bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of cardiac resynchronization therapy on ambulatory blood pressure monitoring indices in patients with heart failure and hypertension
Authors: Sherafati Alborz , Tootoonchian Mohammad Jalil , Eslami Masoud , Najafi Mohammad Taghi , Mollazadeh Reza 
Published: June 2021

Objective
Blood pressure (BP) variability is associated with increased mortality in patients with hypertension and heart failure. The aim of our study was to evaluate the effect of cardiac resynchronization therapy (CRT) on different parameters of 24-h ambulatory blood pressure monitoring (ABPM) in patients with hypertension and heart failure.

Methods
Patients with heart failure and hypertension who were candidate for CRT implantation were enrolled in our study. Twenty-four hour ABPM was performed before, and 6 months after CRT implantation. BP variables and average real variability (ARV) were compared in all patients.

Result
Sixteen consecutive patients entered our study. There was a significant increase in ARV following CRT implantation (P value = 0.009).

Conclusion
CRT implantation is associated with increased ARV, but the effect of this improvement on cardiovascular outcome needs more investigation.
Impact of blood pressure lowering on ventricular repolarization heterogeneity in patients with newly diagnosed hypertension
Authors: Eyuboglu Mehmet , Celik Atac 
Published: June 2021

Objective
Frontal plane QRS-T (fQRS-T) angle is a marker of ventricular repolarization heterogeneity and increased fQRS-T angle is associated with arrhythmias, adverse events and mortality. However, little is known about the importance and usefulness of fQRS-T angle in hypertensive patients. The present study aimed to investigate the association between blood pressure (BP) levels and fQRS-T angle. The main goal was to demonstrate whether BP lowering has a favorable effect on fQRS-T angle in hypertensive patients.

Methods
This study included 392 newly diagnosed hypertensive patients who underwent antihypertensive therapy. Responders and nonresponders to antihypertensive therapy were compared regarding baseline and post-treatment fQRS-T angle. fQRS-T angle was calculated as the absolute difference between QRS and T wave axes that were obtained from electrocardiography. Response to treatment was defined as achieving BP levels <140/90 mmHg.

Results
At the 1-month follow-up visit, responders had significantly lower fQRS-T angle compared to nonresponders despite the similar baseline fQRS-T angle (baseline: 57° ± 18.2° vs.56.6° ± 16.3°; P = 0.819, at 1 month: 36.9° ± 13.7 vs.53.5° ± 15.6°; P < 0.001). Moreover, after 3 months of antihypertensive treatment, both responders at 1 month and 3 months had significantly lower fQRS-T angle compared to nonresponders (34.8° ± 13.3° vs. 35.4° ± 12.9° vs. 52.3° ± 13.9°; P < 0.001). Furthermore, a significant moderate positive correlation was observed between systolic BP and fQRS-T angle (r:0.797; P < 0.001), and between diastolic BP and fQRS-T angle (r:0.761; P < 0.001).

Conclusion
In the present study, a significant decrease in fQRS-T angle was observed following BP lowering throughout the study period. Therefore, fQRS-T angle may be useful in the monitoring of antihypertensive treatment.
Sodium-glucose cotransporter 2 inhibition in non-diabetic kidney disease
Authors: Almaimani Mohanad , Sridhar Vikas S. , Cherney David Z.I. 
Published: June 2021

Purpose of review
Sodium-glucose cotransporter 2 (SGLT2) inhibitors have proven cardiorenal protection in patients with diabetes and chronic kidney disease (CKD) as seen in cardiovascular outcome trials (CVOTs) and CREDENCE. In this review, we aim to discuss the mechanisms of kidney protection with SGLT2 inhibition as well as review the results of multiple translational studies and clinical trials of SGLT2 inhibition in the nondiabetic kidney disease (non-DKD) population.

