bluuebunny/crossref_metadata_2025_split huggingface dataset:
Compared with conventional procedures performed via the occipital horn, an intraoperative navigation system for ventriculoperitoneal shunting improves outcomes in patients with hydrocephalus
Authors: Peng AiJun , Zhao Hai , Wu YongKang , Zhao Yi , Zhou LiangXue 
Published: June 2019

Abstract
Background: Ventriculoperitoneal shunting (VPS) is a common neurosurgical procedure used to treat hydrocephalus. Catheter obstruction is one of the most common factors that influences patient prognosis. We therefore evaluated the accuracy of proximal catheter placement and explored the probable relationship between ventricular catheter obstruction and both symptom grade and postoperative Evans index between an intraoperative navigation system for VPS and conventional surgery via the occipital horn.
Methods: We performed a retrospective study of 33 patients with VPS (the navigation surgery group) and 26 patients with VPS (the conventional surgery group) seen between January 2012 and August 2018. The clinical data, follow-up times, catheterization accuracy, postoperative outcomes, cumulative survival times and correlations between catheter placement and obstruction, symptom grade and the postoperative Evans index were analyzed.
Results: Thirty-one patients experienced optimal ventricular catheter placement (grade 1), 2 experienced suboptimal placement (grade 2), and none experienced poor ventricular catheter placement (grade 3) in the navigation surgery group, whereas 6, 14, and 6 patients, respectively, had these results in the conventional surgery group. Greater improvement was observed in postoperative symptoms (P=0.017), including less catheter readjustment (P<0.001), in the navigation surgery group. A Kaplan-Meier survival analysis showed that the cumulative catheter obstruction-free survival time was longer in the navigation surgery group than in the conventional surgery group (P=0.028). Moreover, catheter placement was significantly correlated with catheter obstruction (P<0.001). In addition, catheter obstruction was significantly correlated with the symptom grade (P=0.001) and postoperative Evans index (P<0.001).
Conclusions: An intraoperative navigation system for VPS improved patient outcomes and the accuracy of ventricular catheter placement. Catheter obstruction-free survival times were longer in the navigation surgery group, and catheter placement was significantly correlated with catheter obstruction.
In Silico Investigation of Mitragynine and 7-Hydroxymitragynine Metabolism
Authors: Limpanuparb Taweetham , Noorat Rattha , Tantirungrotechai Yuthana 
Published: June 2019

Abstract
Objective: Mitragynine is the main active compound of Mitragyna speciose (Kratom in Thai). The understanding of mitragynine derivative metabolism in human body is required to develop effective detection techniques in case of drug abuse or establish an appropriate dosage in case of medicinal uses. This in silico study is based upon in vivo results in rat and human by Philipp et al. (J. Mass Spectrom., 2009, 44, 1249.) Results: The gas-phase structures of mitragynine, 7-hydroxymitragynine and their metabolites were obtained by quantum chemical method at B3LYP/6-311++G(d,p) level. Results in terms of standard Gibbs energies of reaction for all metabolic pathways are reported with solvation energy from SMD model. We found that 7-hydroxy substitution leads to changes in reactivity in comparison to mitragynine: position 17 is more reactive towards demethylation and conjugation to a glucuronide and position 9 is less reactive towards conjugation to a glucuronide. Despite the changes, position 9 is the most reactive for demethylation and position 17 is the most reactive for conjugation to a glucuronide for both mitragynine and 7-hydroxymitragynine. Our results suggest that 7-hydroxy substitution could lead to different metabolic pathways and raise an important question for further experimental studies of this more potent derivative.
The effect comparisons of different exercise interventions on blood glucose and insulin resistance relative indicators for prediabetes: a network meta-analysis
Authors: Tang Lijun , Fang Yingjie , Yin Jianchun 
Published: June 2019

