bluuebunny/crossref_metadata_2025_split huggingface dataset:
Severe volcanic SO2 exposure and respiratory morbidity in the Icelandic population – a register study
Authors: Carlsen Hanne Krage , Valdimarsdóttir Unnur , Briem Haraldur , Dominici Francesca , Finnbjornsdottir Ragnhildur Gudrun , Jóhannsson Thorsteinn , Aspelund Thor , Gislason Thorarinn , Gudnason Thorolfur 
Published: February 2021

Abstract
Background
The Holuhraun volcanic eruption September 2014 to February 2015 emitted large amounts of sulfur dioxide (SO2). The aim of this study was to determine the association between volcanic SO2 gases on general population respiratory health some 250 km from the eruption site, in the Icelandic capital area.

Methods
Respiratory health outcomes were: asthma medication dispensing (AMD) from the Icelandic Medicines Register, medical doctor consultations in primary care (PCMD) and hospital emergency department visits (HED) in Reykjavík (population: 215000) for respiratory disease from 1 January 2010 to 31 December 2014. The associations between daily counts of health events and daily mean SO2 concentration and high SO2 levels (24-h mean SO2 > 125 μg/m3) were analysed using generalized additive models.

Results
After the eruption began, AMD was higher than before (129.4 vs. 158.4 individuals per day, p < 0.05). For PCMD and HED, there were no significant differences between the number of daily events before and after the eruption (142.2 vs 144.8 and 18.3 vs 17.5, respectively). In regression analysis adjusted for other pollutants, SO2 was associated with estimated increases in AMD by 0.99% (95% CI 0.39–1.58%) per 10 μg/m3 at lag 0–2, in PCMD for respiratory causes 1.26% (95% CI 0.72–1.80%) per 10 μg/m3 SO2 at lag 0–2, and in HED by 1.02% (95% CI 0.02–2.03%) per 10 μg/m3 SO2 at lag 0–2. For days over the health limit, the estimated increases were 10.9% (95% CI 2.1–19.6%), 17.2% (95% CI 10.0–24.4%) for AMD and PCMD. Dispensing of short-acting medication increased significantly by 1.09% (95% CI 0.49–1.70%), and PCMD for respiratory infections and asthma and COPD diagnoses and increased significantly by 1.12% (95% CI 0.54–1.71%) and 2.08% (1.13–3.04%).

Conclusion
High levels of volcanic SO2 are associated with increases in dispensing of AMD, and health care utilization in primary and tertiary care. Individuals with prevalent respiratory disease may be particularly susceptible.
The impact of reactive oxygen species in the development of cardiometabolic disorders: a review
Authors: Akhigbe Roland , Ajayi Ayodeji 
Published: February 2021

AbstractOxidative stress, an alteration in the balance between reactive oxygen species (ROS) generation and antioxidant buffering capacity, has been implicated in the pathogenesis of cardiometabolic disorders (CMD). At physiological levels, ROS functions as signalling mediators, regulates various physiological functions such as the growth, proliferation, and migration endothelial cells (EC) and smooth muscle cells (SMC); formation and development of new blood vessels; EC and SMC regulated death; vascular tone; host defence; and genomic stability. However, at excessive levels, it causes a deviation in the redox state, mediates the development of CMD. Multiple mechanisms account for the rise in the production of free radicals in the heart. These include mitochondrial dysfunction and uncoupling, increased fatty acid oxidation, exaggerated activity of nicotinamide adenine dinucleotide phosphate oxidase (NOX), reduced antioxidant capacity, and cardiac metabolic memory. The purpose of this study is to discuss the link between oxidative stress and the aetiopathogenesis of CMD and highlight associated mechanisms. Oxidative stress plays a vital role in the development of obesity and dyslipidaemia, insulin resistance and diabetes, hypertension via various mechanisms associated with ROS-led inflammatory response and endothelial dysfunction.
Energy delivery guided by indirect calorimetry in critically ill patients: a systematic review and meta-analysis
Authors: Duan Jing-Yi , Zheng Wen-He , Zhou Hua , Xu Yuan , Huang Hui-Bin 
Published: February 2021

Abstract
Background
The use of indirect calorimetry (IC) is increasing due to its precision in resting energy expenditure (REE) measurement in critically ill patients. Thus, we aimed to evaluate the clinical outcomes of an IC-guided nutrition therapy compared to predictive equations strategy in such a patient population.

