bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of Fiberoptic Phototherapy Compared to Conventional Phototherapy in Treating Hyperbilirubinemia Amongst Term Neonates: a Randomized Control Trial
Authors: Joel Helvi Ndeshihala , Mchaile Deborah , Philemon Rune , Mbwasi Ronald , Msuya Levina 
Published: July 2020

Abstract
Background
Neonatal jaundice is one of the most common problems in newborns. Effective treatment of jaundice requires therapeutic intervention with phototherapy (PT). Conventional phototherapy has been used for more than 50 years, but has been linked with adverse outcomes. Over recent years, several studies suggest fiberoptic phototherapy has been seen to be as effective as conventional phototherapy in preterm newborns with minimal adverse outcomes, however it was found to be less effective than conventional phototherapy in term neonates. These findings were attributed to the illuminated area and irradiance of the fiberoptic units used in previous studies. Our study aimed to compare the effectiveness of fiberoptic phototherapy unit with a larger illuminated area and higher irradiance to conventional phototherapy methods.
Methods
This was a randomized control trial conducted at Kilimanjaro Christian Medical Centre (KCMC). A total of 41 term neonates, less than 7 days of age with unconjugated hyperbilirubinemia were randomized. Thirteen (13) newborns were allocated to receive fiberoptic phototherapy, 13 for blue light conventional phototherapy and 15 for white light conventional phototherapy. Effectiveness was assessed by comparing the duration of phototherapy, bilirubin reduction rate and treatment side effects. The data was evaluated with the independent t-test.
Results
The mean overall bilirubin reduction rate (as %/h) was comparable in the fiberoptic phototherapy group (0.74%/h) and the blue light conventional phototherapy group (0.84%/h), with no statistically significant difference (p-value 0.124). However, white light conventional phototherapy had a significantly lower overall mean bilirubin reduction rate (0.29%/h) as compared to fiberoptic phototherapy (p-value < 0.001). The mean treatment duration of phototherapy was 69 h, 68 h and 90 h in the fiberoptic, blue light conventional and white light conventional phototherapy groups respectively. Side effects such as loose stool and skin rash were noted in some participants who received conventional phototherapy. No treatment side effects were noted in the fiberoptic phototherapy group.
Conclusion
The results confirm and quantify the benefits of increasing surface-area exposure and irradiance of the fiberoptic phototherapy unit. Fiberoptic phototherapy mitigates side effects caused by conventional phototherapy.
Trial registration:
The Pan African Clinical Trial Registry, PACTR202004723570110. Registered 22nd April 2020- Retrospectively registered, http://www.pactr.org/
Regulation of Prdx6 by Nrf-2 is mediated through aiPLA2 in white matter reperfusion injury
Authors: Daverey Amita , Agrawal Sandeep K. 
Published: July 2020

Abstract
BackgroundMechanisms involving upregulation of cytoprotective genes under the control of transcription factors, such as Prdx6 and Nrf2, exist to protect cells from permanent damage and dysfunction under hypoxic conditions. Hypoxia and reperfusion produces overproduction of ROS (reactive oxygen species), which may lead to mitochondrial dysfunction leading to cell death and apoptosis. Here, we explore the hypothesis that Prdx6 protects the spinal cord white matter from hypoxia-reperfusion injury and elucidate the possible mechanism by which Prdx6 elicits its protective effects.MethodsBriefly, rats were deeply anesthetized with 5% isoflurane and maintained at 1.5%-2.5% isoflurane. A 30 mm section of spinal cord was rapidly removed and placed in cold Ringer’s solution (2-4 °C), and then a dorsal column segment was micro-dissected from the spinal cord and adjacent gray matter after longitudinal sectioning. The dissected dorsal column was exposed to hypoxia by perfusing 95% N 2 /5% CO 2 for 1 h. For reperfusion experiments, the Ringer’s was reperfused with 95% O 2 and 5% CO 2 for 2 h and 4 h.ResultsOur results show that the expression of Prdx6 significantly upregulated in white matter after hypoxia compared to the sham group, whereas reperfusion caused a gradual decrease in Prdx6 expression after 2 h and 4 h of reperfusion injury. For the first time, our study revealed the novel expression and localized expression of Prdx6 in astrocytes after hypoxia, and possible communication of astrocytes and axons through Prdx6. Interestingly we observed a gradual increase in Nrf2 expression, which suggests a negative regulation of Prdx6 through Nrf2 signaling. Furthermore, inhibition of aiPLA2 activity of Prdx6 by MJ33 shows that the regulation of Prdx6 by Nrf2 is mediated through aiPLA2 activity.ConclusionThe present study uncovers a differential distribution of Prdx6 in axons and astrocytes under a hypoxic environment of white matter, and regulation of Prdx6 in hypoxia-reperfusion injury. Our data show that low levels of Prdx6 in reperfusion injury leads to increased inflammation and apoptosis in white matter, therefore the results of this study suggests that Prdx6 has a protective role in spinal hypoxia-reperfusion injury.
Modeling the Acceptance and Use of Electronic Medical Records from Patients’ Point of View: Evidence from Saudi Arabia
Authors: Bamufleh Dalal 
Published: July 2020

