bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with mortality in patients with tetanus in Cameroon
Authors: Sangwe Clovis Nchinjoh , Palle John Ngunde , Linwa Edgar Mandeng Ma , Ndung Ako Forbinake , Tabe Benem-Orock Vanessa , Chichom Mefire Alain 
Published: January 2023

Background Tetanus constitutes a significant cause of death in sub-Saharan Africa, with case fatality rates as high as 64%, 47%, and 43.1% reported in Nigeria, Uganda, and Tanzania, respectively. However, the knowledge gap on factors that influence tetanus mortality still exists in Cameroon. Objective To identify the factors that influence the mortality of tetanus patients in three regional hospitals in the North West and South West Regions of Cameroon. Methodology This was a 7-year retrospective case-series study. Socio-demographic and clinical data of tetanus cases admitted in Bamenda, Buea, and Limbe Regional Hospitals from January 2010 to March 2017 were collected and analysed. Results This study recorded 38 cases, but excluded five due to missing inpatient files. Of the 33 cases considered in this study, 27 (81.8%) were males. The mean age of the patients was 32 years. A tetanus mortality rate of 48.5% was recorded – thus, 16 tetanus-related deaths. Mortality was higher amongst patients with incubation periods less than 7 days; the onset of trismus and generalized spasms less than 8 days after exposure; the presence of autonomic dysfunction; the presence of respiratory dysfunction; application or introduction of local regimens, soil or animal waste at the portal of entry; delayed debridement greater than 2 days after onset of tetanus; and a severe clinical disease state. Conclusion This study, therefore, highlights the need to ensure universal vaccination coverage for high-risk populations; males, active population (20–40 years), and farmers. More still, this study emphasizes the need to improve access and utilisation of mechanical ventilation in severe tetanus cases.
Natural rubber/wood composite foam: Thermal insulation and acoustic isolation materials for construction
Authors: Neves de Alencar Laura , Guedes Paiva Fábio Friol , Okimoto Fernando Sérgio , Bacarin Giovani Boaventura , Dognani Guilherme , Salmazo Leandra Oliveira , dos Santos Renivaldo José , Cabrera Flávio Camargo , Job Aldo Eloizo 
Published: January 2023

With the advances in the field of civil construction and the world population growth, the development of policies is necessary for the management and reuse of generated residue. Thus, the present work proposes the use of expanded natural rubber as a polymeric matrix incorporated with eucalyptus filler as a reinforcing filler for the production of composites. Thermal insulation capacity was determined by the transient plane source and acoustic method by impedance tube. NR/W40 foam showed enhanced the acoustic insulation capacity. The maximum absorption of NR/W40 was 0.83, at 3257 Hz, which is three times higher than natural rubber foam. Highly inhomogeneous cell structures were observed with large, interconnected pores, improving the acoustic performance. Sound absorption coefficient for natural rubber foam with 40% wood (0.83 ± 0.046) was similar to PU foam (0.97 ± 0.009) with 20 mm in thickness, a density of 47 kg/m3 and 98% open cell content it is a well-known acoustic absorbent in the building sector. The NR/W40 sample recorded the best acoustic performance among the NR foams analyzed in this work, maintaining good sound absorption above 1500 Hz, demonstrating a possibility of wood reuse as a filler in based-rubber foam for acustic insulation.
Epidemiology of anticoagulation for children supported by extracorporeal membrane oxygenation in the United States: A Pediatric Hospital Information System database study
Authors: Nellis Marianne E , An Anjile , Mahmood Hera , Prishtina Fisnik , Hena Zachary , Karam Oliver 
Published: January 2023

