bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Losartan reduce the severity of COVID-19 in hypertensive patients?
Authors: Mirjalili Mohammadreza , Soodejani Moslem Taheri , Raadabadi Mehdi , Dehghani Ali , Salemi Fateme 
Published: March 2022

Abstract
Background
One of the global problems is to control the coronavirus epidemic, and the role of different medicines is still unknown to policymakers. This study was conducted to evaluate the effects of losartan on the mortality rate of COVID-19 in hypertensive patients.

Methods
The research sample of analytical study included 1458 patients presenting to COVID-19 diagnostic centers in Yazd that were examined in the first six months of 2020. Data were analyzed using descriptive statistics as well as chi-square, Fisher’s exact test, t test, and logistic regression.

Results
Of 1458 subjects that were studied, 280 were hypertensive of whom 179 tested positive for SARS-CoV-2 PCR. The results showed a lower chance of death by more than 5 times in hypertensive patients who used losartan (P = 0.003). Moreover, regarding the effect of losartan on the prevention of COVID-19 in hypertensive patients, it was found that this medicine played a protective role although this relationship was not statistically significant (P = 0.86).

Conclusions
The results showed that losartan reduced the chance of mortality in hypertensive patients. It is recommended that the effect of losartan and other blood pressure medicines on COVID-19 patients be investigated in larger studies as well as laboratory investigations.
The effects of Pre-hospital Trauma Life Support (PHTLS) training program on the on-scene time interval
Authors: Esmaeilzadeh Mohammad Hossein , Rostamian Morteza , Khorasani-Zavareh Davoud , Shirazi Fahimeh Barghi , Mogharab Marzieh 
Published: March 2022

Abstract
Background
Recent studies have shown that reducing pre-hospital time could improve the outcomes of trauma victims. Due to the importance of pre-hospital time management, this study aims to determine the effects of the Pre-hospital Trauma Life Support (PHTLS) training program on the on-scene time interval reduction.

Methods
The PHTLS training program was implemented based on global standards for pre-hospital emergency technicians. The research tool was a questionnaire designed by the Ministry of Health and Medical Education in Iran. The mean on-scene time interval was calculated before, after and one month after the intervention in the control (n = 32) and experimental group (n = 32). The data were analyzed using SPSS.

Results
The mean on-scene time interval in the target group (one month after intervention) has been significantly lower than that of the control group. Moreover, the mean and standard deviation from the on-scene time interval in the target group has been reduced from 17.6 ± 5.5 (before intervention) to 12 ± 3.8 min (one month after intervention) which was statistically significant.

Conclusion
The implementation of the PHTLS training program can lead to the reduction of on-scene time interval. Therefore, considering the role of reducing on-scene time intervals on victims’ survival, the integration of the PHTLS training programs with pre-hospital emergency medical service systems seems inevitable.
Hand grenade blast injuries in the Eastern Democratic Republic of Congo: a case series of 38 patients
Authors: Budema Paul Munguakonkwa , Murhega Romeo Bujiriri , Tshimbombu Tshibambe Nathanael , Toha Georges Kuyigwa , Cikomola Fabrice Gulimwentuga , Mudekereza Paterne Safari , Mubenga Léon-Emmanuel , Balemba Ghislain Maheshe , Badesire Darck Cubaka , Kanmounye Ulrick Sidney 
Published: March 2022

Abstract
Introduction
The armed conflict in the Kivu province of the Democratic Republic of Congo has caused close to 12,000 deaths. One of the most lethal weapons in armed conflicts is the high explosive hand grenade. The study aimed to describe the epidemiology, presentation, and outcomes of hand grenade blast injuries (HGBI) in the Kivu province.

Methods
In this case series, the authors present 2017 to 2020 HGBI admissions at a Congolese trauma center. Measures of central tendency and spread were computed for continuous data. Complication and mortality rates were equally computed. Admission-to-discharge data were disaggregated by the body part injured and by complication status and visualized using time-to-event curves.

