bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early essential newborn care is associated with increased breastfeeding: a quasi-experimental study from Sichuan Province of western China
Authors: Wang Chenran , Li Xiayun , Zhang Lin , Wu Linman , Tan Ling , Yuan Fei , Guo Yao , Williams Sarah , Xu Tao 
Published: June 2020

Abstract
Background: Breastfeeding is critical to promote maternal and child health in a short and long term. China has set national targets to further improve the exclusive breastfeeding rate. We aimed to examine associations between the provision of early essential newborn care (EENC) and breastfeeding outcomes among full-term vaginally delivered neonates in the first six months of life. Methods: We conducted a quasi-experimental study in eight maternal and children’s hospitals in Mianyang City and Deyang City in Sichuan Province of western China. Four hospitals were randomly selected as the intervention group with the implementation of EENC while others as the control group receiving routine care. We assessed effects of EENC on breastfeeding initiation time, duration of first-time breastfeeding, and exclusive breastfeeding rates up to six months of age. Data in both groups were collected after delivery, at hospital discharge, 1 month, 3 months, and 6 months post birth in the baseline phase from May to June 2017 and post-EENC phase from October to December 2017. Written consent was obtained from eligible mothers enrolled in this study. We performed univariate analyses to ascertain differences between the two groups, and difference in difference (DID) models to explore the net effects. Results: Of the 1349 enrolled mother and newborn pairs in our study, 1131 (83.9%) were followed up at 1 month of age, 1075 (79.7%) at 3 months, and 981 (72.7%) at 6 months. EENC was associated with earlier median time to initiate breastfeeding (25min vs. 33min, P<0.01), an increased chance of successful first-time breastfeeding (OR=5.53; 95% CI: 2.69, 11.40), longer duration of skin to skin contact (SSC) (21.53 min; 95% CI: 18.17, 24.89) and longer duration of the first breastfeed (4.16 min; 95% CI: 2.10, 6.22), and an increased likelihood of being exclusively breastfed at discharge (74.5% vs. 55.0%, P<0.001), 3 months (OR=3.20; 95% CI: 1.01, 10.15), and 6 months (OR=4.91; 95% CI: 1.71, 14.13) of age. Conclusions: EENC enhances early and successful breastfeeding initiation, prolongs duration of the first breastfeed, and increases the rate of exclusive breastfeeding at six months of age. Our evidence suggests that nation wide scale up of EENC would increase the exclusive breastfeeding rate in the first six months of life.
Efficacy and safety of intraarticular corticosteroid injections in adolescents with juvenile idiopathic arthritis in the temporomandibular joint: A Norwegian 2-year prospective multicenter pilot study.
Authors: Frid Paula , Augdal Thomas A. , Larheim Tore A. , Halbig Josefine , Rypdal Veronika , Songstad Nils Thomas , Rosen Annika , Tylleskär Karin B. , Berstad Johanna Rykke , Flatø Berit , Stoustrup Peter , Rosendahl Karen , Kirkhus Eva , Nordal Ellen 
Published: June 2020

Abstract
Background. Intraarticular corticosteroids (IACs) have been used to treat temporomandibular joint (TMJ) arthritis. However, prospective clinical studies with magnetic resonance imaging (MRI) scoring are lacking. The aim of this study was to examine efficacy and safety of a single IAC in the TMJ in adolescents with juvenile idiopathic arthritis (JIA) in a clinical setting. Methods. In this Norwegian prospective multicenter pilot study 15 patients with JIA (mostly persistent oligo-arthritis or RF negative polyarthritis categories) and a clinically and MRI-verified diagnosis of TMJ arthritis were treated with IACs and followed for two years. Demographics, systemic medication, general disease activity and outcome measures were recorded including a pain-index score and maximal incisal opening (MIO). Inflammation and bone damage scores were assessed, using two recently published MRI scoring systems with masked radiological evaluation.Results. Among the 15 patients, 13 received a single IAC (5 bilateral), and 2 repeated IACs once unilaterally. Thus, the total number of IACs was 22. Median age was 15 years and the majority had an age not thought of as critical regarding mandibular growth retardation due to steroid injection. During the 2-year observation period systemic medication with disease modifying antirheumatic drugs (DMARDs) including biologics was initiated or adjusted in 10/15 (67%) patients. At the 2-months study visit after injection we observed a minimal improvement in MIO from median 44 (1st, 3rd quartiles; 36, 48) mm to 45 (43, 47) mm, p= 0.045 and decreased MRI mean additive inflammatory score from 4.4±1.8 standard deviations (SD) to 3.4±2.0, p= 0.040. From baseline to the 2-months follow-up pain improved in 6/11 patients but pain scores were not significantly improved. MRI-assessed damage increased in two patients with repeated IACs, and decreased in 3 patients but most of the patients were stable over the 2-year follow-up. Intra-rater repeatability of the MRI scoring system domains varied from poor to excellent.Conclusions. In this pilot study of predominately single IACs to the TMJ in combination with systemic treatment we observed improvement in MRI-assessed inflammation, mostly stable condylar bone conditions and minimal clinical improvement in adolescents with JIA and TMJ arthritis. No severe side effects were seen.
Intravenous Calcium as a Pressor in a Swine Model of Hypoxic Pseudo-Pulseless Electrical Mechanical Activity - A Preliminary Report
Authors: Lindqwister Alexander , Lampe Joshua W. , Gould Jeffrey R. , Kaufman Christopher L. , Moodie Karen , Paradis Norman 
Published: June 2020