Abstract
Background: In order to recommend the optimum type of exercise for type 2 diabetes prevention, the effect of different exercise interventions on glycaemic control and insulin resistance relative indicators were compared.
Methods: The studies involving the curative effect of aerobic exercise trailing (AET) or resistance trailing (RT) for prediabetes were searched with pre-established strategy . The Body Mass Index (BMI), fasting blood glucose (FBG), glycated haemoglobin (HbA1c), Insulin and homeostasis model assessment-insulin resistance index (HOMAIR) were used as outcomes indictors. Q statistic was calculated to evaluate the heterogeneity within studies. A fixed effects model was chosen for pooling data with p > 0.05, otherwise, a random effects model was chosen. The consistency test in this network meta-analysis was conducted by Node-splitting analysis.
Results: A total of 12 eligible studies were included into this network meta-analysis. According to p score values, prediabetes individuals in AET group had better curative effect in BMI (p score = 0.7525), Insulin (p score = 0.6411) and HOMAIR (p score = 0.6411) value controls than in other groups, while the curative effect of RT on FBG (p score = 0.8465) and HbA1c (p score = 0.8550) values were optimum. The rank of P-scores for each indicator under above two effect models was basically consistent, indicating that our results of network meta-analysis were stable.
Conclusions: AET might be a better intervene method for improving insulin resistance to prediabetes, while RT was more effective than AET, AET+RT or CT for glycaemic control in prediabetes.
Factors associated with non-vaccination against measles among 12-23 months old children in Yirgachefe district of SNNPR, Ethiopia, 2016
Authors: Degife Luna Habtamu , Worku Yoseph , Tadesse Muse 
Published: June 2019

Abstract
Immunization is an effective and proven tool for controlling and eliminating life-threatening vaccine preventable infectious diseases. In Ethiopia 5% of childhood mortalities are due to measles. In 2015, 85% of children had received 1 dose of measles vaccine by their second birthday. Despite the availability of a safe and effective vaccine, measles outbreaks secondary to non-vaccination are occurring in southern Ethiopia especially in Yirgachefe district.This study was done to assess the risk factors associated with non-vaccination against measles.

A Community-based unmatched case control study was conducted in Yirgachefe district from December 1-31, 2016.Cases were defined as children in the age group of 12- 23 months of age who did not take measles vaccination. The study was done in 6 randomly selected kebeles and cases and controls were selected randomly by probability proportional to size sampling. A structured questionnaire was used for data collection and data was analyzed by using Epi info version 7 and SPSS version 20. Statistical significance was interpreted using Odds ratio with 95% confidence interval and P value <0.05.

A total of 320 individuals (107 cases and 214 controls) were approached for interview with a response rate of 93.75%. Of the cases, 57% were males and more than half fall in the 12-18 months age group. Lack of Ante Natal Care follow up (Adjusted Odds Ratio (AOR) =3.57; 95% Confidence Interval (CI): 1.22-10.44), lack of knowledge on the importance of vaccination, who should be vaccinated and if measles is contagious with an AOR and CI of (AOR=6.81; 95% CI: 1.56-29.64), (AOR=4.29; 95% CI: 1.83-10.04) and (AOR=8.97; 95%CI: 3.15-25.58) respectively were independent risk factors.

Lack of ANC follow up, lack of knowledge about who should get vaccinated, the importance of vaccination and contagiousness of the disease were identified as risk factors for non-vaccination against measles. Education and awareness about measles and its immunization should be given to the community. Additionally, ANC follow up should also be strengthened.
Strengthening routine immunization in Papua New Guinea: implications for post-polio renewal from a cross-sectional provincial assessment of front-line services
Authors: Morgan Christopher , Saweri Olga PM , Larme Nicholas , Peach Elizabeth , Melepia Pele , Au Lucy , Michelle Scoullar JL , Mohammad Reza S , Lisa Vallely M , McPake Barbara A , Beeson James G 
Published: June 2019

Abstract
Background

Routine immunization programs face challenges in settings such as Papua New Guinea: dispersed rural populations, rugged geography, and limited resources for transport and health. Low routine coverage contributes to outbreaks such as measles and the polio that re-appeared in 2018. Diversion of resources to the necessary emergency response can risk further weakening of the routine system. We report on an in-depth local assessment that documented immunization service provision so as to review new national strategy, and consider how emergency polio responses could simultaneously strengthen routine immunization.