Results
Thirty-eight HGBI patients aged 31.4 (range 17–56) years were included in the study. Twenty-six (68.4%) were male and the patients were admitted 1.8 days post-injury on average. The patients were hemodynamically stable at admission; 84.2% received the antitetanic vaccine, 21.1% received broad-spectrum antibiotics, and all were debrided (100.0%). The complication rate was 13.2%, and the most common complication was anemia (7.9%). In addition, the mortality rate was 2.6%. The median admission-to-discharge time was 17.0 (range 4–71) days, and it was prolonged in patients with lower extremity injuries (23.0 days).

Conclusion
HGBIs cause avertable death and disability in the Kivu regions. These data suggest that the burden of HGBIs can be reduced with appropriate preventive and health systems strengthening interventions.
The quality of pre-announcement communication and the accuracy of estimated arrival time in critically ill patients, a prospective observational study
Authors: Maris Michelle , Berben Sivera A. A. , Verhoef Wouter , van Grunsven Pierre , Tan Edward C. T. H. 
Published: March 2022

Abstract
Background
Efficient communication between (helicopter) emergency medical services ((H)EMS) and healthcare professionals in the emergency department (ED) is essential to facilitate appropriate team mobilization and preparation for critically ill patients. A correct estimated time of arrival (ETA) is crucial for patient safety and time-management since all team members have to be present, but needless waiting must be avoided. The aim of this study is to investigate the quality of the pre-announcement and the accuracy of the ETA.

Methods
A prospective observational study was conducted in potentially critically ill/injured patients transported to the ED of a Level I trauma center by the (H)EMS. Research assistants observed time slots prior to arrival at the ED and during the initial assessment, using a stopwatch and an observation form. Information on the pre-announcement (including mechanisms of injury, vital signs, and the ETA) is also collected.

Results
One hundred and ninety-three critically ill/injured patients were included. Information in the pre-announcement was often incomplete; in particular vital signs (86%). Forty percent of the announced critically ill patients were non-critical at arrival in the ED. The observed time of arrival (OTA) for 66% of the patients was later than the provided ETA (median 5:15 min) and 19% of the patients arrived sooner (3:10 min). Team completeness prior to the arrival of the patient was achieved for 66% of the patients.

Conclusions
The quality of the pre-announcement is moderate, sometimes lacking essential information on vital signs. Forty percent of the critically ill patients turned out to be non-critical at the ED. Furthermore, the ETA was regularly inaccurate and team completeness was insufficient. However, none of the above was correlated to the rate of complications, mortality, LOS, ward of admission or discharge location.
Validity and reliability of the Persian version of the Patient readiness to engage in health information technology (PRE-HIT) instrument
Authors: Safdari Reza , Yu Ping , Khenarinezhad Sahar , Ghazanfari Savadkoohi Ehsan , Javanmard Zohreh , Yousefi Ala , Barzegari Saeed 
Published: March 2022

Abstract
Background
The Patient readiness to engage in health information technology (PRE-HIT) is a conceptually and psychometrically validated questionnaire survey tool to measure willingness of patients with chronic conditions to use health information technology (HIT) resources.

Objectives
This study aimed to translate and validate a health information technology readiness instrument, the PRE-HIT instrument, into the Persian language.

Methods
A rigorous process was followed to translate the PRE-HIT instrument into the Persian language. The face and content validity was validated by impact score, content validity index (CVI) and content validity ratio (CVR). The instrument was used to measure readiness of 289 patients with chronic diseases to engage with digital health with a four point Likert scale. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was used to check the validity of structure. The convergent and discriminant validity, and internal reliability was expressed by average variance extracted (AVE), construct reliability (CR), maximum shared squared variance (MSV), average shared square variance (ASV), and Cronbach's alpha coefficient. Independent samples, t-test and one-way ANOVA were used respectively to compare the impact of sex, education and computer literacy on the performance of all PRE-HIT factors.