Abstract
Background

The employment of IT in healthcare reflects a need to meet the increasing demands of patients and to upgrade the quality and productivity of the provided services. However, the literature demonstrates many failures in systems and IT technology implementation in the context of healthcare. One of the reasons behind these failures is users’ resistance to accept such new technology. The ministry of health in Saudi Arabia has prioritized the embracing of new technologies that could level up the healthcare service, such as the adoption of electronic medical record (EMR) systems. On the other hand, studies that address the acceptance and use of hospital information systems and EMRs in Saudi Arabia from patients’ points of view are scarce. The aim of this study was to explore patients’ acceptance of an EMR system by testing a proposed theoretical model adapted from the technology acceptance model (TAM) and the unified theory of acceptance and use of technology (UTAUT).
Methods

An online questionnaire was used where questions were based on the proposed model constructs (facilitating conditions, perceived ease of use, perceived usefulness, attitude, and behavioral intention). One hundred sixteen patients responded to the questionnaire. The model was then tested using the structural equation modeling method to identify the factors that affect patients’ intention to use the online services of the EMR.
Results

The analysis of the research model suggested that (1) facilitating conditions that involved patients’ knowledge, skills, and the provided support by the hospital directly influenced the degree of perceived ease of use (PEOU) of the system. (2) PEOU directly affected the EMR’s perceived usefulness (PU). (3) PU directly affected patients’ attitudes (ATT) toward using the EMR. (4) A positive effect is found between ATT and the behavioral intention to use EMR.
Conclusion

The study results have implications for healthcare IT acceptance research and efforts in Saudi Arabia, as to date patients’ perspectives have received little attention. The research also makes a theoretical contribution as it validated the proposed model, which integrated constructs from TAM and UTAUT.
Connected Diagnostics to Improve Accurate Diagnosis, Treatment, and Conditional Payment of Malaria Services in Kenya.
Authors: Duijn Shannen Van , Siteyi Angela , Smith Sherzel , Milimo Emmanuel , Stijvers Leon , Oguttu Monica , Amollo Michael , Okeyo Edward , Dayo Lilyana , Kwambai Titus , Onyango Dickens , de Wit Tobias Rinke 
Published: July 2020

Abstract
Background: In sub-Saharan Africa, the material and human capacity to diagnose patients reporting with fever to healthcare providers is largely insufficient. Febrile patients are typically treated presumptively with antimalarials and/or antibiotics. Such over-prescription can lead to drug resistance and involves unnecessary costs to the health system. International funding for malaria is decreasing and transition to domestic funding is challenged by UHC efforts and recent COVID-19 outbreak. Herewith we present a digital approach to markedly improve efficiencies in diagnosis and treatment of malaria in endemic Kisumu, Kenya. The objective of this study is to evaluate feasibility, user experience, clinical performance and of Connected Diagnostics in Kisumu and to assess over-prescription of antimalarials. Methods: Our intervention was performed Oct 2017 – Dec 2018 across seven providers in Kisumu. Patients were enrolled on M-TIBA platform, diagnostic test results digitized, and only positive patients were digitally entitled for malaria treatment. Data on socio-demographics, healthcare transactions and medical outcomes were analysed using standard descriptive quantitative statistics. Provider perspectives were gathered by 19 semi-structured interviews. Results: In total 11,689 febrile patients were tested. Malaria positivity rates ranged from 7.4% to 30.2% between providers, with significantly more positive cases amongst the poor (p< 0.05). Over-prescription of antimalarials was 28%, fluctuating between 4.6% to 63.3% per provider. Prescription of branded versus generic antimalarials was dichotomous. Challenges were encountered transitioning from microscopy to RDT. Conclusion: We provide full proof-of-concept of innovative Connected Diagnostics to use digitized malaria diagnostics to earmark digital entitlements for correct malaria treatment of patients. This approach has large cost-saving and quality improving potential.
Detection and characterisation of Leptospira spp. in dogs diagnosed with kidney and/or liver disease
Authors: Rahman Mohammad Sabri Abdul , Khor Kuan Hua , Bejo Siti Khairani , Lau Seng Fong , Mazlan Mazlina , Roslan Mohd Azri , Goh Soon Heng 
Published: July 2020

