bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unique characteristics that distinguish suicide attempters from patients with nonsuicidal self-injury admitted to the emergency department following self-harm behavior
Authors: Kang Minhyuk , Kim Hyejin 
Published: February 2021

OBJECTIVE:
The objective was to investigate the characteristics of suicide attempters as distinguished from nonsuicidal self-injury (NSSI) among those who are admitted to the emergency department (ED) following self-harm behavior using psychological scales and biochemical markers.

MATERIALS AND METHODS:
The initial assessment forms and medical records of patients referred to the ED after self-harm behavior between March 2017 and December 2019 were retrospectively reviewed. Based on the patients' statements, two groups were formed: the NSSI group and the suicide attempt (SA) group.

RESULTS:
This study included 578 patients, 76.6% (n = 443) in the SA group and 23.4% (n = 135) in the NSSI group. A univariate analysis comparing the SA and NSSI groups revealed that the SA group was statistically significantly associated with male sex, chronic disease, history of depression, unemployment, not seeking help after the attempt, reduced consciousness, and psychiatric consultation. Further, the SA group was older and showed higher Risk-Rescue Rating Scale (RRRS) value and white blood cell value compared to the NSSI group. However, multivariate logistic analysis did not produce statistically significant results for RRRS and any of the biological markers, with one exception for the accessibility to rescue item in the RRRS, where the NSSI group showed a statistically higher “ask for help” score compared to the SA group (P < 0.01).

CONCLUSIONS:
Among patients who were admitted to the ED following self-harm behaviors, the risk factors for SA as opposed to NSSI were chronic disease and not seeking help after the attempt. In addition, suicide attempters tended to be more cooperative in psychiatric consultation following ED admission. In clinical practice, patients admitted due to NSSI should be administered treatment equivalent to that for suicide attempters if they exhibit the characteristics of suicide attempters.
Effects of metronome use on cardiopulmonary resuscitation quality
Authors: Çalışkan Dikmen , Bildik Fikret , Aslaner Mehmet Ali , Kılıçaslan İsa , Keleş Ayfer , Demircan Ahmet 
Published: February 2021

OBJECTIVE:
Whether the use of metronome affects the quality of cardiopulmonary resuscitation (CPR) remains unclear. In this study, we investigated the effect of metronome use on CPR quality.

METHODS:
This was a prospective, simulation-based CPR manikin study. There were two phases: without and with metronome use. Chest compression was performed for 2 min, and three CPR quality criteria including chest compression depth, recoil, and rate were recorded with TrueCPR Feedback Device in both phases.

RESULTS:
In all, 102 resident physicians were included. The achievement of optimal chest compression depth and complete recoil was better with metronome use than without (83% and 77% vs. 78% and 39%, P ≤ 0.001, respectively). Optimal chest compression rate was also reached with metronome use because the range of the compression rate was closer to the normal limits than those without metronome use (110 [interquartile range (IQR) 109–113] vs. 120 [IQR 109–129], P ≤ 0.001). Of all the participants, 70.6% stated that metronome use had a positive effect on their performance during the CPR application and 66.7% stated that they wished to use the metronome in their daily practice.

CONCLUSION:
Using a metronome during simulation-based CPR improved the compression depth and recoil by fixing chest compression rate. We suggested that metronome should be used in CPR trainings of health-care professionals.
Randomized controlled trials of remdesivir in hospitalized coronavirus disease 2019 patients
Authors: Sarfraz Azza , Sarfraz Zouina , Sanchez-Gonzalez Marcos , Michel Jack , Michel George , Frontela Odalys , Posada Jorge , Cardona Jose , Angueira Eugenio 
Published: February 2021

BACKGROUND:
The first cases of the coronavirus disease 2019 (COVID-19) were reported in Wuhan, China. No antiviral treatment options are currently available with proven clinical efficacy. However, preliminary findings from phase III trials suggest that remdesivir is an effective and safe treatment option for COVID-19 patients with both moderate and severe disease.

OBJECTIVE:
The aim of the present meta-analysis was to investigate whether remdesivir was effective for treating COVID-19 including reduced in-hospital adverse events, oxygen support, and mortality rates.

