bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between systolic blood pressure parameters and unexplained early neurological deterioration (UnND) in acute ischemic stroke patients treated with mechanical thrombectomy
Authors: Vilionskis Aleksandras , Gaigalaite Virginija , Salasevicius Lukas , Jatuzis Dalius 
Published: June 2022

Background: Neurological deterioration (ND) after mechanical thrombectomy (MT) of acute ischemic stroke (AIS) in anterior circulation is an important complication associated with a poor outcome. Moreover, evident causes of ND may remain unexplained (UnND). Objective: We sought to evaluate the association of the systolic blood pressure (SBP) parameters before MT, during MT, and during a 24-h period after MT with UnND. Methods: We analyzed 382 MT-treated AIS patients in two stroke centers from 2017 to 2019. The patients with unsuccessful recanalization and/or with symptomatic intracerebral hemorrhage after MT were excluded. Multivariate logistic regression analysis was used to identify the SBP parameters that predict UnND. Results: There were 5.9% patients with UnND within 24 h after MT among patients with successful recanalization what comprises 4.9% of all patients who had undergone MT. SBP > 180 mmHg on admission (odds ratio (OR): 4, 95% confidence interval (CI): 1.6–10, p = 0.004) and a drop of SBP below100 mmHg during MT (OR: 4.7, 95% CI: 1.3–17, p = 0.019) were associated with UnND occurrence within 7 days without a significant association with UnND within 24 h. UnND within 7 days was predicted by the episodes of SBP exceeding the level of SBP observed before the groin puncture and occurring over the first 2 h following recanalization (OR: 5, 95% CI: 1.3–19, p = 0.021), an increase of SBP of more than 20% within 2–24 h after MT (OR: 3.4, 95% CI: 1.1–10, p = 0.035), and a drop of SBP below 100 mmHg after MT (OR: 3.2, 95% CI: 1.1–9, p = 0.039). Conclusion: The association between the SBP parameters and UnND depends on the treatment period and the time of UnND occurrence. The J/U resembling relationship between SBP and UnEND was established during a 24-h period after MT.
Cancer-cell-derived cell-free DNA can predict distant metastasis earlier in pancreatic cancer: a prospective cohort study
Authors: Huang Chien-Jui , Huang Wen-Yen , Chen Chien-Yu , Chao Ying-Jui , Chiang Nai-Jung , Shan Yan-Shen 
Published: June 2022

Background: Carbohydrate antigen 19-9 (CA19-9) is the only biomarker for monitoring responses during treatments of pancreatic cancer, but its accuracy for disease outcome is controversial. Fluid biopsy is a new method for diagnosis and monitoring treatment response. In this study, we investigate the usefulness of cell-free DNA (cfDNA) in predicting disease progression during the treatment of pancreatic cancer. Methods: Biopsy-proved advanced pancreatic cancer patients who received systemic chemotherapy were enrolled after signed informed consent. CA19-9 and cfDNA in blood were measured before and after every two cycles of treatments, and the disease progression was monitored by computed tomography (CT) with 3-month interval. Results: In total, 74 patients and 148 blood samples were enrolled in this study. Patients whose average blood cfDNA concentration of >9.71 ng/mL before and after first two courses of chemotherapy would subsequently show new distant metastasis (NDM) on CT scans 3 months later. The accuracy was 94.37% (AUC 0.9705, p < 0.0001) and the progression-free survival (PFS) and overall survival (OS) of patients with cfDNA concentration of >9.71 ng/mL were worse than those patients with cfDNA concentration of <9.71 ng/mL (median PFS: 95 days versus 322 days, p < 0.0001; median OS: 150 days versus 431 days, p < 0.0001). The cfDNA concentration of >9.71 ng/mL is a predictor for PFS, OS, and distant metastasis-free survival by multivariate analysis. Comparison of KRAS G12 variants detected by next-generation sequencing from tumor tissue issue and remnant DNA of cfDNA showed that increased cfDNA was primarily derived from cancer cells. Conclusion: The cancer-cell-derived cfDNA levels could be served as a powerful biomarker for prediction of NDM in patients with advanced/metastatic pancreatic cancer.
Elementary math class in face-to-face, fully online, and flipped mode: A comparative study on students’ achievement and satisfaction
Authors: Kundu Arnab , Bej Tripti , Mondal Gourish C 
Published: June 2022

