bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anestesia espinal y sus complicaciones neurológicas. Un artículo de revisión de la literatura
Authors: Hidalgo Acosta Javier Aquiles , Mawyin Muñoz Carlos Enrique , Cujilema Parreño Milton Cesar , González Echeverría Kléber Eduardo , Montenegro Jara José Luis , Ruiz Alejandro Michel Romina , Quito Espinoza Anthony Ariosto , Cobeña Vera Jonathan Gabriel 
Published: November 2022

Introducción: La lesión de la médula espinal puede ocurrir, durante la práctica anestésica y es un evento raro, pero puede alcanzar una morbilidad y mortalidad aumentada, Las principales complicaciones neurológicas de la anestesia espinal son: cefalea pospunción dural y daño neurológico. Objetivo: realizar una revisión de la literatura sobre anestesia espinal y sus complicaciones neurológicas. Materiales y Métodos: Se realizó un estudio descriptivo retrospectivo, búsqueda avanzada de 27 artículos en su mayoría desde el año 2017, que incluyen: revisiones sistemáticas, artículos de presentación de casos clínicos, investigaciones sobre anestesia espinal y sus complicaciones neurológicas, consultando en bases de datos de alto reconocimiento académico e investigativo, tales como Pubmed, Elsevier, BMJ Journals, Organización Mundial de la Salud-Federación Mundial de Sociedades de Anestesiólogos, epistemonikos, springer, entre otras. Discusión: según metaanálisis y estudios consultados, la lidocaína es el anestésico local que tiene mayor asociación con complicación neurológica del tipo síndrome neurológico transitorio, sin embargo, también se han descrito casos de en menor porcentaje con otros anestésicos. La posición en decúbito lateral durante la técnica de anestesia, influye mucho, como medida de prevención de la cefalea post punción, que se presenta en algunos pacientes como complicación de anestesia espinal. Existen múltiples factores que contribuyen al desarrollo de una complicación neurológica tales como factores genéticos, la edad del paciente, anomalías en el canal vertebral, obesidad, diabetes, etc. Conclusión: Las complicaciones neurológicas más frecuentes de la anestesia espinal son la cefalea post punción y el síndrome neurológico transitorio, por lo cual, todo anestesiólogo debe ser consciente de la posibilidad del desarrollo de las mismas y tomar las medidas preventivas necesarias, especialmente en pacientes en los que, la punción es difícil, adaptando técnicas anestésicas y fármacos adecuados, mejorando así la calidad de la anestesia administrada.
Mother’s Knowledge regarding the Functions of Children's Primary Teeth in Salapian District, Langkat-North Sumatera
Authors: Octiara Essie , Tarigan Grace Anastasia 
Published: November 2022

Primary teeth play a role in mastication, speech function, appearance, and as a provider of space for children's permanent teeth. Mothers need to know the functions of their children's primary teeth so they are willing to take care of their children's teeth. This study aims to see the relationship of a mother’s knowledge regarding the functions of children’s primary teeth to the number of children and the level of education in Salapian District, Langkat. This study is an analytical study with a cross-sectional design. The research subjects were 100 people; 30 prospective mothers, 30 mothers with one child, and 40 mothers with more than one child. Data were collected using the interview technique and the analytical test used was the Kruskal Wallis test with a significance value of p<0.05. The results showed that 15 respondents (15%) had a good level of mother’s knowledge regarding the functions of children’s primary teeth, 36 respondents (36%) were in an insufficient category, and 49 respondents (49%) were in less category. Statistical analysis showed a significant relationship between the mother’s knowledge regarding children’s primary teeth functions the number of children and education level (p=0.001 and p=0.001). This study concluded that mothers who have many children have a better knowledge about functions of primary teeth than mothers with few children. Mothers with higher education levels have a better level of knowledge than mothers with primarysecondary education.

