bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Propensity-Matched Analysis of Survival of Clinically Diagnosed Early-Stage Lung Cancer and Biopsy-Proven Early-Stage Non-Small Cell Lung Cancer Following Stereotactic Ablative Radiotherapy
Authors: Zhang Ran , Guo Yanling , Yan Yujie , Liu Yuanjun , Zhu Yaoyao , Kang Jingjing , Li Fangjuan , Sun Xiaojiang , Xing Ligang , Xu Yaping 
Published: August 2021

PurposeStereotactic body radiotherapy (SBRT) has been increasingly regarded as a reasonable option for early-stage lung cancer patients without pretreatment pathologic results, but the efficacy and safety in a Chinese population remains unclear. The aim of this study was to compare survival outcomes and toxicities between patients with clinically diagnosed early-stage lung cancer or biopsy-proven early-stage non-small cell lung cancer and to demonstrate the rationality of this treatment.Material and MethodsFrom May 2012 to December 2018, 56 patients with clinically diagnosed early-stage lung cancer and 60 patients with early-stage biopsy-proven were selected into non-pathological group and pathological group, respectively. Propensity score matching (PSM) was performed to reduce patient selection bias. Survival analysis with log-rank test was used to assess the differences of treatment outcomes, which included local control (LC), progression-free survival (PFS), and overall survival (OS).ResultsThe median age was 76 (range 47–93) years, and the median follow-up time was 58.3 (range 4.3–95.1) months in the cohort without pathologic results. The median age was 74 (range 57–88) years, and the median follow-up time was 56.3 (range 2.6–94) months in the cohort with pathologic results. 45 matched-pair were analyzed. The 5-year LC, PFS, and OS rates in matched-pair patients with or without pathologic biopsy were 85.5% and 89.8%, 40.6% and 70.9%, and 63.2% and 76.1%, respectively. On Kaplan-Meier survival analysis after PSM analysis, there was no significant difference between patients with pathologic results versus patients with no pathologic results in terms of LC (P= 0.498) and OS (P=0.141). Of the matched-pair patients treated with SBRT, only 1 patient experienced grade 3 or above radiation pneumonitis.ConclusionFor early-stage lung cancer patients with medically inoperable or not suitable for invasive diagnosis, SBRT may be a good local treatment.
Mexiletine Treatment for Neonatal LQT3 Syndrome: Case Report and Literature Review
Authors: Bagkaki Alena , Tsoutsinos Alexandros , Hatzidaki Eleftheria , Tzatzarakis Manolis , Parthenakis Fragiskos , Germanakis Ioannis 
Published: August 2021

Background: Early diagnosis of long QT type 3 (LQT3) syndrome during the neonatal period is of paramount clinical importance. LQT3 syndrome results in increased mortality and a mutation-specific response to treatment compared to other more common types of LQT syndrome. Mexiletine, a sodium channel blocker, demonstrates a mutation-specific QTc shortening effect in LQT3 syndrome patients.Case Presentation: A neonate manifested marked QTc prolongation after birth. An electrocardiogram (ECG) recording was performed due to positive family history of genetically confirmed LQT3 syndrome (SCN5A gene missense mutation Tyr1795Cys), and an association with sudden cardiac death was found in family members. The mexiletine QTc normalizing effect (QTc shortening from 537 to 443 ms), practical issues related to oral mexiletine treatment of our young patient, along with a literature review regarding identification and mexiletine treatment in infants with LQT3 syndrome are presented.Conclusions: Mexiletine could be considered in the treatment of high-risk LQT3 patients already in the neonatal period in addition to b-blocker therapy. Availability of standardized commercial mexiletine pediatric formulas, serum mexiletine level analyses, and future prospective studies are needed to evaluate the potential beneficial effect of early mexiletine treatment on the incidence of future acute cardiac events in these high-risk LQT syndrome patients.
Role of Hemoperfusion With CytoSorb Associated With Continuous Kidney Replacement Therapy on Renal Outcome in Critically III Children With Septic Shock
Authors: Bottari Gabriella , Lorenzetti Giulia , Severini Flavia , Cappoli Andrea , Cecchetti Corrado , Guzzo Isabella 
Published: August 2021

