bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of individualized PEEP obtained by two different titration methods on postoperative atelectasis in obese patients: study protocol for a randomized controlled trial
Authors: Wang Qing-Yuan , Ji Yu-Wei , An Li-Xin , Cao Lei , Xue Fu-Shan 
Published: October 2021

Abstract
Background
The incidence of postoperative pulmonary complications (PPCs) is higher in obese patients undergoing general anesthesia and mechanical ventilation due to the reduction of oxygen reserve, functional residual capacity, and lung compliance. Individualized positive end-expiratory pressure (iPEEP) along with other lung-protective strategies is effective in alleviating postoperative atelectasis. Here, we compared the best static lung compliance (Cstat) titration of iPEEP with electrical impedance tomography (EIT) titration to observe their effects on postoperative atelectasis in obese patients undergoing laparoscopic surgery.

Methods
A total number of 140 obese patients with BMI ≥ 32.5kg/m2 undergoing elective laparoscopic gastric volume reduction and at moderate to high risk of developing PPCs will be enrolled and randomized into the optimal static lung compliance-directed iPEEP group and EIT titration iPEEP group. The primary endpoint will be pulmonary atelectasis measured and calculated by EIT immediately after extubation and 2 h after surgery. Secondary endpoints will be intraoperative oxygenation index, organ dysfunction, incidence of PPCs, hospital expenses, and length of hospital stay.

Discussion
Many iPEEP titration methods effective for normal weight patients may not be appropriate for obese patients. Although EIT-guided iPEEP titration is effective in obese patients, its high price and complexity limit its application in many clinical facilities. This trial will test the efficacy of iPEEP via the optimal static lung compliance-guided titration procedure by comparing it with EIT-guided PEEP titration. The results of this trial will provide a feasible and convenient method for anesthesiologists to set individualized PEEP for obese patients during laparoscopic surgery.

Trial registration
ClinicalTrials.govChiCTR2000039144. Registered on October 19, 2020
Age, vascular disease, and Alzheimer’s disease pathologies in amyloid negative elderly adults
Authors: Guo Tengfei , Landau Susan M. , Jagust William J. ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: October 2021

Abstract
Background
We recently reported that CSF phosphorylated tau (p-Tau181) relative to Aβ40 (CSF p-Tau/Aβ40 ratio) was less noisy and increased associations with Alzheimer’s disease (AD) biomarkers compared to CSF p-Tau181 alone. While elevations of CSF p-Tau/Aβ40 can occur in amyloid-β (Aβ) negative (Aβ-) individuals, the factors associated with these elevations and their role in neurodegeneration and cognitive decline are unknown. We aim to explore factors associated with elevated tau in CSF, and how these elevated tau are related to neurodegeneration and cognitive decline in the absence of Aβ positivity.

Methods
We examined relationships between CSF p-Tau/Aβ40, and CSF Aβ42/Aβ40, Aβ PET, and white matter hyperintensities (WMH) as well as vascular risk factors in 149 cognitively unimpaired and 52 impaired individuals who were presumably not on the Alzheimer’s disease (AD) pathway due to negative Aβ status on both CSF and PET. Subgroups had 18F-fluorodeoxyglucose (FDG) PET and adjusted hippocampal volume (aHCV), and longitudinal measures of CSF, aHCV, FDG PET, and cognition data, so we examined CSF p-Tau/Aβ40 associations with these measures as well.

Results
Elevated CSF p-Tau/Aβ40 was associated with older age, male sex, greater WMH, and hypertension as well as a pattern of hippocampal atrophy and temporoparietal hypometabolism characteristic of AD. Lower CSF Aβ42/Aβ40, higher WMH, and hypertension but not age, sex, Aβ PET, APOE-ε4 status, body mass index, smoking, and hyperlipidemia at baseline predicted CSF p-Tau/Aβ40 increases over approximately 5 years of follow-up. The relationship between CSF p-Tau/Aβ40 and subsequent cognitive decline was partially or fully explained by neurodegenerative measurements.

