract
Background
People with kidney failure have a high incidence of major surgery, though the risk of perioperative outcomes at a population-level is unknown. Our objective was to estimate the proportion of people with kidney failure that experience acute myocardial infarction (AMI) or death within 30 days of major non-cardiac surgery, based on surgery type.

Methods
In this retrospective population-based cohort study, we used administrative health data to identify adults from Alberta, Canada with major surgery between April 1, 2005 and February 28, 2017 that had preoperative estimated glomerular filtration rates (eGFRs) < 15 mL/min/1.73m2 or received chronic dialysis. The index surgical procedure for each participant was categorized within one of fourteen surgical groupings based on Canadian Classification of Health Interventions (CCI) codes applied to hospitalization administrative datasets. We estimated the proportion of people that had AMI or died within 30 days of the index surgical procedure (with 95% confidence intervals [CIs]) following logistic regression, stratified by surgery type.

Results
Overall, 3398 people had a major surgery (1905 hemodialysis; 590 peritoneal dialysis; 903 non-dialysis). Participants were more likely male (61.0%) with a median age of 61.5 years (IQR 50.0–72.7). Within 30 days of surgery, 272 people (8.0%) had an AMI or died. The probability was lowest following ophthalmologic surgery at 1.9% (95%CI: 0.5, 7.3) and kidney transplantation at 2.1% (95%CI: 1.3, 3.2). Several types of surgery were associated with greater than one in ten risk of AMI or death, including retroperitoneal (10.0% [95%CI: 2.5, 32.4]), intra-abdominal (11.7% [8.7, 15.5]), skin and soft tissue (12.1% [7.4, 19.1]), musculoskeletal (MSK) (12.3% [9.9, 15.5]), vascular (12.6% [10.2, 15.4]), anorectal (14.7% [6.3, 30.8]), and neurosurgical procedures (38.1% [20.3, 59.8]). Urgent or emergent procedures had the highest risk, with 12.1% experiencing AMI or death (95%CI: 10.7, 13.6) compared with 2.6% (1.9, 3.5) following elective surgery.

Conclusions
After major non-cardiac surgery, the risk of death or AMI for people with kidney failure varies significantly based on surgery type. This study informs our understanding of surgery type and risk for people with kidney failure. Future research should focus on identifying high risk patients and strategies to reduce these risks.
Study on the method of enucleation of anterior uterine fibroids by transverse incision of the lower uterine segment during cesarean section
Authors: Dai Yan , Xia Li , Lin Jinxiao , Xu Rongli , You Wenqiang 
Published: November 2021

Abstract
Introduction
A retrospective study was conducted to investigate the effectiveness and feasibility of fibroid enucleation in the anterior wall of the uterus by transverse uterine incision during cesarean section.

Methods
The medical history, surgical data, preoperative and postoperative changes in the blood system, and complications of 90 pregnant women who underwent myomectomy of the anterior uterine wall during cesarean section at the second Department of Maternal and Child Health Hospital of Fujian Province were analyzed retrospectively.

Results
No significant differences were noted in the leiomyoma number, pathological type, preoperative and postoperative hemoglobin level, perioperative bleeding incidence, blood transfusion frequency, postoperative fever incidence, and duration of lochia between the study and control groups. The proportion of large fibroids was slightly higher in the study group than in the control group (p < 0.05), and the operation time and average hospitalization time were slightly longer in the study group than in the control group (p < 0.05). The distribution of type III–V fibroids was slightly more in the study group than in the control group (p < 0.05), and the distribution of type VI fibroids in the study group was less than that in the control group (p < 0.05).

Conclusion
Fibroid enucleation is safe and effective in the anterior wall of the uterus through the lower uterine transverse incision in cesarean section. It has the potential to reduce the risk of pelvic and intrauterine adhesions in the future.
Nanoliposomal irinotecan plus fluorouracil and folinic acid as a second-line treatment option in patients with metastatic pancreatic ductal adenocarcinoma: a retrospective cohort study
Authors: Park Se Jun , Kim Hyunho , Shin Kabsoo , Hong Tae Ho , Suh Ja Hee , Lee Myung Ah 
Published: November 2021

Abstract
Background
According to the NAPOLI-1 trial, nanoliposomal irinotecan (nal-IRI) plus fluorouracil/folinic acid (5-FU/LV) showed improved overall survival compared to fluorouracil alone for patients with metastatic pancreatic cancer who were previously treated with gemcitabine-based therapy. In that trial, Asian patients had frequent dose modification due to haematological toxicity. There has been limited information on the clinical benefits and toxicity of this regimen in real-world settings. In this study, we assessed real-world experience of nal-IRI plus 5-FU/LV in patients with advanced pancreatic cancer after gemcitabine failure.

