bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immediate Intravenous Epinephrine (Within 1-minute) Versus Early Intravenous Epinephrine (After 1-minute) for In-Hospital Cardiopulmonary Arrest: A Multicenter Retrospective Review
Authors: Bakhsh Abdullah , Safhi Maha , Alghamdi Ashwaq , Alharazi Amjad , Alshabibi Bedoor , Alobaidi Rajwa , Alnashri Maryam 
Published: January 2021

Abstract
Background: intravenous epinephrine has been a key treatment for cardiopulmonary arrest since the early 1960s. Although, many studies have questioned neurological outcome benefit, it remains to be recommended in international guidelines for its benefit on return of spontaneous circulation (ROSC). The ideal timing for the first epinephrine dose is uncertain. We aimed to look at the association of immediate epinephrine administration (within 1-minute of cardiac arrest recognition) with return of spontaneous circulation (ROSC) up to 24-hours and beyond 24-hours.Methods: this was a multicenter retrospective chart review of patients undergoing cardiopulmonary resuscitation.Results: immediate epinephrine administration (within 1-minute) is associated with higher rates of ROSC up to 24-hours (OR=2.36, 95% CI; [1.46-3.81]) and beyond 24-hours (OR=2.26, 95% CI; [1.06-4.83]).Conclusions: we encourage immediate administration of epinephrine in conjunction with high-quality CPR, as this is associated with higher rates of ROSC.
Aortic Arch Aneurysm. Compression Respiratory Complications as a Vital Indication for Emergency Surgery.
Authors: Balkhy Husam H. , Komarov Roman , Parshin Vladimir , Ismailbayev Alisher , Kurasov Nikolay , Keyko Olga , Ivashov Ivan , Danachev Alexander 
Published: January 2021

Abstract
Background: giant thoracic aortic aneurysms and aortic arch dissections are accompanied by high mortality rates, cardiac and neurologic events and pulmonary complications. Aorta-tracheal fistula and tracheobronchial compression are formidable and well-known complications of aneurysms of the thoracic aorta. Twenty-two percent of aneurysms that size >6 cm are ruptured with 80% mortality rate.Case presentation: a 56-year-old man with severe multivascular coronary artery injury and giant aneurysm of ascending aorta and aortic arch, complicated by respiratory failure and recurrent community-acquired pneumonia. Preoperative chest CT showed giant partially-thrombosed ampullary false aneurysm of ascending aorta, aortic arch and initial part of the thoracic aorta, 80x100x65 mm in size. Patient successfully underwent simultaneous surgical intervention with artificial blood circulation, the total time of cardiopulmonary bypass was 190 minutes.Conclusions: tracheobronchial compression syndrome with the aortic arch aneurysms is one of the urgent conditions that needs emergency surgery. Urgent indications for surgery in such cases include both significant size of the aneurysm and high risk of rupture, as well as potential for developing critical respiratory failure and recurrent nonresolving pneumonias. Preoperative CT enables to find out the exact location and evaluate the degree of airway compression, which determines further intraoperative actions. We recommend to use bronchoscopy at all steps of treatment of such patients, from intubation in operating room to extubation in intensive care unit. Thus, aggressive surgical tactics along with careful pre-operative diagnostic are the key to success and the only chance for such patients.
Coexistence of Papillary Thyroid Carcinoma in Secondary Hyperparathyroidism
Authors: Ma Junhao , Mao Zhuochao , Yao Yunjin , Lu Yimin , Wang Haohao , Yang Yan , Yang Jun , Wang Weibin , teng lisong 
Published: January 2021

