bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thresholds for Spinal Anaesthesia-induced Hypotension During Caesarean Section
Authors: Gautam B. , Bhattarai A. 
Published: November 2022

Background Spinal anaesthesia is the current standard for caesarean section. Hypotension, a common complication, potentially results in adverse foetal and maternal outcomes. However, hypotension-defining criteria are varied.
Objective To identify the blood pressure thresholds for spinal anaesthesia-induced hypotension during caesarean section.
Method This is a retrospective cohort study of spinal anaesthesia-induced hypotension that occurred till baby-delivery during caesarean section. Reports on intraoperative hypotension, collected previously from January to December 2019, were reviewed to identify the hypotension-defining thresholds. The thresholds were categorized into systolic blood pressure (SBP) of 80, 90 or 100 mmHg, mean arterial pressure (MAP) of 60, 65 or 70 mmHg, combinations, and others. Parturient and anaesthesia characteristics, and associated hypotensive symptoms were also recorded for descriptive analysis.
Result Spinal anaesthesia-induced hypotension was identified in 129 (11.5%) cases among 1116 caesarean sections. Altogether, 12 hypotension-defining thresholds were employed. Thresholds of SBP 90, MAP 60, and SBP 80 mmHg were used in 53 (41%), 28 (21.7%), and 21 (16.2%) cases respectively. Mean maternal age was 28 (±4.22) years and 87 (67.4%) cases underwent emergency surgery. Median sensory blockade level was T4. Nausea-vomiting, bradycardia, and tachycardia were associated during five (3.8%), six (4.6%), and 15 (11.6%) hypotensive incidents respectively. Two cases had unrecordable blood pressure but there was no maternal mortality.
Conclusion Systolic blood pressure of 90 mmHg and mean arterial pressure of 60 mmHg included the most common thresholds for spinal anaesthesia-induced hypotension during caesarean section. Identifying the safe and clinically relevant hypotension-defining criteria needs further investigation.
Translation and Validation of Oral Health-Related Early Childhood Quality of Life Tool for Nepalese Preschool Children
Authors: Upadhyay S. , Mathur V. P. , Dhillon J. K. , Poudyal S. 
Published: November 2022

Background Early childhood caries (ECC) in preschool children debilitate their quality of life affecting oral function, appearance and social well-being. A tool for measuring oral health-related quality of life for preschoolers may help in making clinical decisions and assist policy makers in planning and management of health programs in the country.
Objective To translate oral health-related early childhood quality of life (OH-ECQoL) tool into Nepali language and test its validity and reliability.
Method OH-ECQoL was translated into Nepali language by two Nepalese professional translators which was back translated by professional English translator. This was sent to three independent advisors to see the appropriateness of translation. Pilot testing was done in 20 parents and questionnaire was finalized after needed corrections. Final version was introduced to the 118 parents of children aged 24- 71 months. Caries status was recorded for all children participating in the study. Concurrent, construct, discriminant validity and internal consistency reliability, test -retest reliability were evaluated.
Result OH-ECQoL scores and perception of parents for general and oral health of their children was significant (at 0.01 level). There was significant difference in OH-ECQoL scores between no ECC and severe ECC groups and moderate and severe ECC groups (at 0.05 level). There was also a significant correlation between child impact section and family impact section (at 0.01 level). Cronbach’s alpha was 0.891 demonstrating good internal consistency. Intra class coefficient was 0.963 suggesting excellent test-retest reliability. Ninety-one (77.1%) children had severe ECC and 40(33.9%) parents were from upper middle class.
Conclusion The Nepali version of OH-ECQoL is a valid and reliable tool for assessing the oral health-related early childhood quality of life in children of Nepal.
Dyslexia biomarker detection with Quantitative electroencephalography (QEEG) data in children: Feasibility, Acceptability, Economic impact, Pilot Study and Survey Results
Authors: Eroglu Gunet , Köprülü Mertali , Karabacak Berdan 
Published: November 2022