Excellent certificates are not enough to make excellent teachers rather, teaching demands constant insight, reflection, and suitable pedagogy. Determining the best pedagogical method of course delivery plagues faculty members and schools across the globe. This paper reports on an investigation and outcomes of a comparative study of three different methods of course delivery offered for the same course in an Indian elementary school before the COVID-19 pandemic. The study followed a Design-Based Research (DBR) approach. Comparisons have been made to the collected quantitative data from each teaching method-face-to-face, blended flipped, and fully online-in respect of students’ learning achievement and satisfaction. Findings revealed that participants in the face-to-face group achieved better than the rest two groups. However, students in the flipped group reported better satisfaction with the course than in the other two modes, and it happened within 8 weeks. These results offer implications for selecting the best method of course delivery for elementary mathematics even in unequipped schools, echoing an insight for practice to add effectiveness to the delivery mode.
Estimation of cardiac QTc intervals in people prescribed antipsychotics: a comparison of correction factors
Authors: Andric Teodora , Winckel Karl , Tanzer Timothy David , Hollingworth Samantha , Smith Lesley , Isoardi Katherine , Tan Olivier , Siskind Dan 
Published: June 2022

Background: A prolonged electrocardiogram (ECG) QT interval is associated with cardiac events and increased mortality. Antipsychotics can prolong the QT interval. The QT interval requires correction (QTc) for heart rate using a formula or QT-nomogram. The QT and QTc can be calculated automatically by the ECG machine or manually; however, machine-measured QT(c) intervals may be inaccurate. Objective: We aimed to investigate the mean QTc and proportion of prolonged QTc intervals in people taking antipsychotic medicines. Methods: We conducted an observational retrospective chart review and data analysis of all consecutive patients taking antipsychotics, with an ECG record, admitted to the psychiatric unit of a large tertiary hospital in Brisbane, Australia, between 1 January 2017 and 30 January 2019. We investigated the mean QTc of people taking antipsychotics to determine differences using (a) machine versus manual QT interval measurement and (b) QTc correction formulae (Bazett, Fridericia, Framingham, Hodges and Rautaharju) and the QT-nomogram. We also determined the number of people with a prolonged QTc using different methods and compared rates of prolonged QTc with antipsychotic monotherapy and polypharmacy. Results: Of 920 included people, the mean (±SD) machine-measured, Bazett-corrected QT interval (recorded from the ECG) was 435 ms (±27), significantly longer ( p < 0.001) than the mean manually measured corrected QT intervals with Fridericia 394 ms (±24), Framingham 395 ms (±22), Hodges 398 ms (±22) and Rautaharju 400 ms (±24) formulae. There were significantly more people with a prolonged QTc using machine-measured QT and the Bazett formula (12.0%, 110/920) when compared with manually measured QT and the Fridericia formula (2.2%, 20/920) or QT-nomogram (0.7%, 6/920). Rates of QTc prolongation did not differ between people taking antipsychotic polypharmacy compared with monotherapy. Conclusion: Machine-measured QTc using the Bazett formula overestimates the QTc interval length and number of people with a prolonged QTc, compared with other formulae and the QT-nomogram. We recommend manually measuring the QT and correcting with the Fridericia formula or QT-nomogram prior to modifying antipsychotic therapies.
Cost effectiveness of virtual reality game compared to clinic based McKenzie extension therapy for chronic non-specific low back pain
Authors: Fatoye Francis , Gebrye Tadesse , Mbada Chidozie Emmanuel , Fatoye Clara T , Makinde Moses O , Ayomide Salami , Ige Blessing 
Published: June 2022