Abstract
Background: Coexistence of primary hyperparathyroidism and papillary thyroid carcinoma is common and may be associative with more aggressive papillary thyroid carcinoma for higher rates of extrathyroidal extension and multicentricity. However, it remains unclear whether secondary hyperparathyroidism accounts for more invasive papillary thyroid carcinoma in terms of morbidity, tumor pathological characteristics and prognosis. The aim of this study was to evaluate the rate and tumor characteristics of papillary thyroid carcinoma in patients of SHPT.Methods: A total of 531 patients diagnosed of SHPT and underwent surgery were evaluated retrospectively from January 2013 to December 2018 in the first affiliated hospital of the Zhejiang University. Patients’ demographics, operation records and follow-up information were recorded and analyzed. Among them, 34 patients had PTC concurrent with SHPT (PTC+SHPT) were enrolled. Control subjects were derived through 1:4 matching for age, sex and gender pathological subtype. 136 patients of papillary thyroid carcinoma were selected as control group after matching 1:4 for age, gender and pathological subtype.Results: There were 34 patients coexisting with PTC+SHPT among the 531 surgery patients diagnosed as SHPT (6.4%). Mean tumor diameter of PTC+SHPT group was smaller than that in PTC group(5.57mm vs 9.00mm, p＜0.001). The proportion of papillary thyroid micro-carcinoma in PTC+SHPT group were significantly higher than that in PTC group [29 (85.29%) vs 86 (63.24%), P=0.014]. There were no statistically significant difference among the tumor multicentricity [15 (44.12%) vs 39 (28.68%), P=0.066], tumor bilaterality [9(26.47%) vs29(21.32%), P=0.499]，tumor extrathyroidal extension [2(5.88%) vs19 (13.97%), P=0.255] and lymph node metastasizes rate [12 (35.29%) vs 49 (36.03%), P=1.000]. We found differences between PTC+SHPT group and PTC group patients with respect to contralateral thyroidectomy [10 (29.41%) vs 70(51.47%), P=0.023] and lymph node dissection [22 (64.71%) vs 125(91.91%), P＜0.001].There was no significant difference between PTC+SHPT group and PTC group in prognostic staging [33 (97.06%) vs 122 (89.71%), P=0.309] and recurrence [mean follow-up time 36 months vs 39 months, P=0.33].Conclusions: The prevalence of PTC is high in patients with SHPT. Compared with PTC in the general population, most of PTC with SHPT are occult thyroid carcinoma and present no significant difference in tumor pathological features and prognostic staging. It is necessary for surgeons to make more adequate preoperative prediction and do more careful examination during the surgery in case of missing the coexistence of PTC in SHPT patients.
Natural history of chronic hepatitis B infection in Eritrean patients: a laboratory-based cross-sectional study
Authors: Hamida Mohammed Elfatih , Raja Saud Mohammed , Seyoum Yemane , Elkhidir Isam Mohammed , Tekle Freweini 
Published: January 2021

Abstract
Background Understanding the natural history of chronic hepatitis B (CHB) virus infection is important for determining optimal management and predicting prognosis in patients. The aim of this study was to determine the prevalence of different phases of CHB infection among Eritrean patients and to identify the proportion of patients eligible for treatment according to 2018 American Association for the Study of Liver Diseases (AASLD) guidelines.Methods This cross-sectional study enrolled 293 CHB patients between Jan 2017 and Feb 2019 and classified them into four groups, namely, immunotolerant, immune clearance, immune control, and immune escape, based on the results of Hepatitis B virus (HBV) serological panel (HBsAg, anti-HBc total, HBeAg and anti-HBe), ALT levels, and HBV DNA viral load.Results Our study cohort of 293 patients comprised 213 males and 80 females, with a mean age of 41.66 ± 13.84 years. Of these, 5 (1.7%) were at the immune tolerant phase, 46 (15.7%) at immune clearance, 217 (74.1%) at immune control, and 25 (8.5%) at immune escape phase; thus, 71 (24.2%) patients were eligible for treatment, i.e., patients in immune clearance and immune escape phases. As most subjects (93%) were HBeAg-negative, based on AASLD guidelines, only 5 (1.7%) were eligible for treatment, and these patients were part of the group of 71 patients eligible for treatment based on chronic HBV status.Conclusions Our data show that CHB patients in Eritrea were predominantly in the immune control phase. Although initiating antiviral therapy is not recommended in these patients, periodic assessment of liver function and disease severity should be considered in patients older than 40 years. The immunotolerant phase had the fewest patients, most of whom were above 20 years old, attesting to the success of incorporating HBV vaccine in the national childhood immunization program since 2002. Our study shows that adopting AASLD treatment guidelines with adjustments to suit the local setting represent a suitable option in the management of Eritrean CHB patients.
Current Substances Use Among Students in Ethiopia: A Systematic Review and Meta-analysis of 20-years Evidence
Authors: Roba Hirbo Shore , Gebremichael Berhe , Abdi Hassen , Beyene Addisu Shunu 
Published: January 2021