Methods
We searched PubMed, EMBASE, and Cochrane library databases up to October 25, 2020. Randomized controlled trials (RCTs) were included if they focused on energy delivery guided by either IC or predictive equations in critically ill adults. We used the Cochrane risk-of-bias tool to assess the quality of the included studies. Short-term mortality was the primary outcome. The meta-analysis was performed with the fixed-effect model or random-effect model according to the heterogeneity.

Results
Eight RCTs with 991 adults met the inclusion criteria. The overall quality of the included studies was moderate. Significantly higher mean energy delivered per day was observed in the IC group, as well as percent delivered energy over REE targets, than the control group. IC-guided energy delivery significantly reduced short-term mortality compared with the control group (risk ratio = 0.77; 95% CI 0.60 to 0.98; I2 = 3%, P = 0.03). IC-guided strategy did not significantly prolong the duration of mechanical ventilation (mean difference [MD] = 0.61 days; 95% CI − 1.08 to 2.29; P = 0.48), length of stay in ICU (MD = 0.32 days; 95% CI − 2.51 to 3.16; P = 0.82) and hospital (MD = 0.30 days; 95% CI − 3.23 to 3.83; P = 0.87). Additionally, adverse events were similar between the two groups.

Conclusions
This meta-analysis indicates that IC-guided energy delivery significantly reduces short-term mortality in critically ill patients. This finding encourages the use of IC-guided energy delivery during critical nutrition support. But more high-quality studies are still needed to confirm these findings.
Advanced machine learning for predicting individual risk of flares in rheumatoid arthritis patients tapering biologic drugs
Authors:   on behalf of the RETRO study group, Vodencarevic Asmir , Tascilar Koray , Hartmann Fabian , Reiser Michaela , Hueber Axel J. , Haschka Judith , Bayat Sara , Meinderink Timo , Knitza Johannes , Mendez Larissa , Hagen Melanie , Krönke Gerhard , Rech Jürgen , Manger Bernhard , Kleyer Arnd , Zimmermann-Rittereiser Marcus , Schett Georg , Simon David 
Published: February 2021

Abstract
Background
Biological disease-modifying anti-rheumatic drugs (bDMARDs) can be tapered in some rheumatoid arthritis (RA) patients in sustained remission. The purpose of this study was to assess the feasibility of building a model to estimate the individual flare probability in RA patients tapering bDMARDs using machine learning methods.

Methods
Longitudinal clinical data of RA patients on bDMARDs from a randomized controlled trial of treatment withdrawal (RETRO) were used to build a predictive model to estimate the probability of a flare. Four basic machine learning models were trained, and their predictions were additionally combined to train an ensemble learning method, a stacking meta-classifier model to predict the individual flare probability within 14 weeks after each visit. Prediction performance was estimated using nested cross-validation as the area under the receiver operating curve (AUROC). Predictor importance was estimated using the permutation importance approach.

Results
Data of 135 visits from 41 patients were included. A model selection approach based on nested cross-validation was implemented to find the most suitable modeling formalism for the flare prediction task as well as the optimal model hyper-parameters. Moreover, an approach based on stacking different classifiers was successfully applied to create a powerful and flexible prediction model with the final measured AUROC of 0.81 (95%CI 0.73–0.89). The percent dose change of bDMARDs, clinical disease activity (DAS-28 ESR), disease duration, and inflammatory markers were the most important predictors of a flare.

Conclusion
Machine learning methods were deemed feasible to predict flares after tapering bDMARDs in RA patients in sustained remission.
Evaluating a tylosin dosage regimen for treatment of Staphylococcus delphini infection in mink (Neovison vison): a pharmacokinetic-pharmacodynamic approach
Authors: Ronaghinia Amir Atabak , Birch Julie Melsted , Frandsen Henrik Lauritz , Toutain Pierre-Louis , Damborg Peter , Struve Tina 
Published: February 2021