Abstract
Background

Leptospirosis is a zoonotic bacterial disease that affects both humans and animals. In humans, a wide range of symptoms had been described but in dogs, it is commonly associated with kidney and/or liver disease. In Malaysia, information with regards to the common serovars causing leptospiral infection in dogs remains limited. Therefore, this study investigated the occurrences of leptospiral infection in 124 pet dogs diagnosed with kidney and/or liver disease in Malaysia.
Results

Based on microscopic agglutination test, 42.7% (53/124) of the dogs were seropositive for leptospiral infection. The predominant serovars detected were Bataviae (n = 12), Javanica (n = 10) and Icterohaemorrhagiae (n = 10). The direct detection using polymerase chain reaction showed that 33.9% (42/124) of the whole blood and 31.9% (36/113) of the urine samples were positive to pathogenic Leptospira spp. For tissue samples, 9.1% (2/23) of the kidney and 9.1% (2/23) of liver were positive for pathogenic Leptospira spp. Addition samples of abdominal effusion from four dogs were positive for pathogenic Leptospira spp. The species detected were L. interrogans, L. borgpetersenii, L. kirshneri and L. kmetyi by partial 16S rRNA sequencing. In this study, 11 Leptospira spp. isolated successfully from the eight dogs were further identified and characterised as Bataviae, Javanica and Australis. Unfortunately, the mortality rate of the infected dogs was high at 34.0% (18/53).
Conclusions

This study allowed for greater understanding of canine leptospirosis through the provision of crucial diagnostic confirmation.
Geriatric Depression in the Emergency Department of a Teaching Hospital in Nepal: Prevalence, Contributing Factors, and Metric Properties of 5 item Geriatric Depression Scale in this Population
Authors: Shrestha Roshana , Shrestha Anmol Purna , Shrestha Abha , Kamholz Barbara 
Published: July 2020

Abstract
Background
Depression is prevalent but poorly recognized in the Emergency Department (ED). We aimed to determine the prevalence of geriatric depression and its possible determinants in the ED using the 15-item geriatric depression scale (GDS). We also aimed to explore the performance of the shorter, five-item GDS as compared to the 15-item GDS.
Methods
This was a cross-sectional study with convenience sampling of the ED patients ≥ 60 years. The previously validated Nepali version of GDS-15 screened the sample into “no”, “mild-moderate” and “severe" depression using cutoff values of 4/5, and 8/9 respectively. Demographic and socioeconomic factors, comorbidities and health seeking behaviour were studied and the relation was assessed with binary (Chi-square and Kruskal-Wallis test) and multinomial regression analysis. The performance of GDS-5 was compared with the GDS-15 as standard. Cronbach’s alpha was calculated to investigate reliability. Validity was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, Spearman’s correlation, receiver operating characteristic curve, and kappa coefficient.
Results
280 patients were enrolled with an overall prevalence of depression of 45.7% [104 (81.3%) mild-moderate depression, and 24 (18.8%) severe depression]. The mean age of the sample was 71.36 with female predominance (61%), and 82.5% were illiterate. In the binary analysis, those who had more pain, visited the ED more often, had musculoskeletal diseases and sleep problems, mobility problems, visited local healers previously, and who reported self-perceived “heart and mind” disease showed statistically significant differences among the three categories. In multinomial regression analysis, visits to local healers, sleep problems and frequency of pain were significantly related to depression. The sensitivity, specificity, area under curve and Spearman’s correlation of GDS-5 were 75.8%, 96%, 0.919, and 0.827 respectively. Cronbach's alpha for GDS-5 was low (0.416), therefore a new version was proposed which improved the sensitivity to 90.6% and Cronbach’s alpha to 0.623.
Conclusions
Geriatric depression was highly prevalent which urges the need for ED-based interventions for screening and referral. The proposed brief GDS-5 correlated well with the GDS-15 with better validity and internal reliability and offers a more expeditious form of screening for geriatric depression in emergency settings in Nepal.
Factors Affecting Root Migration After Coronectomy of the Mandibular Third Molar
Authors: Lee Nan-ju , Jung Seo-Yeon , Park Kyeong-Mee , Choi Yiseul , Huh Jisun , Park Wonse 
Published: July 2020