Abstract
Background: The use of psychoactive substances is the main cause of morbidity and becomes important public health and socio-economic issue worldwide. However, there is a lack of evidence on the magnitude of current use substances among students in Ethiopia. Therefore, this review and meta-analysis aimed to provide comprehensive views of the current prevalence of substance use among students in Ethiopia.Methods: Literature searches were done from electronic biomedical databases; PubMed/Medline, HINARI, AJOL, Google Scholar, Science Direct and manully seared master thesis and dissertation done until 31/12/2019. Two authors autonomously selected studies, extracted data, and evaluated the quality of studies. The prevalence of current substances with 95% confidence interval (95%) estimated using the random-effects model. The results were displayed using forest plots, and Cochrane Q-test and I2 use to measure the extents of between-study variations.Results: A total of 1543 study articles were identified from electronic databases, and 32 of them were included in the meta-analysis. The prevalence of current use of at least one substance was 37.63% (95% CI: 33.66, 41.69; I2=91.2%, P<0.00), alcohol 27.61% (95%CI: 22.10, 33.48; I2=98.08%, P<0.00), khat 17.20% (95%CI: 14.03, 20.62; I2=97.2%, p<0.00) and smoking 9.74% (95%CI: 7.17, 12.64; I2=95.06%, P<0.00). Subgroup analysis revealed that the prevalence of any substance by high school students versus university/college students was 41.55% (95% CI: 38.83, 44.29) vs 36.24% (95% CI: 32.37, 40.20), alcohol 24.21% (95% CI: 14.05, 36.11) vs 25.27% (95% CI: 19.76, 31.20), khat 13.82% (95% CI: 8.61, 20.02) vs 17.30% (95%CI:13.75, 21.16), and cigarette 8.30% (95% CI: 1.89, 18.60) vs 9.80% (95% CI: 7.32, 12.58). Meta-regression analysis revealed publication year, sample size, female proportion, and age was not significantly associated with the current use of substances.Conclusion: The prevalence of the current use of substances was high and highlights the extent the problem among students in Ethiopia. Overall currrent substance use was high for all substances use categories; any substance, alcohol, chewing khat and smoking cigarettes. Comparable to university/college students a significant propoartion of high school students were already using susbstances before joining teritiary education. Caution is needed while interpreting the findings due to significant heterogeneity between studies. Policymakers should formulate and implement strictly binding regulations to control the pervasive use of substances around educational institution sites at the national level. Protocol registration: The protocol has been registered on 19 Auguest 2019 on PROSPERO (the International Prospective Register of Systematic Reviews) with ID: CDR42019130560.
Distributed Groundwater Recharge Potentials Assessment Based on GIS&nbsp;Model and Its Dynamics in the Crystalline Rocks of South India
Authors: Fauzia Fauzia , Lagudu Surinaidu , Rahman Abdur , Ahmed Shakeel 
Published: January 2021

Abstract
Extensive change in land use, climate, and over-exploitation of groundwater has increased pressure on aquifers, especially in the case of crystalline rocks throughout the world. To support sustainability in groundwater management, require proper understating of groundwater dynamics and recharge potential. The present study utilized a GIS-based Weighted Overlay Index (WOI) model to identify the potential recharge zones and to gain deep knowledge of groundwater dynamics. The in situ infiltration tests have been carried out, which is the key process in groundwater recharge and is neglected in many cases for WOI. In the WOI, 10 thematic layers from the parameters influencing and involved in the recharge process are considered to identify potential recharge zones. The results suggested a significant underestimation of recharge potential, without considering site-specific infiltration rates that one needs to be considered. The WOI model considering in situ infiltration information classified the entire area into four recharge zones, good, moderate, poor, and very poor. The final integrated map compared with the real-time field data like water level fluctuation and infiltration to analyse occurrence and quantification of recharge. The estimated average groundwater draft is 21.9 mcm while annual renewable recharge is only 5.7 mcm that causing a continuous fall of the groundwater table. The study is useful in selecting regions with more focussed recharge studies and suggested that the need of reducing groundwater demand with the change in cropping pattern through a predictive decision support tool.
Radiofrequency Therapy Improves Exercise Capacity of Mice with Emphysema
Authors: Tsutsui Mai , Cheung Chung Yan , Wada Takeyuki , Jaw Jen-erh , Yang Cheng Wei Tony , Bernatchez Pascal , White Zoe , Yang Chen Xi , Bae Eun Jeong , Choi Lauren H. , Gelbart Dan , Lichtenstein Samuel , Machan Lindsay , Elizur Eran , Wolff Kim , Goodacre Evan , Lipnicki Marek , Wong Denny , Sin Don 
Published: January 2021