Recent findings
The application of SGLT2 inhibitors as dedicated kidney-protective agents continues to evolve with the publication of the dapagliflozin in patients with chronic kidney disease (DAPA CKD) trial, which extends their cardiorenal protection to patients with nondiabetic CKD. This trial was preceded by CREDENCE, a dedicated kidney outcome study in participants with DKD that demonstrated a 30% reduction in the risk of the composite kidney outcome. From a physiological perspective, mechanistic benefits of SGLT2 inhibitors are independent of their glucose-lowering effects as demonstrated in preclinical studies and post hoc analyses of dedicated CVOTs in participants with type 2 diabetes. From a clinical perspective, there is a growing body of evidence for kidney protection in nondiabetes mellitus patients.

Summary
There exists strong rationale for SGLT2 inhibition to be incorporated into standard of care for appropriate groups of patients with nondiabetic kidney disease.
Rubber Bullet Induced Traumatic Brain Injury
Authors: Ali Rohaid , Poggi Jonathan , Doberstein Cody A. , Woo Albert S. , Oyelese Adetokunbo A. 
Published: June 2021

Abstract
Rubber bullets have long been known to cause, on rare occasions, traumatic brain injury (TBI). However, neurosurgical literature on this occurrence is limited, and no focused review of this injury pattern has been conducted. The authors present the case of a 28-year-old male struck by a rubber bullet in the left periorbital region, causing TBI in addition to complete left visual loss and complex facial fractures. After developing a cerebrospinal fluid (CSF) leak, the patient was taken to the operating room for combined neurosurgical-craniofacial intervention. Utilizing frameless intraoperative computation tomography navigation assistance, a successful repair was made of both the patient's CSF leak and complex craniofacial injuries. TBI due to a rubber bullet is a rare but severe occurrence. Unfortunately, much of the limited literature on this topic is bereft of demographic, clinical course, injury pattern, and imaging data. Presented here is the first operative case report of TBI due to a rubber bullet. Volume rendered imaging is provided to demonstrate the extent of trauma incurred. Additionally, a methodology for frameless intraoperative computation tomography navigation assistance is shared for consideration, as it served as a helpful adjunct for a combined intracranial-craniofacial surgical repair. The experience of treating the patient's traumatic CSF leak in the context of severe craniofacial and ophthalmologic injuries highlights the need for a multidisciplinary surgical approach that may arise when treating patients with TBI due to a rubber bullet.
Device Malfunction Associated With Mandibular Distraction for Infants With Robin Sequence
Authors: Manrique Monica , McGrath Jeniffer L. , Bryant Justin R. , Mantilla-Rivas Esperanza , Rana Md Sohel , Boyajian Michael K. , Rogers Gary F. , Oh Albert K. 
Published: June 2021

Introduction:
Mandibular distraction osteogenesis (MDO) effectively treats upper airway obstruction (UAO) in young patients with Robin sequence (RS). The most commonly used MDO devices have internal and external components that require manual activation. Although complications associated with MDO in infants with RS have been well documented, hardware/device malfunction has not been precisely described. The present study reports the authors’ recent experiences with such problems, in an effort to shed light on these complications and identify potential steps to mitigate future related issues.

Design:
The authors reviewed a prospectively gathered database to identify all young children under the age of 3 years who underwent MDO using buried internal devices for UAO associated with grade 3 RS from March 2007 to September 2019. We specifically focused on complications attributable to the hardware itself.

Results:
Nineteen patients with 40 devices met inclusion criteria. The median age at MDO was 2.3 months (interquartile range 1.4–6.3 months). Intraoperative activation of all devices under direct vision resulted in satisfactory distraction. Four devices (10.5%) developed postoperative complications directly related to the device, including break down of component parts (N = 3) and failure to maintain distraction distance (N = 1). Two patients required surgical replacement of one device each, whereas the remaining complications occurred during the consolidation phase and did not require intervention.

Conclusions:
This report documents a series of device/hardware malfunction in infants and young children undergoing MDO for severe UAO associated with RS. Despite rigorous testing and development, these devices may fail, resulting in patient morbidity.
Postpartum Urinary Incontinence: A Qualitative Study on Sexuality and Life Experiences of Muslim Turkish Women
Authors: Erkal Aksoy Yasemin , Akin Bihter , Dereli Yilmaz Sema 
Published: June 2021

Objectives
The study was planned to identify the sexuality and life experiences of Muslim Turkish women with urinary incontinence (UI) within 12 months postpartum.