Background Low-back pain (LBP) is a major public health problem globally and its direct and indirect healthcare costs are growing rapidly. Virtual reality involving the use of video games or non-game applications are alternatives to conventional face-to-face physical therapy for LBP. The purpose of this study was to assess the cost-effectiveness of Back Extension-Virtual Reality Game (BE-VRG) compared to Clinic-based McKenzie therapy (CBMT) for chronic non-specific LBP in Nigeria. Methods Patients with chronic non-specific LBP were randomised into either BE-VRG or CBMT group. Patients’ level of disability was assessed using Oswestry Disability Index (ODI) at week 4 and week 8. ODI was mapped to SF-6D to generate quality adjusted life years (QALYs) used for cost-effectiveness analysis. Resource use and costs were assessed based on rehabilitation services from a healthcare perspective. Cost-effectiveness analysis which included direct healthcare costs was conducted. Incremental cost per QALY was also calculated. Results Forty-six patients (BE-VRG, n = 22; CBMT, n = 24) with the mean (±SD) age of 32.6 ± (11.5) years for BE-VRG and 48.8 ± (10.2) years for CBMT intervention completed in this study. The mean direct health costs per patient were USD100.67 and USD106.3 for BE-VRG and CBMT, respectively. The mean quality adjusted life years at week 4 and week 8 were (BE-VRG, 0.0574 ± (0.002); CBMT, 0.0548 ± (0.002)); and (BE-VRG; 0.116 ± (0.002); CBMT; 0.114 ± (0.004)), respectively. Incremental cost-effectiveness ratio showed that BE-VRG arm was less costly and more effective than CBMT. Conclusion The findings of this study suggest that BE-VRG was cost saving for chronic non-specific LBP compared to CBMT. This evidence could guide policy makers, payers and clinicians in evaluating BE-VRG as a treatment option for people with chronic non-specific LBP.
Nurse’s spiritual care perception in Ethiopia: A multicenter cross-sectional study
Authors: Seid Kalid , Eneyew Mekdes 
Published: June 2022

Objectives: Spirituality and spiritual care are the critical components of patient care. In recent years, spirituality has been indicated as a crucial but often overlooked component of patient health. Despite their benefits, several factors prevent nurses from providing spiritual care. Hence, the purpose of this study was to evaluate the current state of spiritual care perception of nurses in Southwest Ethiopia as well as the factors influencing it. Methods: From 1 August to 2 September 2021, an institution-based cross-sectional study was performed on nurses at five government hospitals in Southwest Ethiopia. Study participants were selected using a simple random sampling method. Data were collected using the Spirituality and Spiritual Care Rating Scale (SSCRS). The collected data were recorded into EpiData 4.1 and SPSS version 25. Simple and multivariable linear regression analyses were used to identify factors associated with spiritual care perception. Statistical significance was set at p < 0.05. Results: A total of 390 nurses were enrolled in the study, yielding a response rate of 96.8%. The mean score for nurses’ perception of spiritual care for patients was moderate, that is, 3.11 ± 0.78. Age (p < 0.05), clinical experience (p < 0.05), educational status (p < 0.05), and religion (p < 0.05) were significantly associated with spiritual care perceptions. Conclusion: Nurses’ perception of spiritual care was moderate. It is affected by nurses’ age, clinical experience, educational level, and religion. This expanding body of data should be used to notify nurse managers and nursing management personnel to provide spiritual care training, planning, and services.
The Impact of the COVID-19 Pandemic on Food Insecurity in Northern New England Primary and Prenatal Care Settings
Authors: Hatchell Kayla E. , Canavan Chelsey R. , D’cruze Tiffany , Suresh Arvind , Dev Alka , Boardman Maureen , Kennedy Meaghan A. 
Published: June 2022

Introduction and Objective: Food insecurity (FI) is associated with adverse health outcomes across the lifespan. Primary care and prenatal practices can identify and address FI among patients through screening and interventions. It is unclear how practices and communities responded to FI during the COVID-19 pandemic, and how the pandemic may have impacted practices’ FI strategies. We aimed to understand how practices providing primary care or prenatal care in northern New England experienced changes in FI during the COVID-19 pandemic. Methods: We conducted a web-based survey of clinicians and staff from 43 unique practices providing primary care or prenatal care in northern New England. Results: Most practices (59.5%) reported at least 1 new food program in the practice or community since the pandemic began. Practices reporting new practice- or community-based food programs were more likely to be rural, federally qualified health centers, and have greater confidence in practice and community capacity to address FI (chi-square tests, P < .05). Conclusion: Results suggest that practices and surrounding communities in northern New England responded to FI during the pandemic by increasing food support programs. Future work is needed to examine the impact of food programs initiated during the pandemic and determine optimal strategies for practices to address FI among patients.
Reduction of Instrumentation-Related Spine Surgical Site Infections After Optimization of Surgical Techniques. A Single Center Retrospective Analysis
Authors: San-Juan Rafael , Paredes Igor , Ramírez-Nava Esther , Delgado-Fernández Juan , Panero Irene , Hernández-Ortiz Paula , Ramírez-Vicente Elia , Fernández-Ruiz Mario , López-Medrano Francisco , Corbella Laura , Rodríguez-Goncer Isabel , Brañas Patricia , Lagares Alfonso , Aguado José María 
Published: June 2022

