bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pregnancy outcomes among 31 patients with tetralogy of Fallot, a retrospective study
Authors: Wang Kana , Xin Junguo , Wang Xiaodong , Yu Haiyan , Liu Xinghui 
Published: November 2019

Abstract
Background

Ttralogy of Fallot (TOF) is a severe type of congenital heart disease (CHD) and confers substantial risk to mother and fetus. However, the outcomes of pregnant women with TOF have not been well studied.

Methods

Women with TOF who has been seen and/or delivered at our tertiary-care hospital between April 2008 and January 2018 were retrospective reviewed.

Results

A total of 31 TOF patients with pregnancies were identified in ten-year period. Among these patients, cardiac defects were surgically repaired in 19 cases and remained uncorrected in 12 women. The frequency of miscarriages and preterm birth was greater in the uncorrected group (16.67% vs one, and 50% vs 5.26%, respectively). The percentage of babies who were small for gestational age (SGA) was 41.67% and 10.53% in two groups. The neonatal mortality and fetal mortality were observed in women without correction for TOF, which were 3.23% (1/31) and 6.45(2/31), respectively. Maternal and neonatal risk appeared to be associated with heart functional classifications, pulmonary hypertension and histories of cardiac events such as serious cardiac arrhythmias.

Conclusions

Obstetric and cardiac complications are more frequently present in the pregnant women with uncorrected TOF. Surgical correction is associated with improved maternal and perinatal outcome.
Does Phone Messaging Improves Tuberculosis Treatment Success? A Systematic Review and Meta-analysis
Authors: Gashu Kassahun Dessie , Gelaye Kassahun Alemu , Mekonnen Zeleke Abebaw , Lester Richard , Tilahun Binyam 
Published: November 2019

Abstract
Background: Compliance to anti-TB treatment is crucial in achieving cure and avoiding the emer­gence of drug resistance. Electronic health (eHealth) interventions are included in the strategy to end the global Tuberculosis (TB) epidemic by 2035. Evidences showed that mobile messaging systems could improve patient adherence to clinic appointment for diagnosis and treatment. This review aimed to assess the effect of mobile-phone messaging on anti-TB treatment success. Methods: All randomized controlled trial (RCT) and quasi-experimental studies done prior to August 26, 2019 were included in the review. Studies were retrieved from PubMed, EMBASE, Cochrane and ScienceDirect databases including, grey and non-indexed literatures from Google and Google scholar. Quality of studies were independently assessed using Cochrane Risk of Bias Assessment Tool. A qualitative synthesis and quantitative pooled estimation were used to measure the effect of phone messaging on TB treatment success rate. PRISMA flow diagrams were used to summarize article selection process, see Additional file 1. Results: A total of 1237 articles were identified, with 14 meeting the eligibility criteria for qualitative synthesis. Eight studies with a total of 5680 TB patients (2733 in intervention and 2947 in control groups) were included in meta-analysis. The pooled effect of mobile-phone messaging revealed a small increase in treatment success compared to standard of care (RR 1.04, 95% CI 1.02 to 1.06), with low heterogeneity (I2=7%, p<0.0002). In the review, performance, detection and attrition biases were reported as major risk of biases. Conclusions: Mobile-phone messaging showed a modest effect in improving anti-TB treatment success; however, the quality of evidence was low. Further controlled studies are needed to increase the evidence-base on the role of mHealth interventions to improve TB care. Protocol registration number: CRD420170744339 http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017074439 Key Words: Mobile phone, Treatment success, Text messaging, Tuberculosis
The Sydney Triage to Admission Risk Tool (START) to improve patient flow in an Emergency Department: A model of care implementation pilot study
Authors: Ebker-White Anja , Bein Kendall , Russell Saartje Berendsen , Dinh Michael 
Published: November 2019

Abstract
Background: The Sydney Triage to Admission Risk Tool (START) is a validated clinical analytics tool designed to estimate the probability of in-patient admission based on Emergency Department triage characteristics.
Methods: This was a single centre pilot implementation study using a matched case control sample of patients assessed at ED triage. Patients in the intervention group were identified at triage by the START tool as likely requiring in-patient admission and briefly assessed by an ED Consultant. Bed management were notified of these patients and their likely admitting team based on senior early assessment. Matched controls were identified on the same day of presentation if they were admitted to the same in-patient teams as patients in the intervention group and same START score category. Outcomes were ED length of stay and proportion of patients correctly classified as an in-patient admission by the START tool.
Results: One hundred and thirteen patients were assessed using the START-based model of care. When compared with matched control patients, this intervention model of care was associated with a significant reduction in ED length of stay [301 minutes (IQR 225-397) versus 423 minutes (IQR 297-587) p<0.001] and proportion of patients meeting four hour length of stay thresholds increased from 24% to 45% (p<0.001).
Conclusion: In this small pilot implementation study, the START tool, when used in conjunction with senior early assessment was associated with a reduction in ED length of stay. Further controlled studies are now underway to further examine its utility across other ED settings.
Characterization of Visceral leishmaniasis Outbreak, Marsabit County, Kenya, 2014
Authors: Kanyina Evalyne Jaquelyne Wambui 
Published: November 2019