Methods

In East New Britain Province, over 2016 and 17, we carried out a cross-sectional assessment of 12 rural health facilities, staff and clients. The study was timed to follow implementation of a new national strategy for strengthening routine immunization. We used interview, structured observation, and records review, informed by theory-based evaluation, a World Health Organization quality checklist, and other health services research tools.

Results

We documented strengths and weaknesses across six categories of program performance relevant to national immunization strategy and global standards. We found a functional immunization service with an operational level of staff, equipment and procedures in place; but one that could reach only half to two thirds of its target population. Stronger routine services require improvement in: understanding of population catchments, tracking the unvaccinated, reach and efficiency of outreach visits, staff knowledge of vaccination at birth and beyond the first year of life, handling of multi-dose vials, and engagement of community members. Many local suggestions to enhance national plans, including more reliable on-demand services, integration of other family health services and increased involvement of men.

Conclusions

The national strategy addresses most local gaps, but implementation and resourcing was insufficient. Emergency polio campaigns could support a stronger routine program by building local planning capacity, identifying new outreach sites, sharing intelligence on local population characteristics, integrating high-demand services and other vaccines, distributing educational materials, and modelling better involvement of trained lay health workers. Long-term strengthening requires a major increase in centrally-allocated resources, however there are immediate locally feasible steps within current resources that could boost coverage and quality of routine immunization.
Psychosocial Syndemic Associated with Magnifying Effect of Suicidal Ideation Among Sexually Transmitted infection Patients in Shanghai, China
Authors: Wang Suping , Ni Yang , Gong Ruijie , Shi Yuan , Cai Yong , Ma Jin 
Published: June 2019

Abstract
Background

We sought to verify whether psychosocial health problems among patients with sexually transmitted infections (STIs) were associated with these patients’ suicidal ideation, and to examine the magnifying effect of a syndemic of multiple psychosocial conditions on suicidal ideation.

Methods

This was a cross-sectional study of 519 STI patients at the Shanghai Skin Disease Hospital. Sociodemographic, psychosocial, and suicidal ideation information on the participants was collected. Logistic regressions were performed to detect the association between sociodemographic variables and suicidal ideation, as well as each individual psychosocial variable and suicidal ideation, and to verify the syndemic effect of psychosocial factors.

Results

Of the participants, 25.0% reported having suicidal thoughts. In univariate analysis, low self-esteem, loneliness, depression, entrapment, defeat, and unsatisfied interpersonal needs were associated with suicidal ideation. Multivariable analysis found depression (risk ratio [RR] 2.614; 95% confidence interval [CI]: 1.603–4.262) and entrapment (RR: 4.457; 95%CI: 2.649–7.496) remained significant. STI patients who experienced two or more psychosocial health problems had approximately five times the odds of suicide ideation (adjusted risk ratio [ARR]: 4.643; 95%CI: 2.882–7.481) compared with those in the non-syndemic group, especially in the high-level (five or more psychosocial problems) group (ARR: 6.072; 95%CI: 3.307–11.152).

Conclusions

The study confirmed that STI patients have a high rate of suicidal ideation and suffer from severe psychosocial problems. The results confirm a syndemic effect of psychosocial problems on increasing the odds of suicidal ideation. This suggests greater attention should be paid to STI patients’ psychosocial wellbeing in both nursing and interventions. Efforts to prevent suicidal ideation among STI patients are therefore urgently needed to ameliorate the social and health conditions of this population.
Examining validity and reliability of Objective Structured Clinical Examination for evaluation of clinical skills of midwifery undergraduate students: a descriptive study
Authors: Kolivand Mitra , Esfandyari Marzieh , Heydarpour Sousan 
Published: June 2019