INTRODUCTION
Dyslexia awareness is not high in societies. Although 5-17% of the population is thought to be dyslexic in every global society, only 0.05 % of the population gets a formal diagnosis in Turkey. The financial situation of families of children with dyslexia is not enough to get an early diagnosis and investigate intensive remedial opportunities. Mobile apps have been used to diagnose health conditions in recent years. Worldwide solutions for dyslexia do not exist as the solutions were language-dependent. We need an easily reachable, affordable, language-independent, and worldwide acceptable biomarker detection app for dyslexia at schools because it potentially helps to prevent severe consequences through an early diagnosis that helps provide early intervention. No other research assessed the feasibility and acceptability of using this mobile app to detect dyslexia at home or school. Here we present a dyslexia biomarker detection app based on Z-scored QEEG data that can be used at home or school and has accomplished a high accuracy rate in diagnosing dyslexia. The mobile app can be used at home by parents or teachers at school.

METHODS
We have collected data from 207 children (96 of them have dyslexia, 111 of them are typically developing) between 7-10 years old for 40 sessions on average. The data consists of the eyes-open resting state 2-minute QEEG data from 14-channels.

RESULTS
Using the Artificial Neural Network (ANN) machine learning method, children with dyslexia/ typically developing children (TDC) classification has been done with a high accuracy rate (98.8%). ANN yields the highest accuracy results with standardized QEEG data in the literature. A survey is created to assess the dyslexia biomarker detection app’s feasibility, acceptability, and economic impact. The results have shown that the biomarker detection app is found feasible and acceptable by families, however, it is found expensive to use at home as it includes the costly electroencephalography (EEG) headset.

CONCLUSION
In order for this biomarker detection method to be used extensively at home, EEG headset prices should become more affordable or this dyslexia biomarker detection method can be used at schools.
Pain assessment and management for older patients with hip fractures
Authors: Teo Shyh Poh 
Published: November 2022

Older patients with hip fractures require a multidisciplinary management approach. Central to these considerations and treatment targets is adequate analgesia, which should be provided as early as possible. An overview of pain assessment and management considerations for patients with hip fractures is provided. There are several tools available to assess severity of pain, such as the Numeric Rating Scale (NRS), Visual Analogue Scale, Pictorial Pain Scale and Verbal Descriptor Scale (VDS). For older people, the NRS and VDS may be preferred. For patients with cognitive impairment, the Pain Assessment in Advanced Dementia (PAINAD) scale or the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC) may be used. Ideally, paracetamol should be provided every 6 hours, with opioids for additional breakthrough pain. If this is inadequate or if there is a requirement to reduce administration of opioids, nerve blocks may be considered. Compared to femoral nerve blocks, fascia-iliaca blocks are potentially easier to learn, safer and well-tolerated. Overall, older patients with hip fractures require adequate analgesia, which involves standardised pain assessment using appropriate tools and multimodal pain management approaches.
Sociodemographic Profile among the Victims of Road Traffic Accident Reported in a Tertiary Level Hospital: A Cross Sectional Observation
Authors: Rahman Md Moshiur , Uddin Abu Noman Md Mosleh 
Published: November 2022

Introduction: Road traffic accident is an unbaiting concern of health security issues to the community in Bangladesh. Every individual RTA contributes a tragic social impact due to its morbidity or mortality associated to each family.
Objectives: To assess the sociodemographic profile among the victims of RTA.
Material and Methods: This cross sectional study was conducted in 2010 among purposively selected 126 victims of road traffic accident reported to the medical inspection room of Combined Military Hospital Dhaka.Data were collected by a structured questionnaire through the review of medical records of the patients.
Results: More than half (53.2%) of the respondents were in the age group of 21-40 years and 44.4% were educated up to SSC level. Majority of them (8 1 .7%) were Male and 45.23.8% were from military service. About 27.3% of RTA occurred by truck/covered van/Bus/ minibus which was followed by Jeep/car/microbus and pickup (35.7%) and 44.4% of the affected respondents were from motor vehicle passengers which was followed by pedestrian (37.3%). Majority ofthe patients experienced laceration and cut injuiy (38.1%) which was equally followed by abrasion and fracture (15.9%). Statistically significant (p<0.05) association revealed between education with role of affected personand occupation with morbidity pattern.
Conclusion: As the victims of RTA are mainly male in active and productive period of life, so this group should be motivated.
AKMMC J 2020; 11(2) : 102-106
Inferior Venacaval Thrombosis in Active Tuberculosis
Authors: Momen Abdul Basit Ibne , Twinkle Furial Quraishi , Quraishi Firoz Ahmed 
Published: November 2022