Introduction Due to the risk of thrombosis, nearly all children supported by extracorporeal membrane oxygenation (ECMO) receive systemic anticoagulation. While heparin has traditionally been used, there are reports of increased use of direct thrombin inhibitors. We sought to describe the use of anticoagulation in children supported by ECMO in the United States using a large administrative database. Methods We performed a retrospective cohort study of children supported by ECMO within the Pediatric Health Information System (PHIS) database. Pediatric encounters involving ECMO from 2012 to 2020 were identified. Data regarding demographics, diagnoses, anticoagulation, complications, and outcomes were extracted for eligible encounters. Results Eleven thousand five hundred ninety-five encounters that involved ECMO were identified. Fifty-four percent were male with an age range of 0–17 years and a median (IQR) age of 0 (0–2) years. Unfractionated heparin (UFH) only was used in 94% (95% CI: 93.6–94.5%) of encounters and UFH followed by bivalirudin in 5% (95% CI: 4.3–5.1%) of cases. There was a significant difference in the use of bivalirudin from 2012 to 2020 ( p < 0.001). Differences in anticoagulation regimens were observed between infants and children ( p = 0.004) and between those with and without cardiac indications for ECMO ( p < 0.001). Four percent (95% CI: 4.1–4.8%) of encounters were associated with diagnostic coding for thrombosis and differences in occurrence of thrombosis were observed between different anticoagulant regimens ( p < 0.001). Conclusions Though the majority of children on ECMO in the United States receive heparin anticoagulation, there is an increase in use of direct thrombin inhibitors. Prospective studies must evaluate the efficacy of different anticoagulants in this patient population.
Fulminant sepsis secondary to severe lung contusion from the Lund University Cardiopulmonary Assist System device
Authors: Li Matthew , Al-Qudsi Omar 
Published: January 2023

Introduction Portable mechanical chest compression devices have been developed to improve upon many problems of manual compression, increase patient survival, and improve neurologic outcomes. However, the use of these devices is not without risk of harm to the patient. Case Report We describe a patient who received chest compressions from a mechanical compression device after cardiac arrest and subsequently developed fulminant sepsis secondary to lung contusions and a necrotizing pulmonary infection. Discussion Although injuries from the LUCAS have been reported, we believe this is the first reported fatal complication related to direct pulmonary injury from a mechanical compression device. Conclusion More investigation is needed to determine the safety and efficacy of the LUCAS especially in obese patients.
Continuous positive airway pressure in cluster headache: A randomized, placebo-controlled, triple-blind, crossover study
Authors: Gravdahl Gøril Bruvik , Aakerøy Lars , Stovner Lars Jacob , Engstrøm Morten , Müller Kai Ivar , Bjørk Marte Helene , Tronvik Erling 
Published: January 2023

Background Oxygen inhalation aborts cluster headache attacks, and case reports show the effect of continuous positive airway pressure. The aim of this study was to investigate the prophylactic effect of continuous positive airway pressure in chronic cluster headache. Methods This was a randomized placebo-controlled triple-blind crossover study using active and sham continuous positive airway pressure treatment for chronic cluster headache. Patients entered a one month’s baseline period before randomly being assigned to two months’ active continuous positive airway pressure treatment followed by a four weeks’ washout period and two months’ sham continuous positive airway pressure or vice versa. Primary outcome measure was number of cluster headache attacks/week. Results Of the 30 included participants (12 males, median age 49.5 years, min-max 20–66 years), 25 completed both treatment/sham cycles (two discontinued, three lost to follow-up). The median number of cluster headache attacks per week was reduced from 8.25 (0.75–89.75) attacks to 6.25 (0–56.00) attacks for active continuous positive airway pressure and to 7.50 (0.50–43.75) attacks for sham continuous positive airway pressure, but there was no difference in active versus sham (p = 0.904). One patient had a serious adverse event during active treatment, none occurred during sham treatment. Conclusions Continuous positive airway pressure treatment did not reduce the number of cluster headache attacks compared to sham treatment in chronic cluster headache patients. Trial registration Clinicaltrials.gov NCT03397563
Prevalence and Predictors of Substantial Postpartum Weight Retention Among Participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Southern California
Authors: Yusuf Hanan M. , Koleilat Maria , Whaley Shannon E. 
Published: January 2023