Abstract
Background The purpose of this study was to analyze root migration and its influencing factors at 6 months after coronectomy in both two- and three-dimensions using periapical view and cone-beam computed tomography (CBCT). Methods Thity-three cases of root remnant after coronectomy were analyzed. We measured the amount of migration in CBCT. The following factors that could possibly affect root migration were also analyzed: age, gender, number of mandibular third molar (M3) roots, shape of M3s, Pell and Gregory classification, mesiodistal (MD) angulation, buccolingual (BL) angulation, contact point with the second molar, root curvature, and complete removal of the coronal portion. Results Migration of greater than 2 mm was found in 64% of the roots in the 2D analysis, and the average root migration was 4.11 mm in the 3D analysis. The factors affecting migration were the root morphology, complete removal of the coronal portion, impaction depth, and MD angulation in the 2D analysis, and MD and BL angulation in the 3D analysis. Conclusion In conclusion, complete removal of the coronal portion and ensuring sufficient space for root migration might be important factors after coronectomy of the M3. Clinical relevance Root remnant after coronectomy of M3 may migrate in young patients who has sufficient empty coronal space and this may reduce the nerve damage by the separation of IAN and M3.
“It’s really no more difficult than putting on fluoride varnish”: A qualitative exploration of dental professionals’ views of silver diamine fluoride for the management of carious lesions in children
Authors: Seifo Nassar , Cassie Heather , Radford John , Innes Nicola 
Published: July 2020

Abstract
Background: Despite evidence that Silver Diamine Fluoride (SDF) can be effective in managing carious lesions in primary teeth, there is still limited use the UK. This study explored dental professionals’ views and experiences of using SDF for managing carious lesions in children. In addition, it explored what they perceived to be the advantages, disadvantages, barriers and enablers to the use of SDF in practice.Methods: Fifteen semi-structured face-to-face or over-the-phone interviews were conducted with 14 dental professionals from NHS Tayside and NHS Grampian in Scotland. Interviews were transcribed verbatim, coded and analysed using a framework approach.Results: Thirteen of 14 dental professionals interviewed were familiar with, or had some existing knowledge of, SDF. Four had used it to treat patients. The majority of participants thought that the main advantage of SDF was that it required minimal patient cooperation. Silver diamine fluoride was also perceived as a simple, pain-free and non-invasive treatment approach that could help acclimatise children to the dental environment. However, SDF-induced black staining of arrested carious lesions was most commonly reported as the main disadvantage and greatest barrier to using it in practice. Participants believed that this discolouration would concern some parents who may fear that the black appearance may instigate bullying at school and that others may judge parents as neglecting their child’s oral health. Participants thought that education of clinicians about SDF use and information sheets for parents would enhance the uptake of SDF in dental practice. Participants believed that younger children might not be as bothered by the discolouration as older ones and they anticipated greater acceptance of SDF for posterior primary teeth by both parents and children.Conclusion: Dental professionals were aware that SDF can be used for arresting carious lesions. They pointed out that the staining effect of carious lesions is a major disadvantage that could be a barrier for many parents. Participants considered the application process to be simple and non-invasive and requires a minimum level of child’s cooperation. Participants appreciated the potentials of SDF in paediatric dentistry and suggested actions that could help overcome the barriers they highlighted.
The Impact of COVID-19 Pandemic on Dental Practice: A Questionnaire-Based Report
Authors: Ahmadi Hanie , Ebrahimi Alireza , Ghorbani Farhad 
Published: July 2020