Approximately one third of the world's population is infected with Mycobacterium tuberculosis. TuberculosisJ has several mechanisms that induce a hypercoagulable state and can lead to thromboembolic complications. A variety of factors have been postulated to predispose patients with tuberculosis to venous thrombosis that include local stasis due to venous compression by lymph nodes and relative immobility caused by respiratory, alteration in coagulation factors and reactive thrombocytosis. Only a few case reports showing similar findings. We present a case, man of 26 years old, who presented deep vein thrombus of inferior vena cava from its origin extending up to the entrance of the liver revealed signal changes on L2 vertebrae and CT guided FNAC was negative for malignancy but suggestive of tuberculosis. There might be a possible association between deep venous thrombosis and use of Rifampicin but this does not contraindicate the use of Rifampicin but these patient may need close monitoring.
AKMMC J 2020; 11(2) : 137-139
A prospective, multicenter, real-world observational study evaluating the impact of tibial runoff on clinical outcomes after endovascular therapy for femoropopliteal lesions: Research protocol
Authors: Liu Yang , Wang Qiqi , Wu Ziheng , Fen Zibo , Guo Lianrui , Li Qiang , Fang Xin , Sang Hongfei , Dai Yudi , He Chunshui , Ye Meng 
Published: November 2022

IntroductionCurrent evidence indicates endovascular intervention is a safe and effective treatment for peripheral artery disease of the lower extremity. However, the clinical outcome of endovascular intervention for femoropopliteal lesions has been shown to be affected by the status of tibial runoff. It remains unclear whether endovascular intervention for tibial runoff is associated with additional benefits.Methods and analysisThis prospective, multicenter, real-world observational study is carried out from January 2021 to December 2022 in 8 designated centers across China with an estimated sample size of 1200 patients with severe femoropopliteal disease. The pre-procedural status of tibial runoff is evaluated with the modified SVS score and categorized as good (SVS &lt;5), compromised (SVS 5–10) or poor (SVS &gt;10). Whether the patient will be treated with endovascular intervention for tibial runoff is determined by the treating vascular surgeons. Patients are dichotomized into the intervention group and the non-intervention group, with each group further divided into the good, compromised and poor tibial run-off subgroup, yielding 6 subgroups in total. Patients within various subgroups are compared with regard to the primary patency rate of the femoropopliteal artery, changes in quality of life, changes of Rutherford category, improvement of the Wound, Ischemia, and Foot Infection Classification, and incidence of major adverse events over 24-months follow-up. The results of this study may provide important information to help vascular sspecialists to decide whether the tibial runoff should be endovascularly intervened and which patient population benefits most from tibial runoff intervention.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/NCT04675632?id=NCT04675632&amp;draw=2&amp;rank=1, NCT04675632.
Traditional Chinese medicine method of tonifying kidney for hypertension: Clinical evidence and molecular mechanisms
Authors: Wang Qingqing , Lin Jianguo , Li Cheng , Lin Mingshan , Zhang Qing , Zhang Xiaoxiao , Yao Kuiwu 
Published: November 2022