AbstractStaphylococcus delphini is one of the most common pathogens isolated from mink infections, especially dermatitis. Tylosin (TYL) is used frequently against these infections, although no evidence-based treatment regimen exists. This study aimed to explore the dosage of TYL for infections caused by S. delphini in mink. Two animal experiments with a total of 12 minks were conducted to study the serum pharmacokinetic (PK) characteristics of TYL in mink after 10 mg/kg IV and oral dosing, respectively. The concentration of TYL in serum samples collected before and eight times during 24 h after TYL administration was quantitated with liquid chromatography quadrupole time-of-flight mass spectrometry, and the TYL disposition was analyzed using non-linear mixed effect analysis. The pharmacodynamics (PD) of TYL against S. delphini were studied using semi-mechanistic modeling of in vitro time-kill experiments. PKPD modeling and simulation were done to establish the PKPD index and dosage regimen. The disposition of TYL was described by a two-compartmental model. The area under the free concentration–time curve of TYL over the minimum inhibitory concentration of S. delphini (fAUC/MIC) was determined as PKPD index with breakpoints of 48.9 and 98.7 h for bacteriostatic and bactericidal effect, respectively. The calculated daily oral dose of TYL was 2378 mg/kg, which is 238-fold higher than the currently used TYL oral dosage regimen in mink (10 mg/kg). Accordingly, sufficient TYL concentrations are impossible to achieve in mink plasma, and use of this drug for extra-intestinal infections in this animal species must be discouraged.
Discipline and distinction in the age of the Internet: a sociological study of the fitness practice
Authors: Tang Jun , Xie Zilong 
Published: March 2021

AbstractThis article examines popular fitness sports and home fitness software in China. Drawing on Michel Foucault’s theory of discipline, Norbert Elias’ study on civilization, and Jean Baudrillard’s study on the consumer society, the authors reveal the formation of a new body discipline mechanism against the background of the Internet society and the consumer society. On the one hand, the external disciplinary strategies have been upgraded, including the spatial strategy of liquidity and visibility, the linear and rhythmic time strategy, and the knowledge strategy. On the other hand, different from Foucault’s discussion of discipline, we introduce positive self-discipline. As a unique consumption practice, fitness practices promote a new form of self-discipline among practitioners who also pursue distinctive social positions. The core content of the self-discipline strategy includes code manipulation, time consumption, moral display, and self-writing. In addition, with the continuous infiltration of Internet technologies in daily life, the space-time boundaries of physical discipline gradually blur, whereas the micro-distribution of power changes into a daily distribution form.
Post-discharge Telemonitoring of Physical Activity, Vital Signs, and Patient-Reported Symptoms in Older Patients Undergoing Cancer Surgery
Authors: Jonker Leonie T. , Lahr Maarten M. H. , Oonk Maaike H. M. , de Bock Geertruida H. , van Leeuwen Barbara L. 
Published: February 2021

Abstract
Background
Postoperative home monitoring could potentially detect complications early, but evidence in oncogeriatric surgery is scarce. Therefore, we evaluated whether post-discharge physical activity, vital signs, and patient-reported symptoms are related to post-discharge complications and hospital readmissions in older patients undergoing cancer surgery.

Methods
In this observational cohort study, we monitored older patients (≥65 years of age) undergoing cancer surgery, for 2 weeks post-discharge using tablet-based applications and connected devices. Outcome measures were post-discharge complications and readmissions; physical activity and patient-reported symptoms over time; and threshold violations for physical activity (step count <1000 steps/day), vital signs (temperature <36°C or >38°C; blood pressure <100/60 mmHg or >150/100 mmHg; heart rate <50 bpm or >100 bpm; weight −5% or +5% of weight at discharge); and patient-reported symptoms (pain score greater than the previous day; presence of dyspnea, vomiting, dizziness, fever).

Results
Of 58 patients (mean age 72 years), 24 developed a post-discharge complication and 13 were readmitted. Measured parameters indicated 392 threshold violations out of 5379 measurements (7.3%) in 40 patients, mostly because of physical inactivity. Patients with readmissions had lower physical activity at discharge and at day 9 after discharge and violated a physical activity threshold more often. Patients with post-discharge complications had a higher median pain score compared with patients without these adverse events. No differences in threshold violations of other parameters were observed between patients with and without post-discharge complications and readmissions.