Conclusions
These data provide surprising clues as to the etiology and significance of tau pathology in the absence of Aβ. It seems likely that, in addition to age, both cerebrovascular disease and subthreshold levels of Aβ are related to this tau accumulation. Crucially, this phenotype of CSF tau elevation in amyloid-negative individuals share features with AD such as a pattern of metabolic decline and regional brain atrophy.
A rapid review of early guidance to prevent and control COVID-19 in custodial settings
Authors: Pearce Lindsay A. , Vaisey Alaina , Keen Claire , Calais-Ferreira Lucas , Foulds James A. , Young Jesse T. , Southalan Louise , Borschmann Rohan , Gray Ruth , Stürup-Toft Sunita , Kinner Stuart A. 
Published: October 2021

Abstract
Background
With over 11 million people incarcerated globally, prevention and control of COVID-19 in custodial settings is a critical component of the public health response. Given the risk of rapid transmission in these settings, it is important to know what guidance existed for responding to COVID-19 in the early stages of the pandemic. We sought to identify, collate, and summarise guidance for the prevention and control of COVID-19 in custodial settings in the first six months of 2020. We conducted a systematic search of peer-reviewed and grey literature, and manually searched relevant websites to identify publications up to 30 June 2020 outlining recommendations to prevent and/or control COVID-19 in custodial settings. We inductively developed a coding framework and assessed recommendations using conventional content analysis.

Results
We identified 201 eligible publications containing 374 unique recommendations across 19 domains including: preparedness; physical environments; case identification, screening, and management; communication; external access and visitation; psychological and emotional support; recreation, legal, and health service adaptation; decarceration; release and community reintegration; workforce logistics; surveillance and information sharing; independent monitoring; compensatory measures; lifting control measures; evaluation; and key populations/settings. We identified few conflicting recommendations.

Conclusions
The breadth of recommendations identified in this review reflects the complexity of COVID-19 response in custodial settings. Despite the availability of comprehensive guidance early in the pandemic, important gaps remain in the implementation of recommended prevention and control measures globally, and in the availability of evidence assessing their effectiveness on reducing COVID-19 disease, impact on people in custody and staff, and implementation.
The frequency of Raynaud’s phenomenon, very early diagnosis of systemic sclerosis, and systemic sclerosis in a large Veteran Health Administration database
Authors: Frech Tracy M. , Murtaugh Maureen A. , Amuan Megan , Pugh Mary Jo 
Published: October 2021

Abstract
Background
We describe Raynauds phenomenon (RP), potential very early diagnosis of systemic sclerosis (VEDOSS), and systemic sclerosis (SSc) in Veterans deployed in support of Post-9/11 operations. We sought to describe the military occupation specialty, clinical features, and vasodilator use across the three diagnoses.

Methods
Individual Veterans medical records were assessed for RP (ICD-9443.0), VEDOSS with swelling of hands (ICD-9729.81) and RP (ICD-9443.0), and SSc (ICD-9710.1). The distribution of sociodemographic, military service branch, job classification, vasodilator use, and comorbidities were examined across the three classifications of disease. The chi-squared test and Fisher’s exact compared frequency of these categorical variables. Logistic regression assessed the likelihood of characteristics of the three classifications.

Results
In this population of 607,665 individual Veteran medical records, 857 had RP, 45 met possible VEDOSS criteria, and 71 had a diagnosis of SSc. The majority of RP, potential VEDOSS and SSc cases were white males. Those in craftworks, engineering or maintenance, and healthcare had a greater likelihood of RP. Less than half of RP and VEDOSS patients were on vasodilators. The most common comorbidities in this population were the diagnostic code for pain (highest in the potential VEDOSS group [81.6%]), followed by depression in all groups.

Conclusion
This is a unique Veteran population of predominately-male patients. Our data suggests that vasodilator medications are potentially being under-utilized for RP and potential VEDOSS. Our data highlights mood and pain management as an important aspect of SSc care.
Safety, tolerability, and efficacy of a selective gabapentinoid mirogabalin in neuropathic pain—a topical review
Authors: Nair Abhijit , Kamtikar Subodh , Seelam Suresh 
Published: October 2021