METHODS:
According to the PRISMA reporting guidelines, a review was conducted from January 1, 2020, until August 25, 2020, with MeSH terms including COVID-19, COVID, coronavirus, SARS-CoV-2, remdesivir, adenosine nucleoside triphosphate analog, and Veklury using MEDLINE, Scopus, and CINAHL Plus. A modified Delphi process was utilized to include the studies and ensure that the objectives were addressed. Using dichotomous data for select values, the unadjusted odds ratios (ORs) were calculated applying Mantel–Haenszel random-effects method in Review Manager 5.4.

RESULTS:
Randomized controlled trials pooled in 3013 participants with 46.3% (n = 1395) in the remdesivir group and 53.7% (n = 1618) in the placebo group. The placebo group had a higher risk of mortality as compared to the intervention group with significant OR (0.61) (95% confidence interval of 0.45–0.82; P = 0.001). There was minimal heterogeneity among the studies (I
2 = 0%).

CONCLUSIONS:
Our findings suggest that remdesivir extends clinical benefits by reducing mortality, adverse events, and oxygen support in moderate to severely ill COVID-19 patients. Concerted efforts and further randomized placebo-controlled trials are warranted to examine the potency of antiviral drugs and immunopathological host responses contributing to the severity of COVID-19.
Thoracoscopic oesophago-oesophagostomy in the prone position for oesophageal stenosis caused by dilated azygos vein in polysplenia-associated heterotaxy
Authors: Bhojwani Rajesh , Jain Nikhil 
Published: February 2021

Background:
Heterotaxy syndrome is associated with a plethora of cardiovascular and other multi-system anomalies with a high childhood mortality. A dilated azygos vein as part of the polysplenia variant of heterotaxy syndrome may cause oesophageal stenosis owing to a prolonged compression. We describe our technique of extramediastinal oesophago-oesophagostomy in the prone position for this rare congenital syndromic malformation with an excellent outcome.

Patients and Methods:
A 17-year-old boy with heterotaxy syndrome presented with intermittent dysphagia and postprandial emesis with failure to thrive. Despite the presence of diverse anatomic abnormalities, it was only his symptom of dysphagia due to oesophageal stricture that merited surgical intervention. He underwent an azygos-preserving extramediastinal oesophago-oesophagostomy in the prone position without segmental resection with the establishment of continuity using a modified Collard-type anastomosis.

Results:
The patient had an uneventful convalescence, with imaging after 1 year showing no re-stenosis. After a follow-up of 3 years, the patient is free of symptoms and has gained weight.

Conclusion:
Oesophageal stenosis may result from prolonged compression by anomalous vasculature. An isolated correctable anatomic derangement, young age with good functional reserve, other associated anomalies not causing any symptoms, the physiological advantages of executing the surgery in a prone position and availability of expertise in minimally invasive surgery ensured excellent outcomes. The hitherto unreported technique may open up avenues for further research regarding the behaviour of the oesophageal muscular tube with transection and re-anastomosis for rare benign abnormalities.
Dosimetric Comparison of Two Type'S Applicator Geometry in the Three-Dimensional Computed Tomography Image-Based Intracavitary Brachytherapy Treatment Planning of Carcinoma Uterine Cervix
Authors: Yogi Veenita , Chandel Sanjay Singh , Yadav Suresh , Singh Om Prakash , Goswami Brijesh , Ghosh Gopa , Choudhary Suryanshu 
Published: February 2021

Background:
The swift dose fall-off traits with distance from the applicators are the dominant advantage of brachytherapy. The differences in applicator designs will produce different dose distributions in intracavitary brachytherapy (ICBT) applications.

Aim:
The present study was aimed to find out the dosimetric differences for two type's applicators geometry in ICBT applications for carcinoma uterine cervix (Ca-Cx) performing three-dimensional computed tomography (3D-CT) image-based planning as per recent guidelines from the International Commission on Radiation Units and Measurements report-89.

Materials and Methods:
Retrospectively, 15 patients of Ca-Cx who have received ICBT treatment based on the 3D-CT image during 1st and 2nd fractions using fixed-geometry and flexible-geometry applicators respectively were selected for this study. For comparison of two type's applicators geometry the dose-volume parameters D100% and D90% of high-risk clinical target volume (HR-CTV), V400%, V200%, V150%, V100%, V50% (volume enclosing 400%, 200%, 150%, 100%, and 50% isodoseline of prescribed dose around target, respectively), and average point “A” dose were evaluated for target. While for organs at risk (bladder, rectum, and sigmoid colon) the dose-volume parameters D2cc, D1cc, and D0.1cc were recorded and evaluated.