Methods
We conducted a single institution, retrospective analysis of response, survival and safety in patients who had been treated with nal-IRI with 5-FU/LV. Patients with metastatic pancreatic ductal adenocarcinoma previously treated with gemcitabine-based therapy received nal-IRI (80 mg/m2) with 5-FU/LV every 2 weeks. Kaplan-Meier analysis was performed to obtain median progression free survival and median overall survival. The hazard ratio and 95% confidence interval (CI) were estimated using a stratified Cox regression model. A multivariate Cox proportional hazards regression model was used to identify the effects of clinical factors.

Results
Fifty-one patients received nal-IRI plus 5-FU/LV between January 2015 and December 2020. The median age was 67 years, and males were 58.8%. A total of 40 (78.4%) and 11 (21.6%) patients had received one and two lines of prior chemotherapy before enrollment, respectively. Median progression-free survival was 2.8 months (95% CI 1.8–3.7) and median overall survival was 7.0 months (95% CI 6.0–7.9). Chemotherapy doses were reduced or delayed in 33 (64.7%) patients during the first 6 weeks and median relative dose intensity was 0.87. Thirty-six (70.6%) patients experienced grade 3 or 4 adverse events, most commonly neutropenia (58.8%). Most non-haematologic adverse events were under grade 2. Since the start of first-line chemotherapy, median overall survival was 16.3 months (95% CI 14.1–18.4).

Conclusions
Nal-IRI plus 5-FU/LV seems to be effective, with manageable toxicities, following gemcitabine-based treatment in patients with metastatic pancreatic ductal adenocarcinoma. Nal-IRI plus 5-FU/LV following gemcitabine with nab-paclitaxel is a feasible sequential treatment option in patients with metastatic pancreatic cancer.

Trial registration
Retrospectively registered.
Treatment device for neonatal birth asphyxia related Hypoxic Ischemic Encephalopathy
Authors: Zewdie Rediet , Getachew Lidet , Dubele Geremew , Oluma Ababo , Israel Gedion , Dese Kokeb , Simegn Gizeaddis Lamesgin 
Published: November 2021

Abstract
Background
Birth asphyxia is a leading cause of neonatal brain injury, morbidity, and mortality globally. It leads to a multi-organ dysfunction in the neonate and to a neurological dysfunction called Hypoxic Ischemic Encephalopathy (HIE). Cooling therapy is commonly used to slow or stop the damaging effects of birth asphyxia. However, most of the cooling devices used in the healthcare facility do not have a rewarming functionality after cooling therapy. A separate rewarming device, usually a radiant warmer or incubator is used to rewarm the infant after therapy, causing additional burden to the healthcare system and infant families. The objective of this project was, therefore, to design and develop a cost-effective and efficient total body cooling and rewarming device.

Methods
Our design includes two water reservoirs that operate by pumping cold and warm sterile water to a mattress. After decreasing the infant’s core body temperature to 33.5 °C, the system is designed to maintain it for 72 h. Feedback for temperature regulation is provided by the rectal and mattress temperature sensors. Once the cooling therapy is completed, the system again rewarms the water inside the mattress and gradually increases the neonate temperature to 36.5–37 °C. The water temperature sensors’ effectiveness was evaluated by adding 1000 ml of water to the reservoir and cooling and warming to the required level of temperature using Peltier. Then a digital thermometer was used as a gold standard to compare with the sensor’s readings. This was performed for five iterations.

Results
The prototype was built and gone through different tests and iterations. The proposed device was tested for accuracy, cost-effectiveness and easy to use. Ninety-three point two percent accuracy has been achieved for temperature sensor measurement, and the prototype was built only with a component cost of less than 200 USD. This is excluding design, manufacturing, and other costs.