Introduction: Sepsis-associated acute kidney injury (SA-AKI) represents a relevant cause of mortality and morbidity in critically ill children. Since with the “inflammatory theory” the authors have been witnessed an important role of inflammatory mediators in the pathophysiology and in the prognosis of SA-AKI, making the need of adjunctive therapies in association with kidney replacement therapies mandatory. Hemoperfusion with CytoSorb is a safe and well-tolerated therapy in septic shock: the very high surface area of the absorber means it is able to efficiently remove cytokines and other medium size molecules involved in cytokine storm, thus playing a synergistic effect with Continuous Kidney Replacement Therapy (CKRT).Materials and Methods: We retrospectively analyzed data from a cohort of eight critically ill children treated from January 2018 to March 2020 describing the impact of CKRT plus hemoperfusion with CytoSorb on renal outcome in critically ill children with septic shock.Results: We evidenced a significant reduction in interleukin (IL)-6 an IL-10 after hemoperfusion with CytoSorb in our pediatric population. Furthermore, we were able to show a significant improvement of creatinine and blood urea nitrogen (BUN) after blood purification and at pediatric intensive care units (PICU) discharge. We have observed a median of 2.5 CKRT days after stop of hemoperfusion (Q1 0.25; Q3 18.75). None of our patients required CKRT 30 days after PICU discharge (PICU-D). None of them developed CKD.Conclusion: Hemoperfusion with CytoSorb is a valuable therapeutic option in combination with CKRT in SA-AKI. More studies are warranted to confirm our results and in particular to define the role of this adjuvant therapy as a preemptive strategy to protect renal function in pediatric septic shock.
Optimized Dosing Regimens of Meropenem in Septic Children Receiving Extracorporeal Life Support
Authors: Wang Yixue , Chen Weiming , Huang Yidie , Wang Guangfei , Li Zhiping , Yan Gangfeng , Chen Chao , Lu Guoping 
Published: August 2021

Objectives: To develop a population pharmacokinetic model of meropenem in children with sepsis receiving extracorporeal life support (ECLS) and optimize the dosage regimen based on investigating the probability of target attainment (PTA).Methods: The children with sepsis were prospectively enrolled in a pediatric intensive care unit from January 2018 to December 2019. The concentration-time data were fitted using nonlinear mixed effect model approach by NONMEM program. The stochastic simulation considering various scenarios based on proposed population pharmacokinetics model were conducted, and the PTAs were calculated to optimize the dosage regimens.Results: A total of 25 children with sepsis were enrolled, of whom13 received ECMO, 9 received CRRT, and 4 received ECMO combined with CRRT. 12 children received a two-step 3-h infusion and 13 children received 1-h infusion. Bodyweight and creatinine clearance had significant impacts on the PK parameters. ECMO intervention was not related to the PK properties. If 100%T &gt; MIC was chosen as target, children receiving 40 mg/kg q8h over a 3 h-infusion only reached the PTA up to 77.4%. If bacteria with MIC 2 mg/L were to be treated with meropenem and the PTA target was 50%T &gt; MIC, a dose of 40 mg/kg q8h for 1 h infusion would be necessary.Conclusions: The PK properties of meropenem in septic children receiving extracorporeal life support were best described. We recommended the opitimized dosing regimens for septic children receiving ECLS depending on the PTA of PK target 50%T &gt; MIC and 100%T &gt; MIC, for children with sepsis during ECLS with different body weight, estimated creatinine clearance (eCRCL) and MIC of bacteria.
Assessment of Cardiovascular Functioning Among Regular Kratom (Mitragyna speciosa Korth) Users: A Case Series
Authors: Leong Bin Abdullah Mohammad Farris Iman , Singh Darshan 
Published: August 2021

Multiorgan toxicities have been extensively reported in kratom (Mitragyna speciosa Korth) users in Western countries but not in Southeast Asia. Existing literature argued that this discrepancy may be due to underreporting of kratom-related toxicity cases in Southeast Asia. Hence, this case series filled the research gap by clinically assessing the cardiovascular functioning and serum mitragynine level of regular kratom users in its traditional settings in Malaysia. Nine regular kratom users without history of polysubstance use were recruited from the same community via snowball sampling and were subjected to electrocardiogram (ECG) and echocardiogram assessments. Serum mitragynine analysis was also performed by solid-phase extraction and liquid chromatography-tandem mass spectrometry. The mean serum mitragynine level was 10.3 mg/L (SD = 6.9) and ranged from 2.5 mg/L to 22.4 mg/L. Those who consumed an average daily quantity of four or more glasses of brewed kratom juice (p = 0.045) and those who had prolonged QTc intervals (p = 0.017) had significantly higher serum mitragynine level. Echocardiographic findings of all the respondents were normal except one reported left ventricular hypertrophy and another had trivial tricuspid regurgitation with pulmonary artery systolic pressure (PASP) of 10 + 5 mmHg. Regular kratom use without concomitant use of other illicit substances may not provoke any risk of cardiovascular impairment or toxicity except for prolonged QTc interval, which appeared to be dose dependent. However, as this study was limited by a small sample size, future studies with larger sample size are warranted to confirm our findings.
Research on the Failure Evolution Process of Rock Mass Base on the Acoustic Emission Parameters
Authors: Liu Xiaohui , Zhao Xiaoping , Zhang Shishu , Congyan Ran , Zhao Rui 
Published: August 2021