Results
Eight factors were extracted: health information needs, computer anxiety, computer/internet experience and expertise, preferred mode of interaction, no news is good news, relationship with doctor, cell phone expertise, and internet privacy concerns. They explained 69% of the total variance and the KMO value was 0.79; Bartlett's test of sphericity was also statistically significant (sig < 0.001). The communality of items was higher than 0.5. An acceptable model fit of the instrument was achieved (CFI = 0.943, TLI = 0.931, IFI = 0.944, GFI = 0.893, RMSEA ≤ 0.06, χ2/df = 1.625, df = 292, P-value ≤ 0.001). The Cronbach's alpha coefficient achieved a satisfactory level of 0.729. The AVE for all factors was higher than 0.50 except for PMI (0.427) and CIEE (0.463) and also the CR for all factors was higher than 0.7, therefore, the convergent validity of the instrument is adequate. The MSV and ASV values for each factor were lower than AVE values; therefore, the divergent validity was acceptable.

Conclusion
The Persian version of the PRE-HIT was empirically proved for its validity to assess the level of readiness of patients to engage with digital health.
Application of a nomogram to radiomics labels in the treatment prediction scheme for lumbar disc herniation
Authors: Yu Gang , Yang Wenlong , Zhang Jingkun , Zhang Qi , Zhou Jian , Hong Yuan , Luo Jiaojiao , Shi Quan , Yang Zhidan , Zhang Kangyu , Tu Hong 
Published: March 2022

Abstract
Objective
To investigate and verify the efficiency and effectiveness of a nomogram based on radiomics labels in predicting the treatment of lumbar disc herniation (LDH).

Methods
By reviewing medical records that were analysed over the past three years, clinical and imaging data of 200 lumbar disc patients at the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine were obtained. The collected cases were randomly divided into a training group (n = 140) and a testing group (n = 60) at a ratio of 7:3. Two radiologists with experience in reading orthopaedics images independently segmented the ROIs. The whole intervertebral disc with the most obvious protrusion in the sagittal plane T2WI lumbar MRI as a mask (ROI) is sketched. The LASSO (Least Absolute Shrinkage And Selection Operator) algorithm was used to filter the features after extracting the radiomics features. The multivariate logistic regression model was used to construct a quantitative imaging Rad‑Score for the selected features with nonzero coefficients. The radiomics labels and nomogram were evaluated using the receiver operating characteristic curve (ROC) and the area under the curve (AUC). The calibration curve was used to evaluate the consistency between the nomogram prediction and the actual treatment plan. The DCA decision curve was used to evaluate the clinical applicability of the nomogram.

Result
Following feature extraction, 11 radiomics features were used to construct the radiomics label for predicting the treatment plan of LDH. A nomogram was then constructed. The AUC was 0.93 (95% CI: 0.90–0.97), with a sensitivity of 89%, a specificity of 91%, a positive predictive value of 92.7%, a negative predictive value of 89.4%, and an accuracy of 91%. The calibration curve showed that there was good consistency between the prediction and the actual observation. The DCA decision curve analysis showed that the nomogram of the imaging group has great potential for clinical application when the risk threshold is between 5 and 72%.

Conclusion
A nomogram based on radiomics labels has good predictive value for the treatment of LDH and can be used as a reference for clinical decision-making.
Regorafenib-induced renal-limited thrombotic microangiopathy: a case report and review of literatures
Authors: Yin Qinghua , Guo Na , Zhou Xueli , Xu Huan , Lei Song , Fu Ping , Zhong Hui 
Published: March 2022

Abstract
Background
Regorafenib belongs to a sub-group of small-molecule multi-targeted tyrosine kinase inhibitors(TKIs). In various studies with respect to the side-effect of regorafenib, drug-associated proteinuria standardly qualified to be defined as nephrotic syndrome was rarely reported as well as the relation of regorafenib with the occurrence and development of thrombotic microangiopathy (TMA).

Case presentation
In this case report and literature review, we presented a 62-year-old patient receiving regorafenib for metastatic colon cancer, manifesting abundant proteinuria, in which TMA was also diagnosed through renal biopsy. As far as we were concerned, this was the first reported in terms of regorafenib-induced TMA confirmed by renal biopsy.