Conclusion
A device that can monitor and regulate the neonate core body temperature at the neuroprotective range is designed and developed. This is achieved by continuous monitoring and regulation of the water reservoirs, mattress, and rectal temperatures. The device also allows continuous monitoring of the infant’s body temperature, mattress temperature, reservoir temperature, and pulse rate. The proposed device has the potential to play a significant role in reducing neonatal brain injury and death due to HIE, especially in low resource settings, where the expertise and the means are scarce.
Knowledge of ovarian cancer symptoms among women in Palestine: a national cross-sectional study
Authors: Elshami Mohamedraed , Yaseen Areej , Alser Mohammed , Al-Slaibi Ibrahim , Jabr Hadeel , Ubaiat Sara , Tuffaha Aya , Khader Salma , Khraishi Reem , Jaber Inas , Arafeh Zeina Abu , Al-Madhoun Sondos , Alqattaa Aya , El Hadi Asmaa Abd , Barhoush Ola , Hijazy Maysun , Eleyan Tamara , Alser Amany , Hziema Amal Abu , Shatat Amany , Almakhtoob Falasteen , Mohamad Balqees , Farhat Walaa , Abuamra Yasmeen , Mousa Hanaa , Adawi Reem , Musallam Alaa , Abu-El-Noor Nasser , Bottcher Bettina 
Published: November 2021

Abstract
Introduction
Ovarian cancer (OC) is often diagnosed at advanced stages. This study aimed to assess the Palestinian women’s knowledge about OC symptoms and determine the factors associated with having good knowledge.

Methods
A cross-sectional study was conducted from July 2019 to March 2020 in the two main areas of Palestine: the West Bank and Jerusalem as well as the Gaza Strip. A translated-into-Arabic version of the validated OC awareness measure (OCAM) was utilized for data collection. Stratified convenience sampling was used to recruit adult women attending hospitals, primary healthcare centers, and public spaces at 11 governorates. The knowledge level was categorized into three categories based on the number of symptoms recognized: poor (0 to 4), fair (5 to 8), and good (9 to 11).

Results
Of 6095 approached, 5618 participants completed the Arabic OCAM (response rate = 92.1%).A total of 5411 questionnaires were included in the analysis: 2278 from the Gaza Strip and 3133 from the West Bank and Jerusalem. Participants living in the West Bank and Jerusalem were older, of higher monthly income, and with more chronic diseases than those living in the Gaza Strip.
The most frequently identified symptoms were ‘extreme generalized fatigue’ (n = 3821, 70.6%), ‘unexplained weight loss’ (n = 3607, 66.7%), and ‘increased abdominal size on most days’ (n = 3252, 60.1%). On the other hand, the least recognized symptoms were ‘feeling full persistently’ (n = 1553, 28.7%) and ‘difficulty eating on most days’ (n = 1971, 36.4%).
Only 943 participants (17.4%) displayed good knowledge of OC symptoms. Participants from the Gaza Strip had a higher likelihood than participants from the West Bank and Jerusalem to have a good level of knowledge (21.0% vs. 14.8%). Being married, knowing someone with cancer, and visiting hospitals were all associated with a higher likelihood of having good knowledge level. However, living in the West Bank and Jerusalem was associated with a lower likelihood of having good knowledge.

Conclusion
The overall knowledge of OC symptoms in this study was low. Educational interventions are needed to improve Palestinian women’s knowledge about OC symptoms.
Trends in emergency contraception awareness among women and girls in 28 sub-Saharan countries
Authors: Awopegba Oluwafemi Emmanuel , Chukwudeh Okechukwu Stephen , Owolabi Eyitayo Omolara , Ajayi Anthony Idowu 
Published: November 2021

Abstract
Background
Studies have shown that emergency contraception (EC) remains underutilised in preventing unintended pregnancy in sub-Saharan Africa (SSA). Small-scale surveys have attributed EC underutilisation to gaps in EC awareness among SSA women and girls. However, limited studies have explored trends in EC awareness in SSA. We address this gap by examining trends in EC awareness using data from 28 SSA countries. Our analysis was disaggregated by age distribution, place of residence, level of education, and wealth to show differences in EC awareness trend.

Methods
We analysed the Demographic and Health Surveys (DHS) data of 1,030,029 women aged 15 to 49 on emergency contraception awareness. EC awareness was defined as having ever heard of special pills to prevent pregnancy within 3 days after unprotected sexual intercourse. Frequencies and percentages were used to summarise trends in EC awareness between years 2000 and 2019.

Results
Overall, there was an upward shift in the level of EC awareness in all countries, except in Burkina Faso, Niger, Chad, and Ethiopia. While some countries recorded a significant upward trend in EC awareness, others recorded just a slight increase. Women in Kenya, Ghana, Gabon, and Cameroon had the highest upward shift in EC awareness. For example, only 28% of women were aware of EC in Ghana in 2003, but in 2014, 64% of women knew about EC, an increase of over 36 percentage points. Increase in EC awareness was starker among women aged 20–24 years, those who resided in urban areas, had higher education, and belong to the highest wealth quintile, than those aged 15–19, in rural areas, with no formal education and belonging to the lowest wealth quintile.