Fracture mechanics behavior and acoustic emission (AE) characteristics of fractured rock mass are related to underground engineering safety construction, disaster prediction, and early warning. In this study, the failure evolution characteristics of intact and fracture (e.g., single fracture, parallel fractures, cross fractures, and mixed fractures) coal were studied and contrasted with each other on the basis of the distribution of max amplitude of AE. The study revealed some meaningful results, where the value of b (i.e., the distribution characteristic of max amplitude of AE) could represent the failure evolution process of intact and fractured coal. The maximum amplitude distribution of AE events was characterized by Gaussian normal distribution, and the probability of the maximum amplitude of AE events corresponding to 35∼50 dB was the largest. In the stress range of 60∼80%, AE events and maximum amplitude increased rapidly, and the corresponding b value decreased. The energy of AE events showed a downward trend after reaching the maximum value at about 80% stress level. Under the same stress level, the more complex the fracture was, the larger the b value of coal–rock mass was, and the stronger the inhibition effect on the fracture expansion caused by the internal fracture distribution was. Due to the anisotropy of coal–rock mass with a single crack, the distribution of the b value was more discrete, while the anisotropy of coal–rock mass with mixed crack decreased, and the dispersion of the b value decreased. The deformation of cracked coal mainly caused by the adjustment of cracks during the initial loading b value experienced a trend of decreasing first, then increasing, and then decreasing in the loading process. When the load reached 0.8 times of the peak strength, the b value had a secondary decreasing trend, indicating the macroscopic failure of the sample, which could be used as a precursor criterion for the complete failure of coal–rock mass.
Development of 18F-Labeled Resazurin Derivatives for the Detection of Tumor Metabolic Activity Using Cerenkov Imaging
Authors: Arroyo Alejandro D. , Guzman Andrea E. , Kachur Alexander V. , Popov Anatoliy V. , Delikatny E. James 
Published: August 2021

This paper describes functional fluorinated bioactivatable molecules to study cancer metabolism using Cerenkov imaging. Resazurin (RA), or Alamar Blue, is a commonly used viability dye and redox sensor. Under reductive conditions or by the action of NADH dehydrogenases, RA is reduced into resorufin (RAred), a highly fluorescent molecule. Cold- and radiolabeled monofluorinated resazurin (MFRA) and difluorinated resazurin (DFRA) were synthesized using electrophilic fluorination. The fluorescence of the reduced probes allowed for the detection of Cerenkov Radiation Energy Transfer (CRET). Cerenkov imaging of MFRAred showed a 4-fold increase in signal at 640 nm relative to MFRA, demonstrating the ability to differentiate between oxidized and reduced species via optical imaging. CRET allows the measurement of signal at longer wavelengths closer to the near infrared (NIR) window, ideal for in vivo imaging. MFRA reduction showed different rates in two breast cancer cell lines: MDA-MB-231, a triple-negative breast cancer, and 4175-Luc+, an aggressive MDA-MB-231 variant, isolated from murine lung metastases. 4175-Luc + cells showed a more rapid reduction of RA and MFRAox than MDA-MB-231 cells. Intratumoral injections of 18F-FDG/MFRA showed a faster reduction of the probe in 4175-Luc + tumors than in MDA-MB-231, suggesting that the metabolic feature observed in the cells is maintained in the tumors. MFRA is a promising probe to determine tumor energy imbalance, reductive environments and assess metastatic potential of tumors. Furthermore, the use of 18F-labeled probes allows for dual modality PET/Cerenkov imaging for probe localization and biodistribution while assessing probe reduction simultaneously.
Increased Mobility of the Atrial Septum in Aortic Root Dilation: An Observational Study on Transesophageal Echocardiography
Authors: Heidemann Altair , Dall'Oglio Lorença , Bertoldi Eduardo Gehling , Foppa Murilo 
Published: August 2021