Conclusion
This case indicates that regorafenib, a kind of TKIs may result in TMA, which is a rare but life-threatening complication of cancer treatment drug. Insights from this case might help physicians diagnose rare forms of TMA and adjust treatment for patients in a timely manner.
Expression and 7-day time course of circulating microRNAs in septic patients treated with nephrotoxic antibiotic agents
Authors: Petejova Nadezda , Martinek Arnost , Zadrazil Josef , Klementa Viktor , Pribylova Lenka , Bris Radim , Kanova Marcela , Sigutova Radka , Kacirova Ivana , Svagera Zdenek , Bace Eva , Stejskal David 
Published: March 2022

Abstract
Background
Through regulation of signaling pathways, microRNAs (miRNAs) can be involved in sepsis and associated organ dysfunction. The aims of this study were to track the 7-day time course of blood miRNAs in patients with sepsis treated with vancomycin, gentamicin, or a non-nephrotoxic antibiotic and miRNA associations with neutrophil gelatinase-associated lipokalin (NGAL), creatinine, procalcitonin, interleukin-6, and acute kidney injury (AKI) stage.

Methods
Of 46 adult patients, 7 were on vancomycin, 20 on gentamicin, and 19 on another antibiotic. Blood samples were collected on days 1, 4, and 7 of treatment, and miRNAs were identified using quantitative reverse transcription PCR.

Results
The results showed no relationship between miRNA levels and biochemical variables on day 1. By day 7 of gentamicin treatment miR-15a-5p provided good discrimination between AKI and non-AKI (area under curve, 0.828). In patients taking vancomycin, miR-155-5p and miR-192-5p positively correlated with creatinine and NGAL values, and miR-192-5p and miR-423-5p positively correlated with procalcitonin and interleukin-6 in patients treated with a non-nephrotoxic antibiotic. In patients together we found positive correlation between miR-155-5p and miR-423-5p and all biochemical markers.

Conclusion
The results suggest that these four miRNAs may serve as diagnostic or therapeutic tool in sepsis, renal injury and nephrotoxic treatment.

Trial registration
ClinicalTrials.gov, ID: NCT04991376. Registered on 27 July 2021.
Interaction between socioeconomic deprivation and ethnicity for likelihood of receiving living-donor kidney transplantation
Authors: Khalil Khalid , Brotherton Anna , Moore Sue , Evison Felicity , Gallier Suzy , Hodson James , Sharif Adnan 
Published: March 2022

Abstract
Background
The interplay between ethnicity and socioeconomic deprivation for living-donor kidney transplantation (LDKT) opportunities is unclear.

Methods
Data for 2040 consecutive kidney-alone transplant recipients receiving an allograft between 1st January 2007 and 30th June 2020 at a single center were retrospectively analyzed. The associations between the proportions of transplants that were LDKT (versus deceased donation) and both ethnicity and socioeconomic deprivation were assessed, with the latter quantified by the Index of Multiple Deprivation (IMD) quintile.

Results
The cohort comprised recipients of White (64.7%), South Asian (21.7%), Black (7.0%) and other (6.6%) ethnic groups. Recipients tended to be from socioeconomically deprived areas, with the most deprived quintile being the most frequently observed (quintile 1: 38.6% of patients); non-White recipients were significantly more likely to live in socioeconomically deprived areas (p < 0.001). Overall, 36.5% of transplants were LDKT, with this proportion declining progressively with socioeconomic deprivation, from 50.4 to 27.6% in the least versus most deprived IMD quintile (p < 0.001). A significant difference across recipient ethnicities was also observed, with the proportion of LDKTs ranging from 43.2% in White recipients to 17.8% in Black recipients (p < 0.001). Both socioeconomic deprivation (p < 0.001) and ethnicity (p = 0.005) remained significant predictors of LDKT on multivariable analysis, with a significant interaction between these factors also being observed (p < 0.001). Further assessment of this interaction effect found that, whilst there was a marked difference in the proportions of transplants that were LDKT between White versus non-White recipients in the most socioeconomically deprived groups (39.5% versus 19.3%), no such difference was seen in the least deprived recipients (48.5% versus 51.9%).