AbstractGabapentin and pregabalin, known as gabapentinoids, have been used effectively as a monotherapy or in combination with other agents for managing chronic neuropathic pain due to various etiologies. These drugs act via α2δ-1 and α2δ-2 subunits of voltage-gated calcium channels (VGCCs) non-selectively. Due to its non-selective action, a certain group of patients reports central nervous system adverse effects like dizziness, drowsiness, somnolence, and cerebellar ataxia.Mirogabalin besylate is an orally administered next-generation gabapentinoid approved for use in diabetic neuropathy and post-herpetic neuralgia. It binds selectively and with greater affinity to the α2δ-1 and α2δ-2 subunits of human VGCCs and thus has lesser central nervous system adverse events making it more tolerable. We reviewed all articles in various categories, published in reputed databases since 2014 where mirogabalin was used to treat chronic neuropathic pain. Case series and open-label studies have demonstrated the safety and efficacy of mirogabalin in cancer pain and lumbar spine disease. Pharmacokinetic/pharmacodynamic studies have cautioned using full dose in patients with renal/hepatic impairment and along with drugs that could lead to adverse effects like sedatives and opioids. Dose up to 30 mg/day when administered as a twice-daily divided dose has been tolerated quite well with adequate pain relief in diabetic neuropathy and post-herpetic neuralgia.Mirogabalin appears to be a safe gabapentinoid in diabetic neuropathy and post-herpetic neuralgia. Further studies need to be conducted to explore the role of mirogabalin in cancer pain, postoperative pain, and neuropathic pain due to various other etiologies.
Successful recovery from COVID-19 pneumonia with awake early self-proning
Authors: Yılmaz Fulya , Bas Koray 
Published: October 2021

Abstract
Background
Since COVID-19 global pandemic, “early awake proning in non-intubated patients with COVID-19” has been suggested as anecdotal evidence. Hereby, we report an awake and non-intubated patient with COVID-19 pneumonia who was successfully managed with early self-proning.

Case presentation
A 68-year-old male presented to the emergency department with a respiratory distress. He was non-smoker and denied any significant past medical history. His chest computed tomography scan showed “ground glass opacities” and “consolidation areas” located especially in the peripheral sites of both lungs which were consistent with a coronavirus pneumonia and reverse transcription polymerase chain reaction amplification by a nasopharyngeal swab sample for SARS-Cov-2 was also positive. His initial therapy with hdroxychloroquine and favipiravir was started. Due to deterioration of the patient’s oxygenation, he was transferred to the intensive care unit for further treatment with non-invasive mechanical ventilation on supine position and intermittent “awake early self-proning positioning” was applied. Additionally, antibiotherapy, anticoagulant therapy, and convalescent plasma therapy were also administered to the patient. On the 17th day of the ICU admission, he was transferred back to the ward. And the patient was discharged from the hospital on the 19th day of his initial admission.

Conclusions
Although some case reports and small case series initially noted potential improvement in oxygenation by awake proning, further research is required to evaluate the exact benefits and proper applications of prone positioning in awake patients with COVID-19 pneumonia.
Excision of brain tumour in a peritoneal dialysis dependent patient by awake craniotomy: a case report
Authors: Roy Debashree , Guha Subhajit , Shah Dimple , Ghosh Indranil 
Published: October 2021

Abstract
Background
End-stage renal disease has a high prevalence worldwide. Quiet often, we come across patients with end-stage renal disease surviving on haemodialysis or peritoneal dialysis who need surgery. The management of such patients is a challenging task for the anaesthesiologist.

Case presentation
A patient suffering from end-stage renal disease on peritoneal dialysis was posted for removal of supratentorial space occupying lesion in our operation theatre. We describe the successful management of this case by the technique of awake craniotomy.

Conclusion
Awake craniotomy can be a safe alternative for high-risk patients undergoing craniotomy for brain tumours.
Traditional Sri Lankan fermented buffalo (Bubalus bubalis) milk gel (Meekiri): technology, microbiology and quality characteristics
Authors: Priyashantha Hasitha , Ranadheera C. S. , Rasika D. M. D. , Vidanarachchi Janak K. 
Published: October 2021

AbstractMeekiri (sometimes also known as Mee-Deekiri); fermented buffalo milk gel is a deep-rooted dairy product in Sri Lankan food culture and the production of Meekiri plays an integral part in the livelihood of rural farming. Meekiri consumption is widespread irrespective of geographic boundaries, across the cultural and/or ethnic communities. In Sri Lanka, buffalo milk is predominantly used in producing Meekiri, where production has been specialized in various geographic areas in the country, associated with major buffalo farming regions. Physicochemical and microbiological quality attributes are apparent to differ in Meekiri according to varying production regions, processing techniques and storage conditions. The mouthfeel and taste of Meekiri are widely accepted to be thicker and creamier with a pleasant note and is whiter in colour compared to fermented cow milk gel/yoghurt. Since Meekiri production is localized in Sri Lanka and available as traditional know-how at the primary production level, up-to-date comprehensive scientific literature that accounts for processing and detailed product quality characteristics is lacking. Hence, this review evaluates and outlines updated information about the Meekiri production, associated buffalo farming systems, quality characteristics of Meekiri including physicochemical, sensorial and microbiological aspects in the final product.
Application of acidic protease in the pickling to simplify the pelt bating process
Authors: Zhang Xu , Gao Mengchu , Chattha Sadaqat Ali , Zhu Yiwen , Peng Biyu , Ye Yongbin 
Published: October 2021