Conclusion
Our results show the potential of telemonitoring older patients after cancer surgery but confirm that detecting post-discharge complications is complex and multifactorial.
Clinical spectrum of chronic liver disease with final outcome in children at a tertiary centre: A single - centre study
Authors: Seerat Iqtadar , Khan Eitzaz UD Din , Atique Muhammad , Aujla Usman Iqbal 
Published: February 2021

Background and Objectives: Chronic liver disease (CLD) in children present a broad spectrum of symptoms. Limited resources in Paediatric Hepatology in developing countries like Pakistan present considerable challenges in investigating and treating children with chronic liver disease in a timely fashion. This study aimed to determine the spectrum and outcomes of CLD other than chronic hep B & C virus (HBV& HCV) liver disease in children.
Methods: This retrospective descriptive study was conducted at the Paediatric Gastroenterology and Hepatology Department, Pakistan Kidney and Liver Institute and Research Centre in Lahore, Pakistan. The duration of the study was from August 2019 to January 2020. A total of 162 children of CLD were seen during this period of time. Of 162 there were 130 children with chronic HBV & HCV who were excluded from this study. 32 children aged 15 years or younger with chronic liver disease were included. The referrals were received from primary and secondary health care centres in different parts of the country. The data were collected from hospital electronic medical records database and then incorporated into a spreadsheet for analysis. The statistical analysis was performed by applying t-test with p value determined.
Results: Of 32 children autoimmune hepatitis (n=11; 34.3%) was the most common cause for chronic liver disease referrals, followed by progressive familial intrahepatic cholestasis type-2, (n=7; 21.8%), post Kasai for biliary atresia, (n=4; 12.5%), glycogen storage disease type-1 (n=5; 15.6%), Wilson disease (n=3; 9.3%) and primary sclerosing cholangitis (n=2; 6.2%). The diagnosis was principally established with the assistance of liver ultrasound, liver biopsy, magnetic resonance cholangiopancreatography and genetic testing.
Conclusion: Autoimmune hepatitis was the most common chronic liver disease. Our systematic approach, in addition to an extensive workup, helped us to diagnose and then initiate an appropriate treatment, which resulted in a more optimal outcome. Prompt referrals to tertiary centres are recommended where resources and expertise are available to reduce patient morbidity and mortality.
doi: https://doi.org/10.12669/pjms.37.3.3862
How to cite this:Seerat I, Khan ED, Atique M, Aujla UI. Clinical spectrum of chronic liver disease with final outcome in children at a tertiary centre: A single - centre study. Pak J Med Sci. 2021;37(3):680-683. doi: https://doi.org/10.12669/pjms.37.3.3862
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Case Report: A 73-year-old suspected COVID-19 patient with severe dyspnea fully recovers after reciting nine true words from Falun Gong
Authors: Dong Yuhong , Trey Margaret , Hsu Kai-Hsiung 
Published: March 2021

Background: The most common severe symptoms of coronavirus disease 2019 (COVID-19) are breathing difficulty and respiratory failure. Unfortunately, mortality of COVID-19 patients with severe breathing difficulties is high. Clinical finding and diagnosis: This report describes the case of a woman in her seventies, who could not taste anything except a metallic taste, had pains all over, low-grade fever, and who soon developed severe breathing difficulties in 15 days. At the time, her doctors described her as having suspected COVID-19 and advised her to self-quarantine at home. Interventions and outcomes: When the patient had her initial symptoms, her treating physician prescribed Tylenol which she took for 13 days. The patient initially felt better, but then developed severe fatigue, achiness within a week, and then severe breathing difficulties. The patient was sometimes unable to breathe and could not walk from her bed to the bathroom. She started feeling fearful of death after 15 days had lapsed. She then started to recite the nine Chinese characters "Fa-Lun Da-Fa Hao, Zhen-Shan-Ren Hao” daily. After she started reciting these nine true words (NTW) frequently and sincerely, the patient felt her lungs opened and she was able to breathe longer and deeper. Within three days of constantly reciting the NTW, her breathing returned to normal and all symptoms ceased. Conclusions: This suspected COVID-19 patient gained significant clinical benefits after sincerely reciting the nine-character true words from Falun Gong.
Knowledge translation platforms to support African evidence-informed policies: challenges and progress
Authors: Adu Joseph , Gyamfi Sebastian , Martin-Yeboah Ebenezer 
Published: February 2021