Methods
A qualitative study was conducted using a semistructured interview. Data were collected between July and December 2019 via an in-depth, face-to-face interview technique using an interview form. The qualitative data obtained in this study were analyzed with the content analysis technique.

Results
The main themes related to sexuality and life experiences of the women with UI in the postpartum period were identified as “problems in daily life,” “emotional effects,” “baby-related effects,” and “spouse’s and family’s attitudes.”

Conclusions
As a result, it was found that women in the postpartum period were affected by UI in terms of behavioral, emotional, and social aspects.
Current Practices and Preferences of Fellows and Program Directors on Taking the Certifying Examination During Subspecialty Fellowships
Authors: Gupta Ankita , Meriwether Kate , Martin Alexandra , Pierson Rebecca C. 
Published: June 2021

Objective
Fellows in obstetrics and gynecology subspecialties often take their oral specialty certifying examination (referred to here as generalist certifying examination [GCE]) during fellowship. We sought to compare the opinions of current fellows and program directors (PDs) regarding their program’s handling of GCE during fellowship.

Methods
In this online, survey-based study, fellows and PDs currently affiliated with an accredited fellowship in maternal-fetal medicine, reproductive endocrinology and infertility, female pelvic medicine and reconstructive surgery, or gynecologic oncology (GO) received the link to an unvalidated survey. This survey was open for 8 weeks, between April and June 2020; eligible participants were contacted through their programs, society Listserv, and social media and received 3 reminder e-mails.

Results
Final analysis included 408 (408/834; response rate, 49%) fellows and 163 (163/223; response rate, 73%) PDs across the 4 subspecialties. There were significant differences in whether fellows responded that they were required or encouraged to take the GCE (52% maternal-fetal medicine, 65% reproductive endocrinology and infertility, 39% female pelvic medicine and reconstructive surgery, 8% GO; P < 0.01) during fellowship. Fewer GO fellows noted that they were permitted to use educational funds for GCE when compared with the other subspecialties (P < 0.01). Most fellows responded that the inability to take GCE during fellowship would decrease their satisfaction with fellowship, and this was significantly higher than PD estimates (78% vs 39%, P < 0.01).

Conclusions
There are significant differences in reported ability to take GCE during fellowship across different obstetrics and gynecology subspecialty fellowships. Program directors significantly underestimate fellow dissatisfaction with inability to take GCE during fellowship.
Increasing the Clinical Utility of the Paced Auditory Serial Addition Test: Normative Data for Standard, Dyad, and Cognitive Fatigability Scoring
Authors: Berard Jason A. , Walker Lisa A.S. 
Published: June 2021

Background:
No normative data currently exist that would allow clinicians to decide whether the degree of cognitive fatigability (CF) experienced in individuals with neurologic disease is greater than expected when compared with a healthy population.

Objective:
To establish discrete and regression-based normative data for CF as defined by an objective decrement in performance over the course of a cognitive task; namely, the Paced Auditory Serial Addition Test (PASAT). In addition, to develop discrete and regression-based normative data for PASAT performance scores—dyad and percent dyad—for which data do not currently exist.

Method:
One hundred and seventy-eight healthy individuals completed the PASAT as part of a larger neuropsychological battery. PASAT performance scores including total correct responses, total dyads, and percent dyad were calculated. CF scores were calculated by comparing the individuals’ performance on the first half (or third) of the test to their performance on the last half (or third) in order to capture any within-task performance decrements over time.

Results:
Both age- and education-based discrete normative data and demographically adjusted (sex, age, and education) regression-based formulas were established for the PASAT performance scores and the CF scores.

Conclusion:
The development of these normative data will allow for greater interpretation of an individual’s performance on the PASAT, beyond just the total correct score, through the use of dyad and percent dyad scores. With respect to CF, these data will allow clinicians to objectively quantify decrements in cognitive performance over time better in individuals with neurologic diseases.
Cognitive–motor Interference in Individuals With a Neurologic Disorder: A Systematic Review of Neural Correlates
Authors: Veldkamp Renee , Goetschalckx Mieke , Hulst Hanneke E. , Nieuwboer Alice , Grieten Kathleen , Baert Ilse , Leone Carmela , Moumdjian Lousin , Feys Peter 
Published: June 2021

Background:
Performing a cognitive task and a motor task simultaneously is an everyday act that can lead to decreased performance on both tasks.