Study Design Retrospective cohort study. Objective Although surgical risk factors for developing spine surgical site infections (S-SSI) have been identified, the impact of such knowledge in its prevention has not been demonstrated. Methods We evaluated in 500 patients undergoing spine surgery between 2011 and 2019 at Hospital 12 de Octubre the changes in S-SSI rates over time. Surgical variables independently related to S-SSI were analyzed by univariate and multivariate analysis using binary logistic regression models. A case-control sub-analysis (1:4), matched by the surgical variables identified in the overall cohort was also performed. Results Twenty cases of S-SSI were identified (4%), with a significant decrease in the incidence rate across consecutive time periods (6.6% [2011-2014] vs .86% [2015-2019]; P-value <.0001)). Multivariate analysis identified arthrodesis involving sacral levels (odds ratio [OR]: 2.57; 95% confidence interval [95%CI]: 1.02-6.47; P-value = .044) and instrumentation over 4-8 vertebrae (OR: 2.82; 95%CI: 1.1-7.1; P-value = .027) as independent risk factors for S-SSI. The reduction in the incidence of S-SSI concurred temporally with a reduction in instrumentations involving 4-8 vertebrae (55% vs 21.8%; P-value <.0001) and sacral vertebrae (46.9% vs 24.6%; P-value <.0001) across both periods. The case-control analysis matched by these surgical variables failed to identify other factors independently related to the occurrence of S-SSI. Conclusions Spinal fusion of more than 4 levels and the inclusion of sacral levels were independently related to the risk of S-SSI. Optimization of surgical techniques by reducing these two types of instrumentation could significantly reduce S-SSI rates.
Postoperative Pain and Paresthesia in Labral Repairs of the Shoulder: Location Does Matter
Authors: Latif Joseph , Aveledo Ricardo , Lam Patrick H. , Murrell George A.C. 
Published: June 2022

Background: Favorable outcomes have been reported regarding postoperative shoulder pain and function after repair of anteroinferior (Bankart) glenohumeral labral tears. However, the outcomes of patients after repair of isolated superior labral anterior-posterior (SLAP) tears are a contentious topic. The authors have also anecdotally noted that patients evaluated with labral tears complained of numbness and tingling in their ipsilateral hand. Purpose: To determine if there is a difference in the temporal outcomes of shoulder pain and hand paresthesia in patients with SLAP tears versus Bankart tears after arthroscopic repair. Study Design: Cohort study; Level of evidence, 3. Methods: Included were 66 consecutive patients who underwent arthroscopic labral repair at a single institution between August 2018 and February 2021. The prevalence and magnitude of shoulder pain as well as numbness and tingling of the hand were assessed using questions from the L’Insalata Shoulder Questionnaire and the Boston Carpal Tunnel Questionnaire preoperatively and at 1 week, 6 weeks, 12 weeks, and 6 months after surgery. Results: Preoperatively, patients with SLAP lesions reported a higher prevalence of shoulder pain during sleep compared with those with Bankart tears ( P < .05). Postoperatively, patients who underwent SLAP repair reported a larger proportion and more severe magnitude of shoulder pain during rest, overhead activities, and sleep compared with those who underwent Bankart repair ( P < .05). Only patients who underwent Bankart repair reported improvements in the prevalence and magnitude of their shoulder pain during rest, overhead activities, and sleep by 6 months postoperatively compared with preoperative levels ( P < .05). Preoperatively, 30% of patients with Bankart repairs and 40% of patients with SLAP repairs reported hand tingling, while 35% and 50%, respectively, reported hand numbness. The prevalence and magnitude of hand tingling and numbness were not significantly different between groups at any time point. Conclusion: Study results indicated that patients who underwent SLAP repair experienced worse shoulder pain outcomes compared with those who underwent Bankart repair using the same anchor and surgical technique. Only patients who underwent Bankart repair reported improvements in their hand numbness after surgery. Therefore, labral tear location does matter with respect to shoulder pain and hand numbness.
Effect of Zinc Supplementation in Children Less Than 5 Years on Diarrhea Attacks: A Randomized Controlled Trial
Authors: Abd El-Ghaffar Yosra S. , Shouman Ahmed Esmat , Hakim Sally Adel , El Gendy Yasmin Gamal Abdo , Wahdan Maha Magdy Mahmoud 
Published: June 2022