Abstract
BACKGROUND: Clinical evaluation is one of the main pillars of medical education. The Objective Structured Clinical Examination is one of the commonly adopted practical tools to evaluate clinical and practical skills of medical students. Validity and reliability of the tool to evaluate clinical skills of midwifery undergraduate students in Kermanshah Midwifery Nursing School were examined.
METHODS: Seven clinical skills were evaluated in this descriptive correlative study using a performance checklist. Thirty-two midwifery students performed the skills at seven stations each monitored by an observer using an evaluation checklist. Criterion-related validity was obtained through determining the correlation between the clinical courses point and the Objective Structured Clinical Evaluation score. The collected data was analyzed in SPSS (v.20) and logistic regression test.
RESULTS: The correlation score of Objective Structured Clinical Examination was significantly related to the mean score of clinical course “Normal Pregnancy I” (0.319, p=0.075), the mean score of clinical course “Normal and Abnormal delivery I” (0.399, p=0.024), the mean score of clinical course “gynaecology “ (0.419, p=0.017) and total average scores(0.23, p=0.200).
The correlation between the total score and mean score of students at the stations showed that out of the seven stations, the correlations of the stations three (communication and collecting medical history) and four (childbirth) were not significant.
CONCLUSION: Although it appeared that Objective Structured Clinical Examination was one of the effective and efficient ways to evaluate clinical competencies and practical skills of students, the tool could not evaluate all the aspects.
Propofol attenuated the effect of TNF-α on occludin expression by inhibiting HIF-1α/VEGF/VEGFR-2/ERK signaling pathway in hCMEC/D3 cells
Authors: Zhang Yue , Ding Xiaowei , Miao Changhong , Chen Jiawei 
Published: June 2019

Abstract
Background: The levels of tight junction proteins (TJs), especially occludin, correlate with blood-brain barrier (BBB) disruption caused by inflammation in central nervous system (CNS). It has been reported that propofol, the most commonly used anesthetic, could inhibit inflammation response in CNS. In this study, we investigated the effects of tumor necrosis factor-α(TNF-α) and propofol on occludin expression in human cerebral microvascular endothelial cell line, D3 clone (hCMEC/D3 cells), and explored the underlying mechanisms.
Methods: The hCMEC/D3 cells were treated with propofol, followed by TNF-α. The expression and phosphorylation of Hif-1α, VEGF, VEGFR-2, ERK, p38MAPK and occludin were measured by Western blot analysis. The cell viability of hCMEC/D3 cells was measured by cell counting kit-8.
Results: TNF-α (10 ng/ml, 4 h) significantly decreased the expression of occludin, which was attenuated by propofol (25 μM). TNF-α induced Hif-1α/VEGF/VEGFR-2/ERK signaling pathway, while propofol could inhibit it. TNF-α induced the phosphorylation of p38MAPK, while propofol had no effect on it. In addition, the inhibitors of Hif-1α, VEGFR-2, and ERK could reduce the effect of TNF-α on occludin expression.
Conclusion: TNF-α could decrease the expression of occludin via activating Hif-1α/VEGF/VEGFR-2/ERK signaling pathway, which was attenuated by propofol.
An Outbreak of Epidemic Keratoconjunctivitis Caused by Human Adenovirus Type 8 in Primary School, Southwest China
Authors: Li Duo , Zhou Jie-Nan , Li Hong , He Cun-Ying , Dai Qing-Shan , Li Xiang-Lan , He Jian-Fang , He Hong , Li Ming-Bao , Jiang LI-Li , Chen Yao-Yao , Xu Wen 
Published: June 2019