Objective:
To provide insight into the neural correlates associated with cognitive–motor dual tasking in individuals with a neurologic disorder.

Method:
We searched the PubMed and Web of Science databases for studies that had been published up to January 16th, 2019. Studies investigating the neural correlates of cognitive–motor dual task performance in individuals with a variety of neurologic disorders were included, independently from whether the study included healthy controls. Clinical and imaging data were abstracted for the comparison between single tasks and a dual task in the individuals with a neurologic disorder and for the comparison between the healthy controls and the individuals with a neurologic disorder.

Results:
Eighteen studies met the inclusion criteria. Study populations included individuals with Parkinson disease, multiple sclerosis, mild cognitive impairment, Alzheimer disease, traumatic brain injury, and stroke. Neuroimaging types used to study the neural correlates of cognitive–motor dual tasking during upper limb or gait tasks included fMRI, functional near-infrared spectroscopy, EEG, and PET.

Conclusion:
Despite large heterogeneity in study methodologies, some recurrent patterns were noted. Particularly, in neurologic patients, an already higher brain activation during single tasks was seen compared with healthy controls, perhaps compromising the patients’ ability to further adapt brain activation with increasing load during dual tasking and resulting in reduced behavioral dual task performance.
In-phase and in-antiphase connectivity in EEG
Authors: O’Reilly Christian , Lewis John D. , Theilmann Rebecca J. , Elsabbagh Mayada , Townsend Jeanne 
Published: June 2021

AbstractZero-lag synchrony is generally discarded from functional connectivity studies to eliminate the confounding effect of volume conduction. Demonstrating genuine and significant unlagged synchronization between distant brain regions would indicate that most electroencephalography (EEG) connectivity studies neglect an important mechanism for neuronal communication. We previously demonstrated that local field potentials recorded intracranially tend to synchronize with no lag between homotopic brain regions. This synchrony occurs most frequently in antiphase, potentially supporting corpus callosal inhibition and interhemispheric rivalry. We are now extending our investigation to EEG. By comparing the coherency in a recorded and a surrogate dataset, we confirm the presence of a significant proportion of genuine zero-lag synchrony unlikely to be due to volume conduction or to recording reference artifacts. These results stress the necessity for integrating zero-lag synchrony in our understanding of neural communication and for disentangling volume conduction and zero-lag synchrony when estimating EEG sources and their functional connectivity.
Is my cough a cold or covid? A qualitative study of COVID-19 symptom recognition and attitudes towards testing in the UK
Authors: Mowbray Fiona , Woodland Lisa , Smith Louise E , Amlôt Richard , Rubin G James 
Published: June 2021

AbstractObjectiveKey to reducing the spread of COVID-19 in the UK is increased use of the NHS Test and Trace (NHSTT) system. This study explored one of the main issues that determine whether people engage with NHSTT, how people understand symptoms that may indicate the presence of COVID-19 and that should trigger a request for a test.MethodsIn this qualitative study, a series of semi-structured telephone interviews were conducted with 40 people (21 members of the general population, 19 students). There was nearly an equal split between male and female participants in both populations. Data were collected between 30 November and 11 December 2020 and explored using thematic analysis. There was substantial similarity in responses for both populations so we combined our results and highlighted where differences were present.ResultsParticipants generally had good knowledge of the main symptoms of COVID-19 (high temperature, new, persistent cough, anosmia) but had low confidence in their ability to differentiate them from symptoms of other illnesses. Attribution of symptoms to COVID-19 was most likely where the symptoms were severe, many symptoms were present, symptoms had lasted for some time and when perceived risk of exposure to infection was high due to previous contact with others. Participants felt encouraged to engage in testing where symptoms were present and had persisted for several days, though many had concerns about the safety of testing centres and the accuracy of test results. Students had mixed feelings about mass asymptomatic testing, seeing it as a way to access a more normal student experience, but also a potential waste of resources.ConclusionsThis study offers novel insights into how people attribute symptoms to COVID-19 and barriers and facilitators to engaging with testing. Participants had positive views of testing, but there is a need to improve not just recognition of each main symptom, but also understanding that even single, mild symptoms may necessitate a test rather than a “wait and see” approach, and to address concerns around test accuracy to increase testing uptake.
Malaria treatment-seeking behaviour and its associated factors: A cross-sectional study in rural East Nusa Tenggara Province, Indonesia
Authors: Guntur Robertus Dole , Kingsley Jonathan , Islam Fakir M. Amirul 
Published: June 2021