Keywords: mother’s knowledge, functions of primary teeth, education level, number of children
Cesarean delivery Characteristics during JKN Implementation
Authors: Al Farizi Sofia , Ernawati Ernawati , Ernawaty Erna W. 
Published: November 2022

Objective: To compare the characteristics of cesarean before and during JKN, also analyzes the factors that influence these differences.
Methods: This was a quantitative study with a longitudinal retrospective design and qualitative research used design case studies. The population were delivery women at the Banyuwangi referral hospital before and during JKN. The quantitative data were analyzed firstly by univariable and then bivariable. The bivariable analysis was performed by comparing the prevalence ratio (PR) between two variables.
Results: The proportion of cesarean delivery had increased significantly during the implementation of JKN. 50% of maternal deaths before JKN gave birth using cesarean delivery, this proportion increased significantly to 60% during JKN. Indications of fraud committed by health workers to be a factor in increasing the proportion of cesarean delivery. Other contributing factors were repeated cesarean delivery, delayed referral, and the number of obstetric complications.
Conclusion: There was an increase in the proportion of cesarean deliveries during the implementation of JKN. BPJS Kesehatan needed to re-evaluate the system they had created so far. The quality of service must be emphasized so that the negative impact on women could be minimized.
Keywords: cesarean section, health insurance, maternal mortality.

Abstrak
Tujuan: Membandingkan karakteristik persalinan sesar sebelum dan selama implementasi JKN, selain itu juga menganalisis faktor-faktor yang berpengaruh.
Metode: Studi kuantitatif dengan desain longitudinal retrospective dan studi kualitatif dengan desain case studies. Populasi adalah ibu bersalin di rumah sakit rujukan Kabupaten Banyuwangi sebelum dan selama JKN. Data kuantitatif dianalisis secara univariabel dan bivariabel. Analisis bivariabel dengan membandingkan prevalensi rasio (PR) diantara dua variabel.
Hasil: Proporsi persalinan sesar meningkat secara signifikan selama implementasi JKN. 50% ibu yang meninggal bersalin dengan metode sesar, proporsi ini meningkat selama JKN menjadi 60%. Indikasi kecurangan oleh tenaga kesehatan menjadi salah satu faktor yang menyebabkan peningkatan ini. Faktor lain yang berkontribusi adalah persalinan sesar yang berulang, keterlambatan rujukan dan banyakanya komplikasi obstetrik.
Kesimpulan: Terdapat peningkatan proporsi persalinan sesar selama implementasi JKN. BPJS Kesehatan perlu mengkaji ulang sistem yang dibuat selama ini. Kualitas pelayanan harus tetap dipertahankan, agar tidak berdampak pada kesehatan ibu.
Kata kunci: jaminan kesehatan, kematian ibu, persalinan sesar.
Model-based analysis of myocardial strains in left bundle branch block
Authors: Taconné Marion , Owashi Kimi P. , Galli Elena , Duchenne Jürgen , Hubert Arnaud , Donal Erwan , Hernàndez Alfredo I. , Le Rolle Virginie 
Published: November 2022

IntroductionAlthough observational studies of patients with left bundle branch block (LBBB) have shown a relation between strain morphologies and responses to cardiac resynchronization therapy (CRT), the evaluation of left ventricle (LV) dyssynchrony from echocardiography remains difficult. The objective of this article is to propose a patient-specific model-based approach to improve the analysis and interpretation of myocardial strain signals.MethodsA system-level model of the cardiovascular system is proposed, integrating: (i) the cardiac electrical system, (ii) right and left atria, (iii) a multi-segment representation of the RVs and LVs, and (iv) the systemic and pulmonary circulations. After a sensitivity analysis step, model parameters were identified specifically for each patient. The proposed approach was evaluated on data obtained from 10 healthy subjects and 20 patients with LBBB with underlying ischemic (n = 10) and non-ischemic (n = 10) cardiomyopathies.ResultsA close match was observed between estimated and observed strain signals, with mean RMSE respectively equal to 5.04 ± 1.02% and 3.90 ± 1.40% in healthy and LBBB cases. The analysis of patient-specific identified parameters, based on bull's-eye representation, shows that strain morphologies are related to both electrical conduction delay, and heterogeneity of contractile levels within the myocardium.DiscussionThe model-based approach improve the interpretability echocardiography data by bringing additional information on the regional electrical and mechanical function of the LV. The analysis of model parameters show that septal motion and global strain morphologies are not only explained by electrical conduction delay but also by the heterogeneity of contractile levels within the myocardium. The proposed approach represents a step forward in the development of personalized LV models for the evaluation of LV dyssynchrony in the field of CRT.
Assessment of a novel patient-specific 3D printed multi-material simulator for endoscopic sinus surgery
Authors: Molinari Giulia , Emiliani Nicolas , Cercenelli Laura , Bortolani Barbara , Gironi Camilla , Fernandez Ignacio Javier , Presutti Livio , Marcelli Emanuela 
Published: November 2022