AbstractTraditionally, universally used pelt bating technologies rely on the application of trypsin, neutral and alkaline microbial proteases but suffer from complicated operation, limited bating efficiency and unsatisfactory leather performance. Therefore, devising a new pelt bating approach to achieve high bating efficiency and excellent leather performance has always been wished for by the leather industry. To pursue this goal, years of persistent research work enabled us to develop a novel approach for pelt bating by means of acidic proteases in pickling process. Initially, basic enzymatic characteristics and bating effectiveness of several typical acidic proteases in pelt pickling medium were investigated; then, the bating effectiveness through the quantitative characterization of protease activity of the optimal acidic protease was compared with that of the conventional bating enzyme. The results indicated that all of the selected acidic proteases had good salt-tolerance and exhibited optimum activity at pH 3.0–4.0. The novel pickling-bating method based on microbial origin acidic protease L80A led to an outstanding performance on pelt bating at the dosage of 150 U/mL of collagenolytic activity. The bating effectiveness of acidic protease L80A was comparable to and even better than that of trypsin BEM due to its moderate proteolytic ability. Moreover, the deep and even penetration of acidic protease in the pelt permitted it to produce soft, organoleptically stable and overall better quality crust leather than that of the conventional trypsin bating method. Additionally, pelt bating was performed along with the pickling process without extra inactivation and washing operation, making the bating operation more efficient, economical, and environment friendly. Results had made us to conclude that this cutting-edge acidic proteases based pickling-bating method could be the first step/ way forward to replace the decades-old traditional pelt bating technology.
Multidetector computed tomography study to measure thoracic aorta diameters in Egyptian population
Authors: Ismail Ahmed Shehata Mohamed , Al-Suraimi Shareefa Ali Mohammad , El Hossary Hossam El Din Ghanem , Salem Mohamed Ali , Kandil Hossam Ibrahim Hamed 
Published: October 2021

Abstract
Background
The aorta is the largest and strongest artery in the body that plays an important role in the control of systemic vascular resistance and heart rate. Aortic diseases contribute to the wide spectrum of arterial diseases that may be diagnosed after a long period of subclinical development. Multidetector computed tomographic scanners (≥ 64 detector rows) for aortic imaging remain one of the most preferred imaging techniques for diagnosis and follow-up of aortic conditions in acute as well as chronic presentations. The aim of this study is to establish a normal reference values for aortic diameters among Egyptian population and to find which of the cardiovascular risk factors could be an independent determinant of the aortic diameters.

Results
Five hundred and sixteen Egyptian individuals were enrolled in our study, the mean age was 53.5 ± 10.9, and males comprised 61.4% of the study population. Aortic root diameters measured at the annulus, sinus and STJ were 23.09 ± 2.55 mm, 33.75 ± 3.93 mm and 26.13 ± 3.05 mm, respectively. The BSA-indexed diameters were 11.70 ± 1.39, 17.10 ± 2.10 and 13.25 ± 1.65, respectively. The diameter of the tubular part of ascending aorta was 30.97 ± 4.16 mm, and the BSA-indexed diameter was 15.71 ± 2.28. The aortic diameters measured at the level of the pulmonary bifurcation were 24.56 ± 2.95 mm and 23.79 ± 2.96 mm at systolic and diastolic phases, respectively. The BSA-indexed diameters were 12.44 ± 1.52 and 12.05 ± 1.52 at systolic and diastolic phases, respectively. At the diaphragmatic level, the mean diameters were 22.39 ± 2.72 mm and 21.49 ± 2.79 mm at systolic and diastolic phases, respectively. The BSA-indexed diameters were 11.34 ± 1.43 and 10.98 ± 1.48 at systolic and diastolic phases, respectively. Age, gender, BSA, BMI and hypertension were statistically significant independent predictors of ascending and descending aortic diameters.