Background: There is a growing interest in the relationship between atrial septal anatomy and cardioembolic stroke. Anecdotal reports suggest that the enlargement of the aortic root could interfere with atrial septal mobility (ASM). We sought to investigate the association between ASM and aortic root dilation.Methods and Findings: From all consecutive clinically requested transesophageal echocardiogram (TEE) studies performed during the study period in a single institution, we were able to review and evaluate the ASM and anteroposterior length, aortic root diameter, and the prevalence of atrial septal aneurysm (ASA) and of patent foramen ovale (PFO) in 336 studies. Additional variables, such as left ventricular ejection fraction, left atrial diameter, diastolic dysfunction, age, sex, weight, height, previous stroke, atrial fibrillation, and TEE indication, were extracted from patient medical records and echocardiographic clinical reports. In 336 patients, we found a mean ASM of 3.4 mm, ranging from 0 to 21 mm; 15% had ASA and 14% had PFO. There was a 1.0 mm increase in ASM for every 10-mm increase in aortic root diameter adjusted for age, sex, weight, height, ejection fraction, and left atrial size (B = 0.1; P = 0.04). Aortic diameter was not associated with a smaller septal length (B = 0.03; P = 0.7).Conclusion: An increased motion of the atrial septum can occur in association with aortic dilation. These findings deserve attention for the relevance of aortic root anatomy in future studies involving atrial septal characteristics and embolic stroke risk.
Co-creation and Evaluation of Nationwide Remote Training Service for Mental Health Education of Community Health Workers in Rwanda
Authors: Willems Annik , Iyamuremye Jean-Damascène , Misage Claire Nancy , Smith-Swintosky Virginia , Kayiteshonga Yvonne 
Published: August 2021

Objective: Johnson &amp; Johnson Global Public Health and the Ministry of Health of Rwanda strengthened the mental health awareness by providing an innovative, low-cost, easily accessible, and scalable remote training service (RTS) on mental health for Community Health Workers (CHWs).Methods: The RTS consisted of eight training modules shared via simple feature phones over a 4-week period. Quiz questions and baseline/endline assessments were included to assess the feasibility and acceptability of the training platform, the knowledge and self-confidence gained by the CHWs, and prospects for the sustainability of the platform.Results: Ninety-three percent of the CHWs completed at least four of the eight training modules, and 42% of the CHWs improved with a higher end score. The training content was considered interesting, easy to understand, and helpful to intervene appropriately to refer patients with signs of mental illness to a hospital and to provide community and family education on mental health topics.Conclusion: The RTS is feasible and acceptable for the delivery of mental health training on a large scale and contributed to strengthening the capacity in delivering mental health care at community level.
The Holistic Health Status of Chinese Homosexual and Bisexual Adults: A Scoping Review
Authors: Wu Chanchan , Choi Edmond Pui Hang , Chau Pui Hing 
Published: August 2021

Background: Same-sex marriage is currently not legalized in China, despite the considerably large number of homosexual and bisexual Chinese populations. At the same time, their holistic health status remains unclear. This is the first scoping review conducted to comprehensively examine all the available literature and map existing evidence on the holistic health of homosexual and bisexual Chinese.Methods: This scoping review used the framework of Arksey and O'Malley and followed the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews (PRISMA-ScR). A comprehensive search strategy was carried out across 20 English (EN) and Chinese (both traditional and simplified) electronic databases from January 1, 2001, to May 31, 2020. Two reviewers conducted the reference screening and study selection independently and consulted a third senior reviewer whenever a consensus must be achieved. Data extraction was conducted using a structured data form based on the Cochrane template, after which a narrative synthesis of the findings was performed.Results: A total of 2,879 references were included in the final analysis, with 2,478 research articles, 167 reviews, and 234 theses. Regarding the study populations, the vast majority of studies centered on men only (96.46%), especially men who have sex with men (MSM). Only 1.32% of the studies targeted female sexual minorities. The geographical distribution of all research sites was uneven, with most of them being conducted in mainland China (95.96%), followed by Hong Kong (2.05%), Taiwan (2.02%), and Macau (0.06%). Regarding the specific study focus in terms of the health domain, around half of the studies (45.93%) focused on sexual health only, and an additional quarter of the studies (24.15%) investigated both sexual health and social well-being. Meanwhile, the studies focusing on mental health only accounted for approximately 15% of the total.Conclusions: This scoping review revealed that previous research focused more on male than female sexual minorities, on disease-centered surveys than person-centered interventions, and investigations on negative health conditions than positive health promotion. Therefore, investigations centered on the female sexual minorities and corresponding person-centered interventions are highly needed.Review Registration: The protocol of this review has been registered within Open Science Framework (https://osf.io/82r7z) on April 27, 2020.
Prevalencia de infección del tracto urinario y perfil de susceptibilidad antimicrobiana en Enterobacterias
Authors: Carriel Álvarez María Gabriela , Ortiz Jonnathan Gerardo 
Published: August 2021