Abstract
Background: Pseudo-pulseless electrical activity (pseudo-PEA) is a lifeless form of profound cardiac shock characterized by measurable cardiac mechanical activity without clinically detectable pulses. Pseudo-PEA may constitute up to 40% of reported cases of cardiac arrest. Resuscitation from pseudo-PEA is often associated with hypotension refractory to catecholamine pressors. We hypothesized that this post-resuscitation state may be associated with hypocalcemic hypotension responsive to intravenous calcium. Methods: Using pre-existing data from our hypoxic swine pseudo-PEA model, we measured blood pressure, hemodynamics, and electrolytes. Physiological data were analyzed on a heartbeat by heartbeat basis. The midpoint of the calcium response was defined using change of curvature feature detection. Hemodynamic parameters were shifted such that the value at the midpoint was equal to zero. Results: In 9 animals with refractory hypotension we administered 37 boluses of intravenous calcium in the dosage range of 5 -20 mg. Comparisons were made between the average values in the time period 40-37 seconds before the midpoint and 35-40 seconds after the midpoint. Of the 37 administered boluses, 34 manifested a change in the blood pressure, with mean aortic pressure, systolic and diastolic pressures all increasing post bolus administration. Conclusions: Administration of intravenous calcium may be associated with a pressor-like response in refractory hypotension after resuscitation from pseudo-PEA. Relative ionized hypocalcemia may cause hypotension after resuscitation from pseudo-PEA. Therapy with intravenous calcium should be further investigated in this setting.
Effects of oral contraceptives on the quality of life of women with polycystic ovary syndrome: a crossover randomized controlled trial
Authors: Amiri Mina , Nahidi Fatemeh , Bidhendi-Yarandi Razieh , Khalili Davood , Tohidi Maryam , Tehrani Fahimeh Ramezani 
Published: June 2020