Background: Three-dimensional (3D) printing is an emerging tool in the creation of anatomical models for surgical training. Its use in endoscopic sinus surgery (ESS) has been limited because of the difficulty in replicating the anatomical details.Aim: To describe the development of a patient-specific 3D printed multi-material simulator for use in ESS, and to validate it as a training tool among a group of residents and experts in ear-nose-throat (ENT) surgery.Methods: Advanced material jetting 3D printing technology was used to produce both soft tissues and bony structures of the simulator to increase anatomical realism and tactile feedback of the model. A total of 3 ENT residents and 9 ENT specialists were recruited to perform both non-destructive tasks and ESS steps on the model. The anatomical fidelity and the usefulness of the simulator in ESS training were evaluated through specific questionnaires.Results: The tasks were accomplished by 100% of participants and the survey showed overall high scores both for anatomy fidelity and usefulness in training. Dacryocystorhinostomy, medial antrostomy, and turbinectomy were rated as accurately replicable on the simulator by 75% of participants. Positive scores were obtained also for ethmoidectomy and DRAF procedures, while the replication of sphenoidotomy received neutral ratings by half of the participants.Conclusion: This study demonstrates that a 3D printed multi-material model of the sino-nasal anatomy can be generated with a high level of anatomical accuracy and haptic response. This technology has the potential to be useful in surgical training as an alternative or complementary tool to cadaveric dissection.
Effect of durations and pressures of cupping therapy on muscle stiffness of triceps
Authors: Li Yameng , Mo Pu-Chun , Jain Sanjiv , Elliott Jeannette , Bleakney Adam , Lyu Shaojun , Jan Yih-Kuen 
Published: November 2022

Cupping therapy has been used for the alleviation of muscle soreness in athletes. However, clinical studies of cupping therapy show conflicting results. Lack of standardized guidelines of the dose-response relationship of cupping therapy, such as appropriate cupping duration and negative pressure, limits the adoption of cupping therapy in clinical practice. The objectives of this study were to investigate the effect of various pressures and durations of cupping therapy on reducing muscle stiffness. The 2 × 2 factorial design with the repeated measures and counterbalanced design was used to test four cupping protocols, including two negative pressures at −225 and −300 mmHg and two durations at 5 and 10 min, in 12 healthy young people. B-mode and elastographic ultrasound was used to assess muscle stiffness of the triceps before and after cupping therapy. The region of interest of elastographic image was divided into the superficial and deep layers for assessing the effect of cupping therapy on stiffness of various depths of the triceps. Normalized stiffness was calculated as a ratio of pre-cupping stiffness divided by post-cupping stiffness of each participant. The two-way analysis of variance (ANOVA) was used to examine the main effects of the pressure and duration factors and the interaction effect between the pressure and duration factors. The results showed that there were no interactions between the pressure and duration factors (overall layer p = 0.149, superficial layer p = 0.632, and deep layer p = 0.491). The main effects of duration of the overall, superficial and deep layers were p = 0.538, p = 0.097 and p = 0.018, respectively. The results showed that 10-min cupping at -300 mmHg is more effective on reducing stiffness of the deep layer of the triceps compared to 5-min cupping (p = 0.031). This study provides the first evidence that the dose of cupping therapy could significantly affect changes of triceps stiffness and the deep layer of the muscle is more sensitive to cupping therapy compared to the superficial and overall layers.
Sex differences in hypertension among people living with HIV after initiation of antiretroviral therapy
Authors: Masenga Sepiso K. , Povia Joreen P. , Mutengo Katongo H. , Hamooya Benson M. , Nzala Selestine , Heimburger Douglas C. , Munsaka Sody M. , Elijovich Fernando , Patel Kaushik P. , Kirabo Annet 
Published: November 2022