Results:
Fixed-geometry applicator produces significantly lesser HR-CTV volume (P = 0.016 <0.05) but delivered significantly 10.88% higher D90 mean doses (P = 0.031 <0.05) in comparison to flexible-geometry applicator. The flexible-geometry applicator created significantly higher central dose-volume structures around the target at the cost of significantly 15.89%, 17.04%, and 18.88% higher mean doses for rectum D2cc, D1cc, and D0.1cc, respectively, insignificant higher bladder dose, but lower sigmoid colon doses.

Conclusion:
The results of this study will be helpful to clinicians to select appropriate/suitable geometry applicator according to the patient's anatomical structure in brachytherapy treatment of Ca-Cx for better clinical outcome.
Study of Dry Eye Parameters in Diabetics in a Tertiary Care Hospital
Authors: Patil Sakshi , Bishnoi Sunita , Joshi Ajit 
Published: February 2021

Aim:
This study aims to study the frequency and severity of dry eye in diabetic patients and their correlation with duration of diabetes.

Materials and Methods:
This cross-sectional prospective study was conducted on all patients with diabetes mellitus presenting to ophthalmology department of a tertiary care hospital between November 1, 2019, and December 31, 2019. The study population included diabetic patients who were above the age of 40 years. Detailed ocular history including diabetic history was recorded and comprehensive ocular clinical examination to assess the dry eye status was done. Schirmer's I test and Tear film Break-Up Time (TBUT) tests were performed and results were recorded.

Results:
In this study, 100 eyes of 50 diabetic patients were subjected to dry eye tests. Varying degree of dryness was seen in 34 patients (68%). Schirmer's test was abnormal (<10 mm) in 24 patients (48%) and TBUT test was abnormal (<10 s) in 34 patients (68%). Majority of patients (60%) were asymptomatic. Statistically significant association was seen between the duration of diabetes with Schirmer's I test and TBUT test (P = 0.00).

Conclusion:
Dry eyes are a frequent association seen in patients with diabetes. Simple noninvasive tests for dry eyes such as Schirmer's test and TBUT test should be considered as an integral part of routine examination in diabetics as these may be asymptomatic.
Awareness and willingness to participate in clinical trials in Togo
Authors: Amadou A. , Dziri S. , Foma W. , Gbadamassi A. 
Published: February 2021

Context:
Clinical Trials (CTs) are the key when it comes to informing clinical decision-making processes. There is a very low number of CTs conducted in Togo, and there is no study that assessed the willingness of Togolese to participate in CTs.

Aims:
The aim of this study was to assess public awareness and willingness to participate in CTs in Togo.

Subjects and Methods:
We designed a cross-sectional study, using an online survey with Google Form in the general population, carried out from December 2019 to March 2020.

Statistical Analysis Used:
An Excel sheet was generated from the Google Form, and we performed a descriptive analysis using IBM SPSS Statistics 21. All variables were presented as frequencies and percentages.

Results:
This study involved 210 participants. The findings of this study are showing that Togolese are reasonably aware about CTs, and they have a positive intention to participate, but they are ignorant of national CTs regulations. Although unawareness and unwillingness may be universally common, one challenge in Togo is the lack of communication.

Conclusions:
The findings of this study are encouraging. The National Bioethics Committee for Health needs to be better communicative, and providing training in clinical research is essential.
The efficacy of the application of the curative criteria of the 5th edition Japanese gastric cancer treatment guidelines for early adenocarcinoma of the esophagogastric junction treated by endoscopic submucosal dissection
Authors: Chen Zhihao , Liu Yong , Dou Lizhou , Zhang Yueming , He Shun , Wang Guiqi 
Published: February 2021

Background:
The curative criteria after endoscopic submucosal dissection for early gastric carcinoma were updated by the Japanese Gastric Cancer Association. No study has shown promising results with endoscopic submucosal dissection for early adenocarcinoma of esophagogastric junction based on the new curative criteria. The purpose of this study was to validate clinical efficacy of the application of the curative criteria of the 5th edition Japanese gastric cancer treatment guidelines for early adenocarcinoma of esophagogastric junction after endoscopic submucosal dissection.

Methods:
Patients who underwent endoscopic submucosal dissection for Siewert type II adenocarcinoma between January 2013 and June 2018 were eligible for this study. Clinical and pathological features and treatment outcomes were retrospectively reviewed using medical records.