Abstract
Background: The highly contagious nature of the novel coronavirus, besides the fact that dental procedures commonly generate blood and saliva droplets that are the routes of contagion lead to the closure of many dental clinics. In the present study, we aimed to evaluate the impact of coronavirus disease 2019 (COVID-19) pandemic on dental practice by conducting an online questionnaire among dental practitioners and finding their perspective on the subject.Methods: This report is based on a questionnaire that was conducted among Iranian dentists. The survey included questions that evaluate the dentists’ attitudes toward the COVID-19 pandemic and its effect on their personal life, financial status, and the quality of dental services for patients. Results: Overall, 240 dentists contributed to this study (214 general dentists and 26 specialists). The majority of the participants (n=219, 91%) did not perform non-emergency procedures during the pandemic. 162 (67%) of the contributors asserted that the COVID-19 test must be performed for the patients before any dental procedure and 234, (97%) of them reported that they encountered a decrease in their financial income since the pandemic.Conclusion: Most of the Iranian dentists performed just non-emergency treatments and reduced their work hours during the pandemic. They executed standard protocols more cautiously than the past, and affirmed that public organizations should support the dental practitioners during the pandemic.
Prevalence of Tumor Necrosis Factor Alpha Inducing Protein (tipα) Gene of Helicobacter Pylori and Its Association with Upper Gastrointestinal Diseases in India
Authors: Mahant Shweta , Mehra Shubham , Chhawchharia Ayushi , Karmakar Bipul Chandra , Paul Sangita , Mukhopadhyay Asish Kumar , Bose Sudeep , Das Kunal , Das Rajashree 
Published: July 2020

Abstract
Background: Helicobacter pylori (H. pylori) is known to cause several gastro-duodenal diseases including chronic Gastritis, Peptic Ulcer disease and Gastric Cancer. Virulent genes of H. pylori like cagA, vacA are known to be responsible for the disease pathogenesis. But these virulence genes are not always found to be associated with disease outcome in all populations around the world. Relationship of H. pylori with Gastro Esophageal Reflux Diseases is controversial and uncertain. Tumor necrosis factor alpha inducing protein tipα is a new discovered virulent gene of H. pylori and is an inducer of certain cytokines and chemokines that are responsible for causing stomach cancer. Therefore, we conducted a study which aims to find the prevalence of tipα gene in the Indian population and its association with H. pylori related upper gastrointestinal diseases.Results: The current study shows the prevalence rate of tipα gene in the Indian population to be 59.9%. Our study has found a significant association (p < 0.05) of tipα gene with Non Ulcer Dyspepsia (NUD) and also an association of cagA and vacAs1m1 with Gastritis and Duodenal Ulcer.Conclusion: Our study demonstrates for the first time the presence of tipα as virulent factor of H. pylori strain in Indian population isolated from patients suffering from upper gastrointestinal diseases. Further, tipα is significantly associated with NUD but not with other upper gastrointestinal diseases in India.
Bacteriological and Molecular Detection of Methicillin-resistant Staphylococcus Aureus Isolated From Cigarette and Hookah Smokers in Khartoum State
Authors: Osman Jara Osman Ali , Bakri Esraa abdulraman Abdallah , Hashim Ahmed Ibahim , Alla Ahmed Bakheet Abd , Altayb Hisham N , Hamedenil Yousif Fadlallah 
Published: July 2020

Abstract
Objective

Staphylococcus aureus is an extra-ordinarily versatile pathogen that causes a wide variety of infections in humans and animals, capable of causing superficial lesions and systemic infections. The aim of this study was to detect mecA gene in smokers of cigarette and hookah.
Results

Forty-one isolates (41%) were identified as S. aureus by traditional culture methods. non-smokers, nasal carriers of S. aureus were 16 (39%) while 25 (60%) among smokers (P = 0.103). Of the overall 25 smoker nasal carriers, 18 were hookah smokers and 7 were cigarettes smokers (P = 0.004). MRSA was 1 (2.4%) in non-smokers and 3 (7.2%) in smokers, 2 in cigarettes and 1 in hookah (P = 0.009). Only 38 isolates were confirmed as S. aureus by PCR (mecA gene). In non-smokers group mecA were 6 (15.8%) positive and 8 (21%) negative, while in smokers were 16 (42.3%) positive and 8 (20.9%) negative isolates (P = 0.187). From hookah 12 mecA positive and 4 from cigarette (P = 0.647). The correlation of MRSA and using of antibiotic during last 6 months indicates significant (P = 0.031).