BackgroundHypertension is common in people living with HIV (PLWH) on antiretroviral therapy (ART). In the general population and in experimental animal models, the incidence of hypertension is greater in males than in females, especially during the premenopausal period. However, it is not known whether there are sex differences in hypertension associated with HIV and ART, and the factors contributing to incident hypertension among PLWH have not been well characterized. In this study, we aimed to determine the time course, sex differences and factors associated with incident hypertension in PLWH initiating ART.Methods and resultsWe conducted a retrospective study in which we used programmatic data from the ART registry to identify sex differences in the determinants of incident hypertension among PLWH initiating the ART regimen from Livingstone University Teaching Hospital in Zambia and followed for 8 years. Males developed hypertension earlier, 2 years after initiating ART, compared to 6 years in females. In multivariable analysis, increasing age, baseline systolic blood pressure and baseline mean arterial pressure (MAP) were associated with increased risk for developing incident hypertension. Also, participants who switched to the integrase strand transfer inhibitor, dolutegravir (DTG) or the protease inhibitor, lopinavir boosted with ritonavir were 2 and 3 times more likely to develop hypertension when compared to those on non-nucleoside reverse transcriptase inhibitors (NNRTIs). However, these relationships were abrogated by sex, as self-reported male sex was the major contributor in predicting incident hypertension. While none of the factors remained significantly associated with incident hypertension upon multivariate analysis among females, body mass index (BMI), and use of protease inhibitors remained strongly associated with hypertension among males.ConclusionOur results indicate that the use of protease inhibitors and BMI are important predictors of incident hypertension among males. Thus, blood pressure and BMI should be closely monitored, particularly in males living with HIV on protease inhibitors. In addition, identifying specific factors that protect females from developing hypertension early is important but remains to be determined.
The impact of high-intensity interval training on vascular function in adults: A systematic review and meta-analysis
Authors: Khalafi Mousa , Sakhaei Mohammad Hossein , Kazeminasab Fatemeh , Symonds Michael E. , Rosenkranz Sara K. 
Published: November 2022

AimWe performed a systematic review and meta-analysis to investigate the effects of high-intensity interval training (HIIT) compared with moderate-intensity continuous training (MICT) or with no exercise (CON) on vascular function in adults who were free of cardiometabolic diseases and those with cardiometabolic diseases.MethodsA search across three electronic databases including Scopus, PubMed, and Web of Science was conducted through February 2022 to identify the randomized trials evaluating HIIT vs. MICT and/or CON on vascular function as measured using brachial artery flow-mediated dilation (FMD) in adults. Separate analyses were conducted for HIIT vs. MICT and/or CON to calculate weighted mean differences (WMD) and 95% confidence intervals (95% CIs) using random or fixed models.ResultsA total of 36 studies involving 1,437 participants who were either free of cardiometabolic diseases or had cardiometabolic diseases were included in the meta-analysis. HIIT effectively increased FMD when compared with MICT [1.59% (95% CI 0.87–2.31), p = 0.001] or CON [3.80% (95% CI 2.58–5.01), p = 0.001]. Subgroup analysis showed that HIIT increased FMD in participants with cardiovascular and metabolic diseases, but not in participants who were free of cardiometabolic diseases. In addition, HIIT effectively increased FMD regardless of age and body mass index.ConclusionWe confirm that HIIT is effective for improving vascular function in individuals with metabolic disorders and cardiovascular diseases and has a superior effect compared to MICT, demonstrating time efficiency.Systematic review registration[https://www.crd.york.ac.uk/prospero], identifier [CRD42022320863].
PAH-specific therapy for pulmonary hypertension and interstitial lung disease: A systemic review and meta-analysis
Authors: Zhao Ning , Chen Jun , Zhang Mingming , Zhou Lihui , Liu Lisong , Yuan Jie , Pang Xingxue , Hu Dayi , Ren Xiaoxia , Jin Zhongyi 
Published: November 2022