Results:
The success rate for en-bloc resection was 97.2% (172/177) and the curative resection rate was 71.2% (126/177). Additional endoscopic submucosal dissection or radical surgery was conducted in 10 patients (5.6%) who did not fulfil the curative resection criteria, while one patient with curative resection remedied with endoscopic submucosal dissection because of recurrence. According to eCura scoring system, 94 patients (53.1%) were categorized into eCura A, 34 patients (19.2%) into eCura B, 11 patients (6.2%) into eCura C-1, and 38 patients (21.5%) into eCura C-2. Five patients categorized as eCura C-2 underwent radical surgery, two of whom have lymph node metastasis.

Conclusions:
Endoscopic submucosal dissection for early adenocarcinoma of esophagogastric junction that met the expanded criteria of the 5th edition Japanese gastric cancer treatment guidelines were acceptable and should be the standard treatment instead of surgical resection.
Bilateral renal involvement in diffuse large B-cell lymphoma on fluorodeoxyglucose positron emission tomography/computed tomography
Authors: Benameur Yassir , Hammani Adnane , Doghmi Kamal , Doudouh Abderrahim 
Published: February 2021

AbstractSecondary renal involvement in patients with diffuse large B-cell lymphoma (DLBCL) is rare and associated with poor prognosis. We, hereby, described a case of a patient diagnosed with DLBCL, in whom bilateral renal involvement was detected on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). The patient received 4 courses of chemotherapy, and follow-up 18F-FDG PET/CT revealed the complete resolution of the diffuse increased renal 18F-FDG uptake. Renal lymphoma is uncommon and 18F-FDG PET/CT is particularly useful for detecting extranodal involvement in DLBLC.
Tinjauan Runway Occupancy Time Landing terhadap Konfigurasi Taxiway diBandar Udara Haluleo Kendari
Authors: Idyaningsih Nining 
Published: February 2021

Keteraturan Lalu lintas Udara di Bandar Udara Haluoleo Kendari belum sepenuhnya terpenuhi karena terbukti masih sering terjadi pesawat yang menggunakan opposite runway harus delay. konflik antara depature and arrival aircraft pada kondisi dimana pesawat akan take-off dari runway 08 dan landing runway 26. Tujuan penelitian untuk mengetahui pengaruh Runway Occupancy Time landing setiap Pesawat yang beroprasi di Bandar Udara Haluoleo Kendari. Metode yang digunakan yaitu membandingkan antara konfigurasi taxiway dan Runway Occupancy Time landing dengan ICAo Doc 9157 - Aerodome design manual part 2 taxiway, keseimbangan antara kapasitas maksimum dan efisiensi dari sebuah aerodrome itu terletak pada balance between runway and apron is taxiway sebagai penghubung. Hasilnya ROTL pesawat yang beroperasi terlalu besar dan untuk efisiensi penerbangan harus dikurangi karena sering menghambat pesawat yang akan lepas landas.
Response Behavior, Emotional and Psychosocial Adjustment of Adults to Covid-19 Pandemic Health Protocols in Western Region of Kenya
Authors: Ogutu Joel Peter , Mabele Nanyama Elizabeth 
Published: February 2021

Purpose: Covid-19 has caused more than 700 deaths with more than 40 thousand infections in Kenya, by end mid October 2020. Undoubtedly, the COVID-19 pandemic contributes to unprecedented spread response behavior and emotional distress among people. The introduction of new health protocols has been a key factor in shaping new norm and psychological behavior, emotional response and adjustment. However, new behavior norms meant to curb spread of COVID-19 has not been without uncertainty. Therefore, the study seeks to establish Adults’ response behavior, emotional and psychological adjustment to COVID19 pandemic global health protocols as emphasized by health subsector in Kenya.Methodology: In this cross-sectional study, 251 adults living in Western region of Kenya completed a survey questionnaire to evaluate the response behavior, emotional response and psychosocial adjustment of adults to covid-19 pandemic health protocols in Western region of Kenya. The survey Questionnaires were districted to target adult participants using WhatsApp and e-mail address during the pandemic. Descriptive statistics, independent sample t-test, and one-way ANOVA were employed to analyze data.Findings: Three tests were conducted and overall, the findings revealed insignificant difference between categorical variables (gender, level of education and occupation category and dependent variables (response behavior, emotional response and psychosocial adjustment of adults to COVID-19 health protocols. The results revealed statistically insignificant differences between; gender and response behavior (t (249) =.583, p ˃0.05), occupation categories and psychosocial adjustment to COVID-19 pandemic (F (3,247) = .516, p ˃0.05), and level of education and emotional responses to COVID-19 health protocols (F (3, 247) = 1.974, p ˃0.05).Unique Contribution to theory, practice and policy: These findings suggest that response behavior response, emotional response and psychosocial adjustment to COVID-19 health protocols do not differ with categorical variables of the adults. The focus therefore should be to work on response behavior, emotional response and psychosocial adjustment indiscriminately in order to help people adapt to the new behavior and norm to curb spread of COVID-19 pandemic.
Uptake of Courses and Finance Availability as Predictors of the Success of Expansion Strategies in Public Training Institutions: A Case Study of Kenya Medical Training College
Authors: Musango Paul Chandoo , Kimwetich Daniel K. 
Published: February 2021