Abstract
Background; Emphysema is a common phenotype of chronic obstructive pulmonary disease (COPD). Although resection of emphysematous tissue can improve lung mechanics, it is invasive and fraught with adverse effects. Meanwhile, radiofrequency (RF) treatment is an extracorporeal method that leads to tissue destruction and remodeling, resulting in “volume reduction” and overall improvement in lung compliance of emphysematous lungs. Whether these changes lead to improved exercise tolerance is unknown. Here, we investigated the effectiveness of RF treatment to improve the exercise capacity of mice with emphysema.Methods;Fifty-two mice (7 weeks of age) were used in this experiment. A bilateral emphysema model was created by intratracheally instilling porcine pancreatic elastase (PPE) (1.5U/100g body weight). RF treatment (0.5W/ g body weight) was performed extracorporeally 14 days later and mice were sacrificed after another 21 days. The exercise capacity of mice was measured using a treadmill. Treadmill runs were performed just before PPE instillation (baseline), before RF treatment and before sacrifice. Following sacrifice, lung compliance and mean linear intercept (Lm) were measured and fibrosis was assessed using a modified Ashcroft score.Results; There were 3 experimental groups: controls (instilled with saline, n=12), emphysema (instilled with porcine pancreatic elastase, PPE, n=11) and emphysema + treatment (instilled with PPE and given RF, n=9). At endpoint, the maximum velocity of the emphysema + treatment group was significantly higher than that of the emphysema group, indicating improved exercise tolerance (86.29% of baseline vs 61.69% of baseline, p=0.011). Histological analysis revealed a significant reduction in emphysema as denoted by Lm between the two groups (median 29.60 µm vs 35.68 µm, p=0.033). The emphysema + treatment group also demonstrated a higher prevalence of lung fibrosis (≧Grade 3) compared with the emphysema group (11.7% vs 5.4%, p<0.0001). No severe adverse events from RF were observed.Conclusion;RF treatment improved the exercise capacity of mice with emphysema. These data highlight the therapeutic potential of RF treatment in improving the functional status of patients with COPD.
Branchial Chamber and Gastrointestinal Tracts Parasites of Fish Species in Rivers Niger and Benue at Lokoja, North Central, Nigeria
Authors: Onoja-Abutu Agatha Eleojo , Okpanachi Martin Abdubala , Yaro Clement Ameh , Nasif Omaima , Alharbi Sulaiman Ali , Batiha Gaber El-Saber 
Published: January 2021

Abstract
Background

Freshwater fish species are posing health challenges by either serving as host of parasites that are harmful to man and animals. This study was conducted to determine the parasitic profile of the branchial and gastrointestinal tracts of freshwater fish species from Niger and Benue Rivers at Lokoja. Fish samples were collected within a period of 12 months, the species and sex of the fish were identified. The two opercula of each fish were removed and examined for parasites, parasites recovered were preserved in 0.7% physiological saline. Gastrointestinal tracts were removed from each fish, placed in physiological saline and examined microscopically for parasites. Prevalence of parasites was calculated and comparison among categories was done using chi-square and student t-test.
Results

A total of seven parasites species were harboured in branchial chamber and gastrointestinal tracts of fish species from Rivers Niger and Benue at Lokoja; Clinostomum sp. (trematode), Camallanus sp. (nematode), Capillaria sp., Rhabdochona congolensis (nematode), Contracaecum sp. (nematode), Proteocephalus sp. (cestode) and Spinitectus guntheri. T. zilli 81(95.3%) had the highest prevalence while O. niloticus, Clarias sp., S. schall and M. atlanticus had prevalence of 87(89.7%), 96(80.0%), 48(70.6%) and 27(38.6%) respectively with prevalence of 191(80.3%) and 148(73.3%) in females and males respectively. The gastrointestinal tracts 287(65.2%) was significantly harboured more parasites than branchial chamber 52(11.8%).
Conclusion