Conclusions
Whilst both socioeconomic deprivation and non-White ethnicity are independent predictors for lower proportions of LDKTs, the significant interaction between the two factors should be appreciated.
Longitudinal extensive transverse myelitis after chemoradiation therapy with durvalumab, a rare complication: case report
Authors: Moodie Travis , Alshaqi Ola , Alchaki Abdul 
Published: March 2022

Abstract
Background
Longitudinal extensive transverse myelitis is a rare and potentially life-threatening complication of chemoradiation. Certain chemotherapy agents have been proposed to increased neurotoxicity with chemoradiation therapy. One such agent is durvalumab, a human IgG1 monoclonal antibody that blocks programmed death ligand 1, allowing T-cells to recognize and kill tumor cells. Durvalumab and other immune checkpoint inhibitors may also cause transverse myelitis without concomitant treatment with radiation. Durvalumab is a standard therapy for non-small cell lung carcinoma. Here we present a case of a 68-year-old male who presented after chemoradiation and durvalumab therapy with transverse myelitis extending outside the irradiation site.

Case presentation
A 68-year-old male presented to the emergency department with pain and weakness in his feet and hesitancy of urination. Medical history is significant for non-small cell lung cancer treated with chemoradiotherapy and consolidation therapy with durvalumab for one year. His last radiation treatment was 15 months prior, and his last infusion of durvalumab was 3 months prior. Exam revealed severe weakness of bilateral legs with absent vibration sensation. MRI showed central longitudinal extensive transverse myelitis extending from C4-T11. CSF studies showed 8 WBC with 63% lymphocyte predominance and a protein of 48. Oligoclonal bands and angiotensin-converting enzyme were negative. Serum Neuromyelitis Optica antibody (AQP4-IgG) and Myelin oligodendrocyte glycoprotein antibody (MOG-IgG) were negative. Infectious workup came back negative. The patient was treated with steroids and plasma exchange with mild improvement. Etiology remained unknown, but longitudinal extensive transverse myelitis following durvalumab chemoradiotherapy was thought to be the likely cause. He was discharged on a high-dose prednisone taper with outpatient follow-up. His condition worsened near the end of the steroid taper. High-dose prednisone and cyclophosphamide infusions were started with mild improvement and stabilization of the patient’s condition. He transitioned to methotrexate after completion of six cyclophosphamide infusions. The patient expired due to complications from his cancer.

Conclusion
Longitudinal extensive transverse myelitis is a rare and potentially life-threatening complication of durvalumab therapy. As durvalumab has become a standard treatment for non-small cell lung cancer, it is important to be able to identify and treat side effects.
Using Doppler sonography resistive index for the diagnosis of perinatal asphyxia: a multi-centered study
Authors: Pishdad Parisa , Yarmahmoodi Fatemeh , Eghbali Tannaz , Arasteh Peyman , Razavi Seyyed Mostajab 
Published: March 2022

Abstract
Background and objective
Inhere we evaluated the diagnostic utility of Doppler sonography (DS) of the anterior cerebral artery (ACA), middle cerebral artery (MCA) and the basilar arteries (BA) based on resistive index (RI) for the diagnosis of asphyxia.

Methods
In this multi-centered cross-sectional study, neonates with clinical diagnosis of asphyxia, were considered for study. During the first 24 h, neonates underwent DS. MRI was done for each neonate during the first month, after discharge or during hospital admission, after obtaining clinical stability. Staging based on DS was compared with staging based on MRI.

Results
Overall, 34 patients entered the study. DS of the ACA, MCA, BA all had significant correlation with MRI findings (regarding severity of asphyxia) (r > 0.8 and p < 0.001).
In the receiver-operating-characteristic analysis, ideal cut-off point for diagnoses of asphyxia based on ACA and BA was RI ≤ 0.62 [area under the curve (AUC) = 0.957 and 95% CI: 0.819–0.997; sensitivity = 95.65; specificity = 100; positive predictive value (PPV) = 100; negative predictive value (NPV) = 90.9 and negative likelihood ratio (NLR) = 0.043]. Regarding MCA, similarly, a RI ≤ 0.62 was ideal for differentiating between normal and asphyxiated neonates (AUC = 0.990 and 95% CI: 0.873–1; sensitivity = 91.30; specificity = 100; PPV = 91.2; NPV = 100 and NLR = 0.087).

Conclusion
For evaluating neonates clinically suspected of asphyxia, especially in centers with limited facilities such as MRI, DS can be used as a first line diagnostic modality and RI of ≤ 0.62 is an appropriate cut-off for the diagnosis of perinatal asphyxia.