Abstract
Background and objective A limited number of studies have evaluated the effects of oral contraceptives (OCs) on the quality of life (QOL) of polycystic ovary syndrome (PCOS) patients. This study aimed to compare the effects of using OCs containing levonorgestrel (LNG) and those containing desogestrel (DSG), cyproterone acetate (CPA) or drospirenone (DRSP) for 6 months on the QOL with PCOS. Methods In this crossover randomized controlled 6-arm trial, 200 eligible patients with PCOS scheduled for OC therapy were randomly assigned to one of the 6 study arms. All 6 arms include two 6-month treatment periods, one period with OCs containing LNG, and the other with each of the 3 OCs containing DSG, CPA, or DRSP. Outcomes of interest were the total score of QOL and its domains, which were assessed using a specific and valid health‐related quality of life questionnaire for PCOS, which is consisted of six domains, including psychosocial–emotional, self-image, fertility, sexual function, hirsutism, and obesity– menstrual disorders.Results Finally, a total of 88 patients were analyzed for this study. The results showed that use of OCs containing DSG, CPA, and DRSP for 3 months was not associated with significant differences in the total scores of QOL compared to those OCs containing LNG, whereas, after 6 months of treatment, patients treated with OCs containing CPA had more improvements in their total scores of QOL, in comparison to OCs containing LNG (P < 0.042). We found no significant differences in QoL domains, including psychosocial–emotional, self-image, fertility, sexual function, hirsutism, and obesity-menstrual disorders after 3- 6 months of treatment with DSG, CPA, or DRSP, compared to LNG. The sequence and period effects were not significant in any of the analyses at 3 and 6 months of treatment. The carry-over effect was not significant for most outcomes assessed. Conclusions This crossover study demonstrated non-inferiority of OCs with newer generation progestins on different domains of QOL, in comparison with older compounds, although usage of products containing CPA was significantly associated with more improvement in total QOL of PCOS patients, compared to those containing LNG after 6-month of treatment. Clinical Trial Registration Number: IRCT201702071281N2.
Metabolic engineering of phosphite metabolism in Synechococcus elongatus PCC 7942 as an effective measure to control biological contaminants in outdoor raceway ponds
Authors: González-Morales Sandra Isabel , Pacheco-Gutiérrez Navid , Ramírez-Rodríguez Carlos A. , Brito-Bello Alethia A. , Estrella-Hernández Priscila , Herrera-Estrella Luis , ARREDONDO DAMAR LOPEZ 
Published: June 2020

Abstract
Background: The use of cyanobacteria and microalgae as cell factories to produce biofuels and added-value bioproducts has received great attention during the last two decades. Important investments have been made by public and private sectors to develop this field. However, it has been a challenge to develop a viable and cost-effective platform for cultivation of cyanobacteria and microalgae under outdoor conditions. Dealing with contamination caused by bacteria, weedy algae/cyanobacteria and other organisms is a major constraint to establish effective cultivation processes.Results: Here we describe the implementation in the cyanobacterium Synechococcus elongatus PCC 7942 of a phosphorus selective nutrition system to control biological contamination during cultivation. The system is based on metabolic engineering of S. elongatus to metabolize phosphite, a phosphorus source not normally metabolized by most organisms, by expressing a bacterial phosphite oxidoreductase (PtxD). Engineered S. elongatus strains expressing PtxD grow at a similar rate on media supplemented with phosphite as the non-transformed control supplemented with phosphate. We show that when grown in media containing phosphite as the sole phosphorus source in glass flasks, the engineered strain was able to grow and outcompete biological contaminants even when the system was intentionally inoculated with natural competitors isolated from an irrigation canal. The PtxD/phosphite system was successfully used for outdoor cultivation of engineered S. elongatus in 100 L cylindrical reactors and 1,000 L raceway ponds, under non-axenic conditions and without the need of sterilizing containers and media. Finally, we also show that the PtxD/phosphite system can be used as selectable marker for S. elongatus PCC 7942 transgenic strains selection, eliminating the need of antibiotic resistance genes. Conclusions: Our results suggest that the PtxD/phosphite system is a stable and sufficiently robust strategy to control biological contaminants without the need of sterilization or other complex aseptic procedures. Our data shows that the PtxD/phosphite system can be used as selectable marker and allows production of the cyanobacterium S. elongatus PCC 7942 in non-axenic outdoor reactors at lower cost, which in principle should be applicable to other cyanobacteria and microalgae engineered to metabolize phosphite.
Tsetse fly distribution and occurrence of Trypanosoma species among cattle and goats around Queen Elizabeth National park, Uganda
Authors: Kangume Mallion , Muhangi Denis , Byaruhanga Joseph , Agaba Aggrey , Sserunkuma Joachim , Kisembo Stallon Justus , Bogere Paul , Vudriko Patrick , Rwego Innocent Bidason 
Published: June 2020

Abstract
Background

African Animal Trypanosomiasis (AAT) is an infectious disease of economic and public health importance hindering agricultural productivity in Sub-Saharan Africa. The current study aimed at providing baseline information on tsetse fly distribution and occurrence of Trypanosoma species in cattle and goats within and around Queen Elizabeth National Park (QENP), in western Uganda. A minimal entomological survey was conducted in April 2017 while blood samples collected from cattle (n = 576) and goats (n = 319) in June 2015 and May 2017 were subjected to microscopy and Polymerase Chain Reaction (PCR) to determine the occurrence of trypanosome species.
Results