Abstract
Background: Two outbreaks of epidemic keratoconjunctivitis (EKC) occurred successively with an interval of five days in two primary boarding schools in Weixi Lisu Autonomous County, Diqing, and Tibetan Autonomous Prefecture, Yunnan. The aims of this study were to determine the intensity and characteristics of the outbreaks, as well as the clinical manifestations in the patients, the risk factors for infection and the pathogen responsible for the two outbreaks.
Methods: An outbreak investigation was conducted in two primary schools, and a case-control study including patients from the Weixi County Ethnic Primary School was performed. Relevant specimens were collected according to the case definition, and next-generation sequencing was employed to identify the pathogen. An epidemiological investigation method was used to analyse the related epidemiological characteristics, such as risk factors. The phylogenetic tree was constructed by MEGA 7.0.
Results: A total of 331 acute conjunctivitis cases, including probable cases of EKC, were reported in the two schools, and the attack rates were 30.59% (171/559, 95%CI: 26.76-34.42) and 20.41% (160/784, 95%CI: 17.58-23.24), respectively. Cases occurred in all grades and classes in both schools, and only one staff member in each school presented illness. The epidemics lasted for 54 days and 45 days, respectively. The patients had typical manifestations of EKC, such as acute onset, follicular hyperplasia, pseudomembrane formation, preauricular lymphadenopathy, corneal involvement and blurred vision, and a relatively long disease course (average 9.40 days, longest 23 days and shortest 7 days). The risk factor for infection was close contact with a patient or personal items contaminated by a patient. The pathogen responsible for the outbreaks was HAdV-8. The virus was highly similar to the 2016 HAdV-8 strain from Tibet, China.
Conclusions: This study strongly suggests that HAdV-8 could lead to serious consequences. This is the second report of a HAdV-8-associated EKC outbreak in mainland China. Tibetan HAdV-8 might be circulating in southwest China; therefore, it is necessary to monitor the pathogens causing acute conjunctivitis in this area.
Effect of opioid-free anaesthesia on post-operative period in cardiac surgery: a retrospective matched case-control study
Authors: Guinot Pierre-Grégoire , Spitz Alexandra , Berthoud Vivien , Ellouze Omar , Missaoui Anis , Constandache Tiberiu , Grosjean Sandrine , Radhouani Mohamed , Anciaux Jean-Baptiste , Parthiot Jean-Philippe , Merle Jean-Pierre , Nowobilski Nicolas , Nguyen Maxime , Bouhemad Belaid 
Published: June 2019

Abstract
Background: No study has been conducted to demonstrate the feasibility of an opioid-free anesthesia (OFA) protocol in cardiac surgery to improve patient care. The aim of the present study was to evaluate the effect of OFA on post-operative morphine consumption and the post-operative course.
Methods: We performed a retrospective matched cohort study (1:1) on cardiac surgery patients with cardiopulmonary bypass. Patients were divided into two groups: OFA (lidocaine, dexamethasone and ketamine) or opioid anaesthesia (OA) (sufentanil). The main outcome was the total postoperative morphine consumption in the 48 hours after surgery. Secondary outcomes were rescue analgesic use, a major adverse event composite endpoint, and ICU and hospital length of stay (LOS).
Results: 110 patients were matched (OFA: n=55; OA: n=55). On inclusion, demographic and surgical data for the OFA and OA groups were comparable. The total morphine consumption was higher in the OA group than in the OFA group (15 (6-34) vs 5 mg (2-18), p=0.001). The pain score during the first 48 post-operative hours did not differ between the two groups. Creatinine values did not differ on the first post-operative day (80 (IQR: 66-115) vs 77 mmol/l (IQR: 69-95), p=0.284). Incidence of the composite endpoint was lower in the OFA group (25 patients (43%) vs 38 patients (68%), p=0.021). The time to extubation and the ICU stays were shorter in the OFA group (3 (1-5) vs 5 (3-6) hours, p=0.001 and 2 (1-3) vs 3 (2-5) days, p=0.037).
Conclusion: The use of OFA was associated with lower morphine consumption and shorter ICU stays. Further randomized studies are needed to confirm these results.
Fault detection in level and flow rate sensors for safe and performant remote-control in a water supply system
Authors: Fellini Sofia , Vesipa Riccardo , Boano Fulvio , Ridolfi Luca 
Published: June 2019

AbstractThis work presents an algorithm for real-time fault detection in the SCADA system of a modern water supply system (WSS) in an Italian alpine valley. By means of both hardware and analytical redundancy, the proposed algorithm compares data and isolates faults on sensors through analysis of residuals. Moreover, the algorithm performs a real-time selection of the most reliable measurements for the automated control of the WSS operations. A coupled model of the hydraulic and remote-control system is developed to test the performance of the WSS when the proposed algorithm is applied or not. Simulations show that the occurrence of errors in the sensors causes significant worsening in the economic, energy and mechanical performance of the infrastructure. In many cases, the operations of the WSS are seriously compromised. The error detection and measurement assessment performed by the proposed algorithm proves to be crucial for the safe control of the WSS.