This study investigates the influence of uptake of courses and finance availability on the expansion strategies in public training institutions with reference to the Kenya Medical Training College. The specific objectives of the study are to: reveal the influence of uptake of courses on the success of expansion strategies in the public training institutions and; assess the influence of finances on the success of expansion strategies in the public training institutions. This study is based on the Ansoff Growth Matrix (AGM) and the theory of customer responsiveness. It adopts the descriptive survey design. The study focuses on 2393 KMTC officers from the 73 KMTC campuses in Kenya, 42 ministries of health officials in the 42 counties that have KMTC campuses, and 42 local leaders from those counties that have KMTC campuses. The total targeted study participants were thus 2477. From these, 10% (248 persons) were sampled. The study used purposive and stratified random sampling techniques to obtain the study sample. Primary data was collected using structured questionnaires and interviews. Data from questionnaires were analysed using the Statistical Package for the Social Sciences (SPSS) version 24. Descriptive statistics (frequencies, percentages, and means) were used to describe the central tendencies of the data. In addition, inferential statistics (Pearson Correlation and Multiple Regression Analysis) were also used. Data from key informants were analysed using content analysis techniques. The findings show that the two study variables influenced the success of expansion strategies at KMTC campuses. In this regard, Pearson correlation shows that there was statistical significant relationship between uptake of courses (r=.308, p<0.001)and; finance availability (r=0.673, p<0.001) and success of expansion strategies. These findings show that finance availability was the strongest factor that influenced the success of expansion strategies. As such, the success of expansion strategies can only be successful if the college put in place strategies aimed at ensuring that there was sufficient finances. This could go on to enhance the development of facilities and equipping them. An effort aimed at ensuring that new campuses had a high intake of students could also contribute to the level of success of expansion strategies at KMTC. High intakes could enhance the revenue generation, further enhancing the funding and success of new KMTC campuses.
Ternary Solid Dispersion Strategy for Solubility Enhancement of Poorly Soluble Drugs by Co-Milling Technique
Authors: Bejaoui Marouene , Oueslati Hanen , Galai Haykel 
Published: February 2021

Amorphous ternary solid dispersion has become one of the strategies commonly used for improving the solubility and bioavailability of poorly water soluble drugs. Such multicomponent solid dispersion can be obtained by different techniques, this chapter provides an overview of ternary solid dispersion by co-milling method from the perspectives of physico-chemical characteristics in vitro and in vivo performance. A considerable improvement of solubility was obtained for many active pharmaceutical ingredients (e.g., Ibuprofen, Probucol, Gliclazid, Fenofibrate, Ibrutinib and Naproxen) and this was correlated to the synergy of multiple factors (hydrophilicity enhancement, particle size reduction, drug-carrier interactions, anti-plasticizing effect and complexation efficiency). This enhanced pharmacokinetic properties and bioavailability of these drug molecules (1.49 to 15-folds increase in plasma drug concentration). A particular focus was accorded to compare the ternary and binary system including Ibuprofen and highlighting the contribution of thermal and spectral characterization techniques. The addition of polyvinylpyrrolidone (PVP K30), a low molecular weight molecule, into the binary solid dispersion (Ibuprofen/β-cyclodextrin), leads to a 1.5–2 folds increase in the drug intrinsic dissolution rate only after 10 min. This resulted from physical stabilization of amorphous Ibuprofen by reducing its molecular mobility and inhibiting its recristallization even under stress conditions (75% RH and T = 40°C for six months).