Fish species in Rivers Niger and Benue are highly infected with parasites. Fish consumers should subject the fish to proper processing before consumption, as some of these parasites maybe of zoonotic importance.
Classifying Patients Seen at an Urban Healthcare for the Homeless Site: A Clinically-Driven Latent Class Analysis
Authors: Mitchell Matthew , Chan Brian , King Caroline , Sledd Miles , Dorr David , Solotaroff Rachel 
Published: January 2021

Abstract
Introduction: Federally qualified health centers (FQHC) provide care to over 28 million people in the United States, primarily serving people with low incomes who are underinsured or not insured. FQHC patients have different patterns of illness than non-FQHC populations, which may require tailored interventions to support at the population level. Model based segmentation methods can identify patterns of need but may generate spurious results without clinical context. Here, we used stakeholder feedback combined with machine learning methods to identify subgroups of patients seen by a large FQHC in an urban setting. Methods: We used electronic health record and administrative hospital utilization data to identify subgroups of patients seen at the FQHC in 2017 using latent class analysis (LCA). We designed an activity to gather feedback from physicians, social service staff, and administrators during model design. We trained a final model using a feed-forward neural network.Results: Using data from 5,985 primary care patients, we identified four candidate LCA models—with 26, 27, 28, and 29 classes—and integrated inter-professional feedback to develop a final model with 19 clinically meaningful classes. Three classes had greater medical complexity and older age, 15 classes were separated primarily by behavioral health diagnoses, and a final class had low complexity.Conclusions: Populations served by FQHCs are clinically heterogenous with varying levels of complexity. Use of LCA can provide insights into patterns among FQHC patients, which can be used to inform the development of interventions tailored to the needs of specific classes.
Specific Time Determinism: Circadian Rhythm of Microbial Community Assembly Patterns Under Common Light in Feces of Laying Hens
Authors: Zhang Yu , Sun Lan , Zhu Run , Zhang Shiyu , Wang Yan , Wu Yinbao , Liao Xindi , Mi Jiandui 
Published: January 2021

Abstract
BackgroundAs an important part of biological rhythm, the circadian rhythm of the gut microbiota plays a crucial role in host health. However, few studies have determined the associations between the circadian rhythm and gut microbiota in laying hens. The purpose of this experiment was to investigate the circadian rhythm of the feces microbiota in laying hens.ResultsFeces samples were collected from ten laying hens at nine different time points (06:00-12:00-18:00-00:00-06:00-12:00-18:00-00:00-06:00) to demonstrate the diurnal oscillation of the feces microbiota. We described the phenomenon of circadian rhythmicity of the feces microbiota in laying hens based on 16S rRNA gene sequencing. According to the results, the α and β diversity of the feces microbiota fluctuated significantly at different time points. Beta Nearest Taxon Index analysis suggested that assembly strategies of the abundant and rare amplicon sequence variants (ASVs) sub-communities are different. Abundant ASVs preferred disperal limitation (weak selction), whereas rare ASVs randomly formed due to the “non-dominant” fractions. Highly robust circadian fluctuations were found, for instance, in Firmicutes and Proteobacteria, which fluctuated oppositely, and the total ratio remained in a dynamic balance over 48 h. We found that temporal dynamic changes had a significant effect on the relative abundance of the important bacteria in the feces microbiota community by using the random forest algorithm. Eight bacteria, Ruminococcus gnavus, Faecalibacterium, Ruminococcaceae, Enterococcus cecorum, Lachnospiraceae, Clostridium, Clostridiales, and Megamonas, gained rhythmicity. Interestingly, one unexpected finding was the fact that these eight bacteria all belong to Firmicutes. In particular, the microbiota profile appears to favor butyrate production, a common indicator of gut health, potentially through increases in the members of Lachnospiraceae, Faecalibacterium and Ruminococcaceae. The pathways were the functionalities that gained rhythmicity within the microbiota, which belonged to the most abundant functions, including xenobiotic biodegradation and metabolism, carbohydrate metabolism, and amino acid metabolism, which were consistent with the metabolic functions of amino acids and carbohydrates from feed.ConclusionThis study has shown that the defecation time could be among the important factors influencing the diversity, proportion, and functions of the feces microbiota community. We also note the potential application of beneficial microbial communities in livestock species, especially in the environment of raising antibiotic-free animals. These results provide references for further exploring the circadian rhythm of the gut microbiota in laying hens.