Conclusions
Our study established a normal reference value for thoracic aortic diameters among Egyptians using contrast enhanced MSCT aortography. Age, Gender, BSA, BMI and hypertension are the major determinants of aortic diameters.
Development, optimization, and in vitro evaluation of atorvastatin calcium and vinpocetine codelivery by solid lipid nanoparticles for cancer therapy
Authors: Lala Rita R. , Shinde Amol S. 
Published: October 2021

Abstract
Background
The main objective of the present study was to formulate, optimize and characterize solid lipid nanoparticles (SLNs) loaded with Atorvastatin Calcium (ATS) and Vinpocetine (VIN) as a potential drug delivery system to improve its solubility and assess its anti-tumor activity on cell lines. The SLNs were formulated by emulsification with high speed homogenization followed by probe sonication. Central composite design was selected for optimization. Drug: lipid ratio, surfactant: co-surfactant ratio and homogenization speed were considered critical process parameters (CPP) to study the effects on critical quality attributes (CQA) of SLNs i.e. particle size, percent entrapment efficiency (% EE) and percent drug loading (% DL).

Results
The optimized (F3) SLNs formulations were characterized by transmission electron microscopy (TEM), X- ray diffraction (X-RD), in vitro drug release by dialysis bag method and stability studies. In vitro cell line studies were performed on HepG2, MCF 7 and melanoma B16 F10 cell line. The optimized F3 formulation showed a particle size of 323 ± 6 nm, poly dispersity index (PDI) 0.333 ± 0.02, Zeta potential (ZP) − 30.4 ± 0.66 emv with % EE 64.69 ± 1.1; 65.98 ± 0.91 of ATS and VIN respectively. In vitro release (F3) of ATS and VIN in PBS pH 7.4 was found to be 89.45% and 91.86%, respectively, up to 24 h.

Conclusions
In vitro cell line study demonstrated that SLNs enhanced the anti-cancer activity of ATS, VIN on all the stated cell lines when compared with free drugs. Combination index (CI) for HEPG2 was 0.8, which signified synergistic effect. The results exhibited that SLNs is effective, stable and had enhanced activity against HepG2, MCF 7 and melanoma B16 F10 cell lines.
Delays in initiating rabies post-exposure prophylaxis among dog bite victims in Wakiso and Kampala districts, Uganda
Authors: Kisaka Stevens , Makumbi Fredrick , Majalija Samuel , Bahizi Gloria , Thumbi SM 
Published: October 2021

Background Although rabies in dog bite patients is preventable through timely initiation of post-exposure prophylaxis (PEP), a number of barriers to achieving PEP exist. This study investigated the delays to initiation of PEP among dog bite patients in the emergency departments of two PEP centers in Uganda. Methods A cross-sectional study was conducted among dog-bite patients that presented to two selected rabies PEP centers. A semi-structured questionnaire was used to collect data. Delay to receive PEP was defined as reporting for PEP beyond 24 hours after the bite event. Generalized linear models were used to calculate prevalence ratios and the 95% confidence intervals as a measure of association between delay and patient factors. Results Out of 376 participants, just over half (53.5%) were males. The majority of participants (54.0%) were 15 years or older and 28.5% had no formal education. Just over three-quarters (77.9%) had category II dog bite wounds. Nearly 40% delayed to receive PEP, and median (IQR) lag time between bite event and seeking medical care of 18 (41) hours. Compared to education level of secondary or above, patients with no formal education (adj. PR=4.06, 95% CI: 2.69 - 6.10) or primary education (adj.PR=2.15, 95% CI: 1.37 - 3.35), belonging to the lowest socio-economic tertile as compared to the highest (adj.PR=1.58, 95% CI: 1.10 - 2.28), knowing the owner of the biting dog (adj.PR=1.30, 95% CI: 1.02 - 1.65) and having category II wounds (adj.PR=2.31, 95% CI: 1.43 - 3.71) were all associated with delayed presentation for PEP. Conclusions and recommendations Delays to receive PEP are common and are associated with poor level of education or low socio-economic status, knowledge of who the dog owner is and less severity of bite wounds. Seeking care irrespective of wound severity or knowledge of dog owner should be promoted.