Hypertension is the most common chronic disease. A large amount of evidence showed that traditional Chinese medicine (TCM) method of tonifying kidney (TK) combined with routine treatment is more effective and safer in the treatment of hypertension. This study integrated meta-analysis, data mining, and network pharmacology to explore the efficacy and potential mechanisms of TK in the treatment of hypertension. Meta-analysis was performed to explore the efficacy and safety of TK combined with routine treatment in the treatment of hypertension. Data mining was used to screen the core herbs of the TK. Network pharmacology was used to predict the antihypertensive mechanism of TK core herbs. A total of 18 studies with 2,024 patients were included in this study. Meta-analysis showed that TK combined with routine treatment was superior to routine treatment alone in lowering blood pressure (systolic and diastolic blood pressures), lowering blood lipids (total cholesterol, triglyceride, low-density lipoprotein cholesterol), improving vascular endothelial functions (nitric oxide, endothelin) and TCM symptoms (headache dizziness, soreness, and weakness of waist and knees). In addition, TK was safe and has no obvious adverse reactions. Data mining showed that the core herbs of TK were Eucommia ulmoides Oliv. (Duzhong), Vitex negundo L. (Huangjing), Taxillus chinensis (DC.) Danser (Sangjisheng), Ligustrum lucidum W.T.Aiton (Nuzhenzi), Astragalus mongholicus Bunge (Huangqi), Rehmannia glutinosa (Gaertn.) DC. (Shudihuang). Network pharmacology predicted that core herbs antihypertensive components were oleanolic acid, ursolic acid, and civetone, and the antihypertensive targets were NOS3, NOS2, MMP9, TNF, PTGS2, HMOX1. In addition, the antihypertensive targets were enriched in cGMP-PKG signaling pathway, calcium signaling pathway, aldosterone-regulated sodium reabsorption, HIF-1 signaling pathway. In conclusion, TK combined with routine treatment for hypertension is effective and safe. The mechanism of TK may be related to GMP-PKG signaling pathway, calcium signaling pathway, aldosterone-regulated sodium reabsorption. On the premise of syndrome differentiation and treatment, it is promising to treat hypertension with TK.Systematic review registration[https://www.crd.york.ac.uk/prospero/], identifier [CRD42022358276].
Epworth sleepiness scale is associated with hypothyroidism in male patients with obstructive sleep apnea
Authors: Wang Le , Fang Xiaoyan , Xu Chong , Pan Na , Wang Yan , Xue Tuai , Zhang Mingchu , Cao Jie , Zhang Jing 
Published: November 2022

BackgroundHypothyroidism could cause obstructive sleep apnea (OSA), however, the specific association of them remained unclear. This cross-sectional study aimed to determine the prevalence of hypothyroidism among patients with OSA, and the characteristics and predictors of hypothyroidism associated with OSA.MethodsA total of 573 patients with OSA were included in the study. Serum levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) were measured in all participants. Univariate and binary logistic regression analysis were performed to assess the association of OSA with hypothyroidism while controlling for potential confounders. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the OSA effect in the distinction between euthyroid and hypothyroidism.ResultsThe prevalence of hypothyroidism was 6.75%、5.12%、10.38% in the total, men, and women cohort, respectively, and the prevalence rate in women OSA patients was significantly higher than that in men OSA patients (P=0.018). The men OSA patients with hypothyroidism had a higher Epworth sleepiness scale (ESS) than women OSA patients with hypothyroidism (P=0.022). Additionally, the ESS was significantly higher in men OSA patients with hypothyroidism than those with euthyroid (P=0.042), while women OSA patients had no such difference (P=0.822). In men patients with OSA, ROC curve analyses revealed that the risk of hypothyroidism increased in accordance with increasing ESS after adjustment for potential confounders, and the optimal cutoff value was 10 score. Higher ESS category was significantly associated with a higher risk of prevalent hypothyroidism in men patients with OSA [odds ratio (OR) = 4.898 for ESS≥10 relative to ESS &lt;10, 95% confidence interval (CI) 1.628-14.731, P = 0.005].ConclusionsThe prevalence of hypothyroidism in OSA patients was relatively higher, especially in women OSA patients. ESS was significantly and positively associated with hypothyroidism in men patients with OSA, suggesting that ESS may have a potential role in identification and diagnosis of men OSA patients complicated with hypothyroidism.
Machine learning models to predict in-hospital mortality in septic patients with diabetes
Authors: Qi Jing , Lei Jingchao , Li Nanyi , Huang Dan , Liu Huaizheng , Zhou Kefu , Dai Zheren , Sun Chuanzheng 
Published: November 2022