Glossina pallidipes and G. fuscipes were the only tsetse fly species trapped in the study area with apparent density of 20.6. The overall prevalence of Trypanosoma spp. in cattle and goats was 38.9% and 37% respectively for samples collected in 2015 while the prevalence of Trypanosome spp in cattle samples collected in 2017 was 38%. In 2015, T. brucei was the highest prevalent trypanosome in both cattle (23%) and goats (18.8%). In both cattle and goats, a mixed infection of T. brucei + T. congolense was most encountered with prevalence of 4.8% and 4.1% in cattle and goats, respectively. In goats a mixed infection of T. brucei + T. congolense + T. vivax was higher (2.8%) than in cattle (2.4%). In 2017, in cattle (n = 250), the prevalence for T. congolense was 32.4%, T. vivax was 6.8% and T. brucei was 6.4%. A co-infection of T. brucei and T. congolense was most prevalent (7.4%). Only 3.2% of the cattle were co-infected with all the three Trypanosome species.
Conclusions

Current findings show that there are two types of Tsetse fly specie, s important in transmission of AAT. Presence of these parasites in goats shows that they also play a key role in epidemiology of the disease and control efforts should aim also involve goat farmers.
Smartphone application for celiac patients: assessing its effect on gastrointestinal symptoms in a randomized controlled clinical trial
Authors: Nikniaz Zeinab , Shirmohammadi Masood , Masserat Elham , Namvar Zahra Akbari 
Published: June 2020

Abstract
Background: We aimed to study the effectiveness of a “celiac” smartphone application on gastrointestinal symptoms in celiac patients. Methods: In the present randomized controlled clinical trial, 60 celiac patients were randomly assigned to receive education through a smartphone application (n=30) or conventional clinical education (n=30). We assessed the gastrointestinal symptoms using the gastrointestinal symptom rating scale (GSRS) questionnaire at baseline and three months after interventions. The GSRS total score, celiac disease GSRS (CD-GSRS) score, abdominal pain, reflux, diarrhea, constipation, and indigestion scores were calculated. Results: Out of 60 randomized patients, 58 patients completed the study. In comparison to baseline, the mean score of GSRS total score (p=0.04), CD-GSRS score (p=0.001), and indigestion subscore (p<0.001) were significantly decreased in the intervention group. In the control group, compared to baseline, the mean scores of CD-GSRS score (p=0.03) and abdominal pain subscore (p=0.04) were significantly reduced; and the mean score of reflux (p=0.01) subscore was significantly increased. The results of the between-group comparisons showed that although the mean GSRS and CD-GSRS total scores were lower in the intervention group compared with the control group, the differences were not statistically significant. In terms of GSRS subscores, there was a significant difference between the two groups only in the mean score of indigestion (P=0.01).Conclusion: According to the results, smartphone application had a significantly positive effect on indigestion symptoms compared with routine clinic education. However, more large studies with longer duration of the follow-up period are needed to assure this approach Trial registration: The protocol of the study was registered in the Iranian registry of clinical trials (IRCT code: IRCT20170117032004N2). trial registry webpage: : https://www.irct.ir/user/trial/40187/view. Trial registry date: 2019.6.26
Intrinsic laws of k-mer spectra of genome sequences and evolution mechanism of genomes
Authors: Zhenhua Yang , Li Hong , Yun Jia , Yan Zheng , Hu Meng , Tonglaga Bao , Xiaolong Li , Liaofu Luo 
Published: June 2020

Abstract
Background K-mer spectra of DNA sequences contain important information about sequence composition and sequence evolution. We want to reveal the evolution rules of genome sequences by studying the k-mer spectra of genome sequences. Results The intrinsic laws of k-mer spectra of 920 genome sequences from primate to prokaryote were analyzed. We found that there are two types of evolution selection modes in genome sequences, named as CG Independent Selection and TA Independent Selection. There is a mutual inhibition relationship between CG and TA independent selections. We found that the intensity of CG and TA independent selections correlates closely with genome evolution and G+C content of genome sequences. The living habits of species are related closely to the independent selection modes adopted by species genomes. Consequently, we proposed an evolution mechanism of genomes in which the genome evolution is determined by the intensities of the CG and TA independent selections and the mutual inhibition relationship. Besides, by the evolution mechanism of genomes, we speculated the evolution modes of prokaryotes in mild and extreme environments in the anaerobic age and the evolving process of prokaryotes from anaerobic to aerobic environment on earth as well as the originations of different eukaryotes. Conclusion We found that there are two independent selection modes in genome sequences. The evolution of genome sequence is determined by the two independent selection modes and the mutual inhibition relationship between them.
Risk factors and electrocardiogram characteristics for mortality of critical inpatients with COVID-19
Authors: Li Lingzhi , Zhang Shudi , He Bing , Chen Xiaobei , Wang Shihong , Qingyan Zhao 
Published: June 2020