Recurrent infections and weak immunity were found to be linked with zinc deficiency especially in children. The goal of this study is to measure the level of blood zinc in children aged 6 months to less than 5 years old, and to assess the effect of 4 months of daily zinc supplements on the incidence and the severity of diarrheal morbidity. A randomized controlled trial study was conducted in Pediatric Outpatient Clinic in Ain Shams University Hospital on 140 children less than 5 years old who are apparently healthy. Random assignment of the sampled children to group receiving zinc (70 children) or group receiving placebo (70 children) was done. A questionnaire containing questions about occurrence of diarrhea was used during follow up. Serum zinc at baseline was measured. The mean age was 25.26 ± 15.7 months. Mean of serum zinc was 51.08 μg/dL, with 70% had low baseline serum zinc level. Cumulative incidence of diarrhea, number of diarrhea episodes per child and frequency of stools/day decreased significantly in zinc group ( P < .05). Risk ratio was found to be 0.79, 95% CI: 0.64 to 0.97. we concluded that incidence of diarrhea and its severity reduced in children received zinc daily for 4 months. This trial was registered at www.clinicaltrials.gov as NCT05002101.
In situ growth of carbon nanotubes on graphene oxide fibers by thermal chemical vapor deposition
Authors: Kaiwen Cao , Songyan Wang , Lianghua Xu , Dongling Zhao , Yuanjian Tong 
Published: June 2022

Aqueous graphene oxide (GO) dispersion was used to produce fibers by wet spinning technique. In situ growth of carbon nanotubes (CNTs) in the graphene fibers was realized by chemical vapor deposition (CVD) of the obtained graphene oxide GO fibers with a diameter about 30 μm using acetylene as precursor gas. Carbon nanotubes with diameters of 107 and 407 nm were found in the resulted graphene fiber (GF) with creation of active nucleation sites as reduction oxygen containing groups in the GO sheets during the CVD process. XPS and Raman spectroscopy results combined with SEM image confirmed the conversion of the GO fibers to the CNTs/GF.
Evaluation of the Global Lung Function Initiative reference equations in Belgian adults
Authors: De Soomer Kevin , Pauwels Evelyn , Vaerenberg Hilde , Derom Eric , Casas Lidia , Verbraecken Johan , Lapperre Thérèse , Oostveen Ellie 
Published: June 2022

BackgroundOver the past decade, the Global Lung Function Initiative (GLI) Network has published all-age reference equations on spirometry, diffusing capacity of the lung for carbon monoxide (DLCO) and lung volumes.MethodsWe evaluated the appropriateness of these equations in an adult Caucasian population. Retrospective lung function data on subjects who performed tests prior to a diagnostic sleep investigation were analysed. From the medical records, lung healthy, lifetime nonsmoking, nonobese subjects were selected, resulting in a population of 1311 subjects (68% male; age range 18–88 years).ResultsMultiple linear regression analysis revealed that lung function z-scores did not differ between subjects with and without sleep apnoea but did depend on height and age. The average forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) z-score was 0 but exhibited an inverse association with height in both sexes (p<0.01). Values of FEV1and FVC in both sexes were larger than predicted (mean±sdz-score +0.30±0.96 or 104±13% pred; p<0.01). Overall, static lung volumes andDLCOwere adequately predicted. However,DLCOz-scores were inversely associated with height in males and age in females (p<0.01). For all lung function indices, the observed scatter was reduced compared with the prediction. Therefore, for all indices <5% of the data were below the GLI-proposed lower limit of normal (LLN) threshold.ConclusionGLI reference equations provide an adequate fit in Belgian adults. However, the GLI-proposed LLN is too low for our Antwerp population, resulting in underdiagnosis of disease. Furthermore, airway obstruction and diffusion disorders might be misclassified due to height and age associations.