Background:An effective health system that ensures availability and access to quality healthcare produces active human capital. Responsive health systems are the results of evidence-informed policy practice which is mostly seen in advanced countries. Deficiencies in most African health systems are due to the ineffective use of health research to reinforce public health policymaking.
Key points for discussion:This paper discusses the progress and challenges faced by Knowledge Translation Platforms (KTPs) in African evidence-informed policymaking among healthcare systems. Large gaps exist between research evidence and policymaking in Africa due to inefficiencies of the KTPs and the lack of political will to use sound ethical research outcomes to inform health policies. Activities of KTPs in Africa are most often curtailed by many obstacles, but not limited to the following; lack of infrastructure, human and financial capital, high turnover among top-level policymakers, and lack of collaboration between academia and industry.
Conclusions and implications:Evidence informed policymaking is crucial to the achievement of the health-related Sustainable Development Goals by 2030.
Escola e Família: Desafios e Harmonia Durante o Período Pandêmico de 2020 no Contexto dos Anos Iniciais / School and Family: Challenges and Harmony During the 2020 Pandemic Period in the Context of the Early Years
Authors: Barros Maria da Conceição Da Silva , Menezes Aurelania Maria De Carvalho 
Published: March 2021

Resumo: O mundo sabe que o ano de 2020 foi repleto de problemas causados pela pandemia do Covid-19. O planeta se viu diante de um vírus que necessitava ser repelido. Outras pandemias já aconteceram, mas muitos que hoje vivem, jamais conheceram de perto os danos causados por uma. Entre tantos afetados, a educação precisou buscar altenativas para que o ano letivo não fosse prejudicado. Sendo assim, escola e família, como partes fundamentais para o desenvolvimento e trajetória de vida das pessoas, enfrentaram os desafios e se harmonizaram em prol de objetivos comuns. Neste trabalho, foram destacadas as contribuições da parceria entre escola e família no contexto dos anos iniciais, enfatizando o trabalho dos professores, o uso das (TICs) tecnologias de informação e comunicação, a nova realidade dos estudantes e a ausência de recursos para o acompanhamento das aulas remotas, assim como a falta de internet. Esta pesquisa tem como objetivo, analisar a parceria entre escola e família durante a pandemia de 2020. Como metodologia, este trabalho é bibliográfico, com natureza qualitativa e descritiva.
ECMO A Terapia Que Salva Vidas: Revisão Sistemática / ECMO Life-Saving Therapy: Systematic Review
Authors: Ribeiro Ágatha Patricia Rodrigues 
Published: March 2021

Resumo: A circulação extracorpórea prolongada promovida a partir de um dispositivo mecânico de uso temporário podendo durar dias ou meses. Com o intuito de fornecer suporte ao coração e o pulmão até promoção de sua recuperação ou substituição. O objetivo deste estudo é explorar os aspectos mais relevantes da circulação extracorpórea e contribuir cientificamente evidenciando os estudos realizados por meio de uma revisão sistemática da literatura. Realizada conforme as recomendações do Preferred Reporting Intens for Systematic Reviews and Meta-Analyses (PRISMA). A busca pelos artigos científicos ocorreu nas bases de dados eletrônicos Extracorporeal Life Support Organization (ELSO), PubMed, Literatura Latino Americana e do Caribe em ciências da Saúde (LILACS) e Scientific Eletronic Library Online (SciELO), PEDro (Physiotherapy Evidence Database) e buscas manuais nas referências dos artigos incluídos. Foi discutido o surgimento e expansão da utilização do ECMO pelo mundo, formas de utilização, qualidade de vida das crianças que utilizaram o ECMO a partir de avaliação neurológica, os riscos de infecções hospitalares associados a terapia, custo-beneficio, comparou-se o ECMO a outras terapias convencionais e os parâmetros ventilatórios, a mobilização precoce e seus benefícios e por fim o desmame. Conclui- se que a ECMO é uma terapia eficaz no tratamento da SDRA ou outras causas de insuficiência respiratória em adultos e crianças aumentando a sobrevida dos pacientes, sendo considerada uma terapia de resgate principalmente em transplantes de pulmão e coração por promover tempo de recuperação e substituição dos órgãos com eficiência e a relação custo-utilidade associada ao uso de oxigenação por membrana extracorpórea no Brasil é potencialmente aceitável.