Purpose Identify the prevalence and predictors of substantial postpartum weight retention (SPPWR) among WIC mothers in Southern California during their first postpartum year. Design Secondary data analysis. Setting The 2020 Los Angeles County WIC Survey. Subjects Mothers of children up to 1-year-old (N = 1019). Measures Outcome variable: SPPWR (≥5 kg above pre-pregnancy weight). Predictors: child’s age, mother’s age, race, education, employment status since having child, healthcare coverage, food insecurity, depressed mood, instrumental support, emotional support, spouse’s participation in child’s life, gestational weight gain (GWG), pre-pregnancy BMI, any breastfeeding, and gestational diabetes. Analysis Weighted descriptive statistics and binary logistic regression. Results The prevalence of SPPWR was 31%. We found that for every 1 month increase in the child’s age (proxy for postpartum duration), the likelihood of SPPWR increased by 9% (AOR = 1.09, CI = 1.04-1.15). Mothers were more likely to have SPPWR when they exceeded GWG guidelines (AOR = 3.43, CI = 2.46-4.79). Compared to mothers with normal pre-pregnancy BMIs, mothers with overweight (AOR = .64, CI = .44-.94) and obese (AOR = .39, CI = .26-.58) pre-pregnancy BMIs were less likely to experience SPPWR. Conclusion Postpartum duration and maternal anthropometric characteristics were associated with SPPWR during the first postpartum year. Extending WIC eligibility for postpartum mothers to 2 years through the Wise Investment in Children Act may give WIC providers the opportunity to work closely with Southern California WIC mothers to achieve a healthy weight after pregnancy.
The Relationship between Personal and Contextual Factors and Participation Restriction in Mid-Life Caregivers
Authors: Klinedinst Tara C. , Beach Scott , Donovan Heidi , Rodakowski Juleen , Campbell Grace 
Published: January 2023

Objectives Mid-life family caregivers (CGs) are at risk for participation restriction, which can worsen quality of care for care recipients (CR) and increase CG burden and poor health. We aimed to identify factors associated with participation restriction in mid-life CGs. Methods This was a cross-sectional study of CGs aged 40–64 years ( n = 1100) from the 2015 cohort of the National Study of Caregiving (NSOC)/National Health and Aging Trends Study (NHATS). Multivariate logistic regression was used to evaluate personal and caregiving attributes associated with restricted participation. Results Individual items from the negative and Positive aspects of caregiving (PAC) scales were associated with participation restriction. Mid-life caregivers with “frequent changes to caregiving routine” and “no time for self” were more likely to report restricted participation and those feeling “closer to the CR” were less likely to report restricted participation. Discussion Interventions to optimize caregiving routines and improve dyadic relationships could decrease participation restriction in mid-life CGs.
Follow-up of patients with a 5-year survival after paraquat poisoning using computed tomography images and spirometry
Authors: Fan Lu , Wang Xuejie , Lv Tianyi , Xue Fei , Wu Benhe , Ma Aiwen , Lu Mingfeng 
Published: January 2023

Objectives The study aimed to examine long-term survival of patients with acute paraquat poisoning using computed tomography (CT) images and spirometry. Methods A total of 36 patients with long-term survival after paraquat poisoning were followed-up and divided into mild (11 patients), moderate (17 patients), and severe (8 patients) paraquat poisoning groups. Differences among the groups were compared using clinical indicators, such as peripheral capillary oxygen saturation, arterial partial pressure of oxygen and 6-min walk test (6-MWT), chest CT, spirometry, and serum immunoglobulin E (IgE). Results The 6-MWT distance was significantly shorter in the severe paraquat poisoning group than that in the mild and moderate paraquat poisoning groups. In the mild paraquat poisoning group, CT revealed no obvious lung injury, and spirometry showed normal lung function in most patients. In moderate or severe paraquat poisoning group, CT images showed fibrotic lesions as cord-like high-density shadows, reticulations, and honeycombs. In addition, other pulmonary changes, including bronchiectasis, increased lung transparency, and pulmonary bullae, were discovered. In moderate or severe paraquat poisoning group, obvious obstructive ventilation dysfunction with slight restrictive and diffuse impairment were observed in some patients, with positive bronchial relaxation test and high serum IgE level. Conclusion In the long-term follow-up, patients with severe paraquat poisoning showed the lowest exercise endurance. In moderate or severe paraquat poisoning group, CT images revealed diversified changes, not only dynamic evolution of pulmonary fibrosis process, but also signs of bronchiectasis, and chronic obstructive pulmonary disease. Some patients with moderate or severe paraquat poisoning developed obstructive ventilatory dysfunction with airway hyperresponsiveness.
Bacteriological Profile of Neonatal Sepsis and Its Antibiotic Susceptibility Along with the Various Indicators of Mortality
Authors: Choubey Kanchan , Mandraha Shipra , Tikkas Rajesh , Shrivastava Jyotsna , Ramteke Sharmila 
Published: January 2023