Abstract
Background
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has subsequently spread worldwide. The number of death has increased rapidly. However, the possible risk factors that lead to death in critical inpatients with coronavirus disease 2019 (COVID-19) are not yet fully known. This study was to explore the risk factors for mortality of critical inpatients with COVID-19.
Methods
In this single-centered, retrospective study, we enrolled 113 critical patients with COVID-19 in Renmin Hospital of Wuhan University between Feb 1, 2020 and Mar 15, 2020. Data were collected using a standard method including clinical records and laboratory findings. Outcomes of survivors and death were compared.
Results
A total of 113 critical patients (from 29 to 95 years) with COVID-19 were recruited, 50 (44.25%) died and 63 recovered (55.75%). The proportion of patients with ventricular arrhythmia was higher in the death group than the recovery group (24.0% vs 4.4%; p = 0.021), and was higher among myocardial damage cases than non-myocardial damage cases (26.1% vs 4.3%; p = 0.013). Multivariate analysis confirmed four independent predictors related to mortality of COVID-19: age > 70 yrs (HR 1.84, 95% CI 1.03–3.28), initial neutrophil count more than 6.5 × 109/L (HR 3.43, 95% CI 1.84–6.40), C-reactive protein greater more than 100 mg/L (HR 1.93, 95% CI 1.04–3.59), and lactate dehydrogenase more than 300 U/L (HR 2.90, 95% CI 1.26–6.67). Immunoglobulin treatment (HR 0.39, 95% CI 0.21–0.73) can reduce the risk of death. There was no significant difference in the QT interval between patients with and without hydroxychloroquine treatment.
Conclusions
Old age (> 70 years), neutrophilia, C-reactive protein greater more than 100 mg/L and lactate dehydrogenase more than 300 U/L are high-risk factors for mortality of critical patients with COVID-19. The incidence of ventricular arrhythmia was higher in deceased patients than survivors.
Fertility Preserving Surgery in A Woman with Synchronous Endometrial and Ovarian Cancer Followed by Successful Pregnancy Outcome: Case Report and Review of Literature
Authors: Suri Vanita , Bansal Ramandeep , Aggarwal Neelam , Sikka Pooja , Chopra Seema , Saha Subhash Chandra , Gupta Nalini , Rai Bhavana 
Published: June 2020

Abstract
Background: Successful pregnancy outcome in women with synchronous ovarian and endometrial cancers is very rare. We report successful pregnancy outcome in a young woman managed conservatively for synchronous endometrial and ovarian cancer. Case presentation: 30 years old nulliparous lady presented following exploratory laparotomy, left salpingo-oophorectomy and hysteroscopic polypectomy for left adnexal mass. Histology revealed endometrioid carcinoma of left ovary and moderately differentiated adenocarcinoma in the resected polyp. She underwent staging laparotomy along with hysteroscopy which confirmed above findings without any evidence of further tumor spread. She was treated conservatively with high dose oral progestin (megestrol acetate, 160mg) and leuprolide acetate 3.75mg monthly injections for three months along with four cycles of carboplatin and paclitaxel based chemotherapy followed by monthly injection of leuprolide for further three months. After failure of spontaneous conception, she underwent ovulation induction for six cycles along with intrauterine insemination which failed. She underwent in vitro fertilization with donor egg followed by elective cesarean section at 37weeks of gestation. She delivered a healthy baby of weight 2.7 Kg. Intraoperatively 5×6cm right ovarian cyst was found which drained chocolate coloured fluid on puncture and cystectomy was carried out. Histological examination revealed endometrioid cyst of right ovary. Uterus was spared as she wanted to preserve her fertility. She is being followed periodically and is normal nine months following delivery. She is on injection Depot medroxy progesterone acetate once every three months.