AbstractIntroductionThe World Health Organization recommends seeking medical treatment within 24 hours after transmission of malaria to reduce the risk of severe complications and its onwards spread. However, in some parts of Indonesia, including East Nusa Tenggara Province (ENTP), this adherence is not achieved for a range of reasons including delays in visiting health centres. This study aims to determine factors related to the poor understanding of appropriate malaria treatment-seeking behaviour (AMTSB) of rural adults in ENTP. AMTSB was defined as seeking treatment at professional health facilities within 24 hours of the onset of malaria symptoms.MethodsA cross-sectional study was conducted in the East Sumba, Belu, and East Manggarai district of ENTP between October and December 2019. A multi-stage cluster sampling procedure was applied to enrol 1495 participants aged between 18 and 89 years old. Data were collected through face-to-face interview. Multivariable logistic regression analyses were used to assess significant factors associated with the poor understanding of AMTSB.Results86% of participants were found to be familiar with the term malaria. However, poor understanding level of AMTSB in rural adults of ENTP achieved 60.4% with a 95% confidence interval (CI): 56.9 – 63.8. The most important factors associated with the poor understanding were lower levels of education, low socio-economic status (SES), occupation, and distance to the nearest health facilities. The poor understanding of AMTSB was significantly higher for adults with no education (adjusted odds ratio (AOR) 3.42, 95% CI: 1.81, 6.48); having low SES (AOR: 1.87, 95% CI: 1.19, 2.96); residing three km away from the nearest health facilities (AOR: 1.73, 95% CI: 1.2, 2.5); and working as housewife (AOR: 1.63, 95%CI: 1.01 – 2.63). Ethnicity, and family size were not associated with the poor understanding of AMTSB.ConclusionThe proportion of rural adults having a poor understanding of AMTSB was high leading to ineffective implementation of artemisinin-based combination therapies as the method to treat malaria in ENTP. Improving awareness of AMTSB for rural adults having low-level education, low SES, working as a housewife, and living three km from the nearest health facilities is critical to support the efficacy of malaria treatment in ENTP, as well as to advance the Indonesian government’s objective to achieve malaria elimination by 2030.
Virucidal activity of a proprietary blend of plant-based oils (Viruxal) against SARS-CoV-2 and influenza viruses – an in vitro study
Authors: Kristjánsson Jón Magnús , Rolfsson Óttar 
Published: June 2021

AbstractBackgroundThe emergence of a novel coronavirus known as SARS-CoV-2 resulting in a global pandemic COVID-19 has led to a dramatic loss of life worldwide and presented an unprecedented challenge to public health. Viruxal is a medical device in a form of a nasal and oral spay containing a a proprietary blend of plant-based oils which acts against enveloped viruses. The aim of this study was to evaluate the virus deactivation activity of Viruxal against SARS-CoV-2 and Influenza A(H1N1) viruses.MethodsAn assay to detect virucidal activity was performed with four concentrations of Viruxal on two virus suspensions. Assessments were made based on log reduction values measured from the assay.ResultsViruxal exhibited virucidal activity by reducing virus titer more than 90% for the enveloped viruses SARS-CoV-2 and influenza A(H1N1) after 30 minutes contact.ConclusionsViruxal was validated for its potential usefulness as a medical device for treatment and prevention of enveloped respiratory viruses.