Background Neonatal sepsis is reported to be the 8th most common cause of under 5 mortality all over the world. Any delay in diagnosis is critical in contributing to neonatal mortality; thus, early diagnosis is necessary. Objectives To determine the risk factors, clinical features, hematological parameters, and bacteriological profile associated with neonatal sepsis and to assess the antibiotic sensitivity in SNCU. Methods This prospective study was conducted in SNCU of the tertiary care center of central India, over the duration of 1 year enrolling 150 participants. All the neonates suspected to be suffering from neonatal sepsis were included. Data was compiled using MS Excel and analyzed using IBM SPSS. Results Median age of neonates was 2 days (IQR: 1-5) with a male predominance. Median birth weight of neonates was 2 kg (IQR: 1.5-2.8). Blood cultures and antibiotic sensitivity revealed that most common organisms involved were staphylococcus aureus (34%; sensitive to penicillin, resistant to ampicillin) and klebsiella (20%; sensitive to colistin, resistant to clindamycin). 17.3% neonatal mortality was observed, amongst predictors of mortality, low birth weight, neonates delivered by LSCS, advanced maternal age, and leucopenia were significant predictors in univariate and multivariate analysis. Conclusion Antibiotic resistance is one of the most important problems of public health importance which is rampant in cases of early, as well as late onset sepsis.
Improving Initial Steps during Neonatal Resuscitation: A Quality Improvement Study
Authors: Shubham Shantanu , Grover Rajat , Singh Poonam , Mishra Divya , Bahadur Anupama , Priyadarshi Mayank , Chaurasia Suman , Basu Sriparna 
Published: January 2023

Background Neonatal resuscitation guided by the Neonatal Resuscitation Program (NRP) algorithm is a frequently performed event. However, strict adherence to the algorithm is often lacking. This quality improvement study was conducted when we identified poor compliance with the NRP algorithm in the ‘initial steps’ as a problem in our hospital. Methods The study was carried out over 48 weeks with an aim to improve the early steps of the NRP algorithm in the delivery room from the existing baseline score (maximum score of 22) of 5 (22%) to at least 13 (60%). Objective scoring, which included 11 domains (maximum score of 2 for each) from antenatal counselling, team briefing, equipment check and initial steps, and the time taken to begin positive pressure ventilation (PPV) were taken as process measures. Improvement of score to >90%, PPV requirement, beginning of PPV within 60 s and the use of various checklists were studied as outcome measures, along with the balancing outcome of neonatal intensive care unit admission temperature. Statistical process control charts were used for data analysis with standard rules for upper and lower control limits. Results A total of 480 resuscitations were scored. All domains of scoring improved from the baseline to the sustenance phase. The control limit improved from a baseline score of 5.1–21 during the sustenance phase, while the time to start PPV improved from 93.7 to 61.7 seconds. There was a significant improvement in the use of checklists for antenatal counselling, team briefing, and equipment checks. The need for PPV remained the same, and it could be started in only 36.4% of households within 60 seconds. Conclusion Proper implementation of the initial steps of the NRP algorithm improved along with the time of initiation of PPV after the study, though no major change was documented in the need for PPV administration.
Silica, Hyaluronate, and Alveolar Macrophage Functional Differentiation
Authors: Bodo Maria , Bellocchio Silvia , Bellucci Catia , Balloni Stefania , Pietrella Donatella , Sbaraglia Giovanni , Muzi Giacomo , Lilli Cinzia , Lumare Alessandro , Dell'Omo Marco , Abbritti Giuseppe 
Published: January 2023