Las Infecciones del Tracto Urinario (ITU), constituyen uno de los principales motivos de consulta en el ámbito de atención primaria, debido al aumento de la resistencia antibacteriana. Objetivo. Caracterizar la prevalencia de infección del tracto urinario y el perfil de susceptibilidad antimicrobiana in vitro en Enterobacterias en los pacientes de la provincia de Santa Elena – Ecuador. Método. Esta investigación fue descriptiva de diseño documental. La población fue de 827 registros de urocultivos, recopilados de la base de datos del laboratorio de microbiología del Centro de Especialidades IESS La Libertad, en el período comprendido desde agosto 2019 hasta marzo de 2020. Los datos fueron procesados mediante estadística descriptiva, análisis de frecuencia y chi cuadrado. Resultados. De este estudio indican que la prevalencia de ITU fue 22,1%; los principales agentes etiológicos fueron: E. coli (76,0%), Klebsiella oxytoca (6,5%), Klebsiella pneumoniae (5,8%) y Proteus mirabilis (3,9%). La ITU y la infección por E. coli fueron estadísticamente mayores en mujeres y adultos mayores. La mayor frecuencia de resistencia de E. coli fue para ácido nalidíxico (81,2%), ampicilina (79,9%), ciprofloxacina (72,6%) y sulfametoxazol trimetoprima (61,5%); en Klebsiella oxytoca fue ampicilina (80,0%), sulfametoxazol trimetoprima (70,0%), ácido nalidíxico (60,0%) y ciprofloxacina (40,0%). Mientras que en Klebsiella pneumoniae se halló una resistencia del (100%) para ampicilina y cefalotina, amoxicilina y ácido clavulánico (66,7%), ciprofloxacina (55,6%), ácido nalidíxico (44,4%), meropenem e imipenem (11,1%). Conclusiones. La E. coli continúa siendo el microorganismo más frecuente en ITU. El tratamiento empírico de ITU debería incluir amikacina, nitrofurantoina y piperacilina tazobactam.
MODERASI BERAGAMA DALAM BINGKAI TOLERANSI
Authors: ABROR MHD. 
Published: August 2021

Pembahasan ini hendak menelaah lebih dalam tentang moderasi beragama di tinjau dari aspek toleransi. Hal ini dimaksudkan agar mendapatkan gambaran yang jelas, bagaimana sebenarnya moderasi beragama dan toleransi serta batas-batasnya. Penelitian ini merupakan jenis penelitian kepustakaan (library research), yaitu suatu penelitian yang data-datanya berasal dari literatur-literatur yang terkait dengan obyek penelitian, kemudian dianalisis muatan isinya. Dari kajian ini menegaskan bahwa, moderasi dalam kerukunan beragama haruslah dilakukan, karena dengan demikian akan terciptalah kerukunan umat antar agama atau keyakinan. Untuk mengelola situasi keagamaan di Indonesia yang sangat beragam, kita membutuhkan visi dan solusi yang dapat menciptakan kerukunan dan kedamaian dalam menjalankan kehidupan keagamaan, yakni dengan mengedepankan moderasi beragama, menghormati keragaman, serta tidak terjebak pada Intoleransi, ekstremisme dan Radikalisme. Toleransi beragama bukanlah untuk saling melebur dalam keyakinan. Tidak juga untuk saling bertukar keyakinan dengan kelompok agama yang berbeda-beda. Toleransi di sini adalah dalam pengertian mu’amalah (interaksi sosial), sehingga adanya batas-batas bersama yang boleh dan tak boleh dilanggar. Inilah esensi moderasi dalam bingkai toleransi di mana masing-masing pihak diharapkan bisa mengendalikan diri dan menyediakan ruang untuk saling menghormati keunikannya masing-masing tanpa merasa terancam keyakinan maupun hak-haknya.