ObjectivePulmonary hypertension (PH) in context with interstitial lung disease (ILD) portends serious clinical consequences and a high rate of mortality. Recently published randomized controlled trials (RCTs) which assessed the pulmonary arterial hypertension (PAH)-specific drugs for pulmonary hypertension and interstitial lung disease (PH-ILD) revealed inconsistent clinical outcomes with previous studies. We conducted a systemic review and meta-analysis to further investigate the effect of PAH-specific therapies for PH-ILD.MethodsClinical trials were searched from the EMBASE, PUBMED, and CENTRAL databases. The duration from the establishment of the database to June 2022 for RCTs evaluates the effect of PAH-specific therapy in patients with PH-ILD. RevMan 5.4 was used for the meta-analysis.ResultsA total of six articles (with a total of 791 patients) were included, including 412 patients in the treated group and 379 patients in the control group. As compared to placebo, the change of 6MWD was a significant improvement with PAH-specific therapy in the six RCTs (23.09; 95% CI, 12.07–34.12 P &lt; 0.0001); but when the study with inhaled treprostinil was excluded, the significant improvement in the change of 6MWD from baseline was not present anymore (MD 11.01, 95%CI−6.43–28.46 P = 0.22). There was no significant improvement in the change in lung function, hemodynamic parameters, clinical worsening, all-cause death, and serious adverse effects in the treated group compared to placebo.ConclusionPAH-specific therapy significantly improved exercise capacity in the patients with PH-ILD, but this is due to the greater contribution of the study with inhaled treprostinil. Therefore, our findings still did not support the routine use of the whole PAH-specific drugs for PH-ILD.
Efficacy of left atrial low-voltage area-guided catheter ablation of atrial fibrillation: An updated systematic review and meta-analysis
Authors: Zhou Yaqiong , Zhang Huamin , Yan Peng , Zhou Peng , Wang Peijian , Li Xiaoping 
Published: November 2022

AimsThis study aimed to evaluate the efficacy of low-voltage area (LVA)-guided substrate modification catheter ablation in patients with atrial fibrillation (AF).MethodsSystematic searches of the PubMed, EMBASE, and Cochrane databases were performed from inception to July 2022 for all available studies. The effect estimates were combined with the Mantel–Haenszel random-effects model. Subgroup analyses, sensitivity analysis, and meta-regression were conducted to explore the sources of statistical heterogeneity.ResultsA total of 16 studies involving 1942 subjects (mean age: 61 ± 10 years, 69% male) were identified. All studies included patients with paroxysmal AF, non-paroxysmal AF, or both. At a mean follow-up of 18.9 months, patients who underwent LVA-guided substrate modification ablation had significantly higher freedom from all-atrial tachycardia recurrence than patients who underwent control ablation [67.7% vs. 48.9%, risk ratios (RR) 0.64, 95% confidence interval (CI) 0.55–0.76, P &lt; 0.001], with 36% relative risk and 18.7% absolute risk reductions in all-atrial tachycardia recurrence. Subgroup analysis based on AF types demonstrated that the decreased risk of all-atrial tachycardia recurrence was present predominantly in non-paroxysmal AF compared with paroxysmal AF (RR 0.60, 95% CI 0.52–0.69 vs. RR 0.96, 95% CI 0.81–1.13).ConclusionLow-voltage area-guided substrate modification ablation combined with PVI appears to have a significant beneficial effect of improving freedom from all-atrial tachycardia recurrence, especially in patients with non-paroxysmal AF.