BackgroundSepsis is a leading cause of morbidity and mortality in hospitalized patients. Up to now, there are no well-established longitudinal networks from molecular mechanisms to clinical phenotypes in sepsis. Adding to the problem, about one of the five patients presented with diabetes. For this subgroup, management is difficult, and prognosis is difficult to evaluate.MethodsFrom the three databases, a total of 7,001 patients were enrolled on the basis of sepsis-3 standard and diabetes diagnosis. Input variable selection is based on the result of correlation analysis in a handpicking way, and 53 variables were left. A total of 5,727 records were collected from Medical Information Mart for Intensive Care database and randomly split into a training set and an internal validation set at a ratio of 7:3. Then, logistic regression with lasso regularization, Bayes logistic regression, decision tree, random forest, and XGBoost were conducted to build the predictive model by using training set. Then, the models were tested by the internal validation set. The data from eICU Collaborative Research Database (n = 815) and dtChina critical care database (n = 459) were used to test the model performance as the external validation set.ResultsIn the internal validation set, the accuracy values of logistic regression with lasso regularization, Bayes logistic regression, decision tree, random forest, and XGBoost were 0.878, 0.883, 0.865, 0.883, and 0.882, respectively. Likewise, in the external validation set 1, lasso regularization = 0.879, Bayes logistic regression = 0.877, decision tree = 0.865, random forest = 0.886, and XGBoost = 0.875. In the external validation set 2, lasso regularization = 0.715, Bayes logistic regression = 0.745, decision tree = 0.763, random forest = 0.760, and XGBoost = 0.699.ConclusionThe top three models for internal validation set were Bayes logistic regression, random forest, and XGBoost, whereas the top three models for external validation set 1 were random forest, logistic regression, and Bayes logistic regression. In addition, the top three models for the external validation set 2 were decision tree, random forest, and Bayes logistic regression. Random forest model performed well with the training and three validation sets. The most important features are age, albumin, and lactate.
A precise inversion method of cable joint core temperature with non-embedded detection based on UMAP and ISSA-BPNN
Authors: Tian Wu , Hesheng Zhu , Qinghua Zhan , Nanji Wang 
Published: November 2022

Obtaining the core temperature of the cable joint is vital to ensure the safe operation of the modern power system with integration. To improve the speed and accuracy of core temperature inversion, this study proposed a non-embedded cable joint temperature inversion method named uniform manifold approximation and projection (UMAP) and the improved sparrow search algorithm (ISSA) optimized the back propagation neural network (BPNN). Firstly, UMAP is used to reduce the feature dimension of sample data input and enhance the data visualization effect. After dimension reduction, the model input features are consistent with the international ampacity calculation standard, and the calculation speed and accuracy of the model are improved. To improve the optimization ability of SSA, the Tent chaotic operator is introduced, and then the ISSA is used to optimize BPNN to address the issue of unstable output and easy falling into a local minimum. At last, the optimization ability and temperature inversion effect of the improved model were compared with other competing algorithms based on the 10 kV cable joint temperature-rise test and CEC2017 benchmark function. The experimental results show that the proposed method shortens the calculation time of the model, and the mean absolute error of temperature inversion is about 0.1°C. The overall performance is the most outstanding, the training data set is unbiased, and the interpretability of the model improves, which can provide a reliable reference for line operation and maintenance personnel.
Exploring the causality between ankylosing spondylitis and atrial fibrillation: A two-sample Mendelian randomization study
Authors: Chen Shuhong , Luo Xiqing , Zhao Jiaoshi , Liang Zhenguo , Gu Jieruo 
Published: November 2022

Objective: To study whether ankylosing spondylitis (AS) has a causal effect on the risk of atrial fibrillation (AF) using two-sample Mendelian randomization (MR) analysis.Methods: Single nucleotide polymorphisms (SNPs) were selected as independent instrumental variables (IVs) from a GWAS study of AS. Summary data from a large-scale GWAS meta-analysis of AF was utilized as the outcome dataset. Inverse-variance weighted (IVW) model was used for the primary analysis. Multiple sensitivity and heterogeneity tests were conducted to confirm the robustness of the results.Results: In total, 18 SNPs were identified as IVs for MR analysis. Five MR methods consistently found that ankylosing spondylitis was not causally associated with atrial fibrillation (IVW: OR = 0.983 (0.894, 1.080), p = 0.718; MR-Egger: OR = 1.190 (0.973, 1.456), p = 0.109; Simple mode: OR = 0.888 (0.718, 1.098), p = 0.287; Weighted mode: OR = 0.989 (0.854, 1.147), p = 0.890; Weight median: OR = 0.963 (0.852, 1.088), p = 0.545). Leave-one-out analysis supported the stability of MR results. Both the MR-Egger intercept and MR-PRESSO method revealed the absence of horizontal pleiotropy.Conclusion: The two-sample MR analysis did not support a causal relationship between AS and the risk of AF.