Background Silicosis is mediated by macrophages, their soluble mediators, and extracellular matrix molecules. In this study, we investigated the effects of silica and/or hyaluronate (HA) on several alveolar macrophage responses. Methods We evaluated glycosaminoglycan (GAG) production by radiolabeled precursors, nitric oxide (NO) release by its oxidation product, phagocytic activity by Candida albicans internalization, and the secretion of two fibrogenic cytokines, tumor necrosis factor (TNF)-α and transforming growth factor (TGF)-β, by specific assays. Results Silica significantly reduced GAG secretion, particularly HA secretion. Alone, it decreased Candida uptake; associated with HA, it enhanced the reduction. Silica and Candida reduced NO release, which was not significantly affected when silica- or Candida-exposed cells were also treated with HA. TNF-α and TGF-β activities were stimulated by silica but reduced by HA. Conclusions The results suggest that silica and HA modify alveolar macrophage functional differentiation. Silica- and HA-induced modifications of the microenvironment could determine whether the response proceeds toward healing and repair or toward lung chronic pathology.
Controlling Blood Pressure in 50% of All Hypertensive Patients: An Achievable Goal in the Healthy People 2010 Report?
Authors: Egan Brent M. , Basile Jan N. 
Published: January 2023

Background One important objective defined in the Healthy People 2010 report was to improve blood pressure (BP) control to < 140/90 mm Hg in 50% of all hypertensive patients. Because the US population is becoming older, more obese, and ethnically diverse, the health and economic benefits of reaching this goal become more valuable each year. Hypertension control rates are currently at ∼ 31% of all hypertensives and have risen slowly and erratically since 1988. In the absence of a coordinated strategic plan, achieving this critically important goal for BP control is highly unlikely. Methods A selected literature review was undertaken to briefly assess the cardiovascular benefits of controlling hypertension. Greater focus was placed on variables that impact hypertension awareness, treatment, and control. The impact on hypertension control rates of theoretic changes in awareness, treatment, and control individually and collectively was examined. Four categories of potential barriers to optimizing BP control are discussed: systems, provider, patient, and treatment factors. Results Raising awareness to 80% of all hypertensives, ensuring treatment of 90% of aware hypertensives, and controlling BP to < 140/90 mm Hg in 70% of treated patients would achieve control rates of 50%. Conclusions The barriers to achieving the Healthy People 2010 goal of controlling hypertension in 50% of all patients are formidable but appear to be resolvable with a coordinated strategic plan. Given projected demographic changes in the United States, the health and economic benefits of attaining the national goal for hypertension control would seem to merit a serious integrated effort.
Feline stress management during air travel: a multimodal approach
Authors: Jahn Katrin , DePorter Theresa 
Published: January 2023

Practical relevance: More cats are travelling by air every year; however, air travel involves several common causes of stress for cats, such as environmental changes and a lack of control and predictability. The use of a multimodal stress management protocol for all stages of the relocation process, including appropriate and effective anxiolytic medication where necessary, is therefore important in order to safeguard the cat’s welfare while travelling. Clinical challenges: Cats may be presented to veterinarians for the purpose of preparing them and/or their documentation for air travel. Maintaining and protecting a cat’s physical, mental and emotional health in a stressful environment, while subjected to likely unfamiliar sights, noises, smells and the movement of the aircraft, and additionally dealing with international legislation, regulations and documents, can pose a complex challenge to veterinarians. Aims: This review describes the importance of stress management during air travel for cats, aims to raise awareness about the often poorly understood challenges involved, and outlines effective and airline-compliant stress management modalities. While the discussion is focused on air travel specifically, the stress management methods described can be applied to all types of longer distance travel, such as a long road trip or a ferry crossing, as well as a stay in a holiday home. Evidence base: There are currently no studies specifically on air travel in cats and, similarly, there are also limited data on air travel in other species. Many of the recommendations made in this review are therefore based on the authors’ extensive experience of preparing pets for travel, supported by published data when available.