Conclusion
Our analysis shows that the level of EC awareness has increased substantially in most SSA countries. However, EC awareness still differs widely within and between SSA countries. Intervention to improve EC awareness should focus on women aged 15 to 19, those with no formal education, residing in rural areas, and within the lowest quintile, especially, in countries such as Chad, Niger, Burkina Faso, and Ethiopia where level of EC is low with lagging progress.
Factors influencing exclusive breastfeeding duration in Pakistan: a population-based cross-sectional study
Authors: Arif Sidra , Khan Hina , Aslam Muhammad , Farooq Muhammad 
Published: November 2021

Abstract
Background
Breastfeeding has the most profound impact on infant health and wellness, and also have significant implications for the mother. The duration of the breastfeeding determines the infant’s protection from malnutrition and other common infectious diseases; consequently, the World Health Organization (WHO) recommends exclusive breastfeeding (EBF) six months, followed by gradual weaning and breastfeeding until the baby is two years old. In Pakistan, the practice of breastfeeding is heavily dependent upon certain demographic, economic, social, and biological factors, which ultimately impact the quality of care provided to the infant and their health. The aim of this paper, therefore, is to measure the impact of these factors on the exclusive breastfeeding duration in Pakistan.

Methods
The data for the study has been collected from Pakistan Demographic and Health Survey (PDHS) for the year 2017–18. Binary logistic regression model and survival analysis are used to determine the relationship between the independent and dependent variables.

Results
We use a binary logistic regression to estimate the effect of each factor on the duration of EBF. The binary logistic regression finds significant relationships between region, maternal education, wealth index, size of a child, watching television, delivery by cesarean, and maternal age and EBF. We then use log-likelihood, AIC, BIC criteria to determine if a parametric or non-parametric model would provide a better fit; based on these results we fit an Inverse Gaussian (Weibull) distribution for the survival analysis. These results show that there are more significant factors associated with EBF duration in parametric survival analysis than in the binary logistic regression results. Thus, the survival analysis is a better method for predicting the relationship between the duration of EBF and its factors. Furthermore, logically EBF is designated to be done for six months which would not be properly gauged with a binary response variable.

Conclusions
The results of this study provide proof that exclusive breastfeeding is a common practice among women in Pakistan, and to improve the quality of post-natal care, health policy in the country needs to focus on the existing demographic and social factors which are found significant in this study.
Heat illness data strengthens vulnerability maps
Authors: Jung Jihoon , Uejio Christopher K. , Kintziger Kristina W. , Duclos Chris , Reid Keshia , Jordan Melissa , Spector June T. 
Published: November 2021

Abstract
Background
Previous extreme heat and human health studies have investigated associations either over time (e.g. case-crossover or time series analysis) or across geographic areas (e.g. spatial models), which may limit the study scope and regional variation. Our study combines a case-crossover design and spatial analysis to identify: 1) the most vulnerable counties to extreme heat; and 2) demographic and socioeconomic variables that are most strongly and consistently related to heat-sensitive health outcomes (cardiovascular disease, dehydration, heat-related illness, acute renal disease, and respiratory disease) across 67 counties in the state of Florida, U. S over 2008–2012.

Methods
We first used a case-crossover design to examine the effects of air temperature on daily counts of health outcomes. We employed a time-stratified design with a 28-day comparison window. Referent periods were extracted from ±7, ±14, or ± 21 days to address seasonality. The results are expressed as odds ratios, or the change in the likelihood of each health outcome for a unit change in heat exposure. We then spatially examined the case-crossover extreme heat and health odds ratios and county level demographic and socioeconomic variables with multiple linear regression or spatial lag models.

Results
Results indicated that southwest Florida has the highest risks of cardiovascular disease, dehydration, acute renal disease, and respiratory disease. Results also suggested demographic and socioeconomic variables were significantly associated with the magnitude of heat-related health risk. The counties with larger populations working in farming, fishing, mining, forestry, construction, and extraction tended to have higher risks of dehydration and acute renal disease, whereas counties with larger populations working in installation, maintenance, and repair workers tended to have lower risks of cardiovascular, dehydration, acute renal disease, and respiratory disease. Finally, our results showed that high income counties consistently have lower health risks of dehydration, heat-related illness, acute renal disease, and respiratory disease.

Conclusions
Our study identified different relationships with demographic/socioeconomic variables for each heat-sensitive health outcome. Results should be incorporated into vulnerability or risk indices for each health outcome.