Abstract
Background: Visceral leishmaniasis (VL) is caused by protozoa of the Leishmania donovani complex. Annually, an estimated 500,000 cases of VL are reported globally posing a public health challenge. The objectives of our study were to confirm and determine the magnitude of VL outbreak, characterize the outbreak clinically and epidemiologically and evaluate the county preparedness and response in Marsabit County, Kenya. Methods: A retrospective review of laboratory registers and patients’ clinical notes was done at Marsabit County Hospital. Cases were persons with confirmed VL diagnosis either by microscopy, serology or molecular technique coming from Marsabit County from May to October 2014. Cases were interviewed using structured questionnaire to collect clinical and epidemiologic information. Blood samples were collected from cases for laboratory confirmation. Results: A total of 136 cases were confirmed of which 77% (105) were male with a median age of 17 (IQR: 22) years and 9.6% (13) case fatality rate. All cases were admitted at Marsabit County Referral Hospital, Kenya. Medical records of 133 cases were retrieved. Of the 133 cases, 102 (77%) presented with fever, 43 (32%) with splenomegaly, 26 (20%) with hepatomegaly and 96 (72%) were managed with Sodium stibogluconate (SSG) monotherapy. Thirty four cases (26%) received Full haemogram (FHG) test and none had more than one Liver Function Tests (LFTs) in a span of six months. No VL case management training had been conducted nor VL treatment guidelines distributed among health care workers (HCWs) in the last one year. Conclusions: VL cases were confirmed. Inadequate case monitoring and management was evident. VL case management sensitization training was conducted. The County health department should put in place VL surveillance and facilitate periodic case management trainings.
Association between the rate of fluoroquinolones-resistant Gram-negative bacteria and antibiotic consumption from China based on 145 tertiary hospitals data in 2014
Authors: Yang Ping , Chen Yunbo , Jiang Saiping , Shen Ping , Lu Xiaoyang , Xiao Yonghong 
Published: November 2019

Abstract
This study aimed to investigate the relationship between the rate of fluoroquinolones-resistant (FQR) gram-negative bacteria and antibiotic consumption intensity in 145 tertiary hospitals from China in 2014.Methods A retrospective study using national surveillance data from 2014 was conducted. Data on the annual consumption of each antibiotic, and the rate of FQR gram-negative bacteria, were collected from each participating hospital, and the correlation between antibiotic consumption and FQR rate was simultaneously investigated.Results The overall antibiotic consumption intensity among the hospitals varied between 23.93 and 115.39 defined daily dosages (DDDs) per 100 patient-days (median, 46.30 DDDs per 100 patient-days). Cephalosporins were the most commonly prescribed antibiotics, followed by fluoroquinolones, penicillins, and carbapenems, and the rate of FQR gram-negative bacteria from each hospital varied. The correlation analysis showed significantly relationship between the percentage of FQR E. coli and the consumption of FQs consumption (r=0.308, p<0.01) and levofloxacin (r=0.252, p<0.01). For FQR K. pneumoniae, not only FQs (r=0.291, p<0.01) and levofloxacin (r=0.260, p<0.01) use but also carbapenems (r=0.242, p<0.01) and overall antibiotics (r=0.247, p<0.01) use showed significant correlation. A strong correlation was observed between the resistant proportion of FQR P. aeruginosa and the consumption of all antibiotics (r=0.260, p<0.01), FQs (r=0.319, p<0.01) and levofloxacin (r=0.377, p<0.01). The percentage of levofloxacin-resistant A. baumannii was significantly correlated with the consumption of all antibiotics (r=0.282, p<0.01), third-generation cephalosporins excluding combinations with beta-lactamase inhibitors (r=0.246, p<0.01), FQs (r=0.254, p<0.01) and levofloxacin (r=0.336, p<0.01). However, the correlation of the ciprofloxacin-resistant A. baumannii and the antibiotics consumption was not found.Conclusions A significant relationship was demonstrated between the antibiotic consumption and the rates of FQR gram-negative bacteria. As unreasonable antibiotics usage remains crucial in the proceeding of resistant bacteria selection, our study could greatly promote the avoidance of unnecessary antibiotic usage.
Profiling of Koumiss Microbiota and Organic Acids and their Effects on Koumiss Taste
Authors: Tang Hai , Ma Huimin , Hou Qiangchuan , Li Weicheng , Xu Haiyan , Liu Wenjun , Sun Zhihong , Haobisi halatu , Menghe Bilige 
Published: November 2019

Abstract
Koumiss, a naturally fermented mare’s milk with a distinctive flavor, has been consumed for thousands of years by Mongolian people. To clarify the contribution of microbiota to the taste of koumiss, bacterial and yeast diversity in koumiss were investigated by single-molecule real-time sequencing; the organic acid content was quantified by HPLC, and the taste was analyzed using the SA402B taste-sensing system. The dominant bacterial species in koumiss were Lactobacillus helveticus, Lactobacillus kefiranofaciens, Lactococcus lactis, Lactococcus raffinolactis, and Citrobacter freundii. The main yeast species were Dekkera anomala, Kazachstania unispora, Meyerozyma caribbica, Pichia sp.BZ159, Kluyveromyces marxianus, and unculturedGuehomyces. The most dominant organic acids were lactic, acetic, tartaric, and malic acids. Organic acid accumulation in koumiss was mainly correlated with bacterial, but not yeast, species abundance. Redundancy analysis suggested that both bacteria and yeast respond to koumiss flavor. To prevent excessive sourness, astringency, and bitter taste during koumiss production, the abundance of Lactobacillus helveticus and Dekkera anomala can be controlled; alternatively, Lactococcus lactis and Kazachstania unispora could be increased in the artificial starter culture.
The prognostic value of routine preoperative blood parameters in muscle-invasive bladder cancer
Authors: zhang jingqi , Zhou Xiaozhou , Ding Hua , Wang Liwei , Liu Sha , Chen Zhiwen 
Published: November 2019

Abstract
Background A routine blood examination is one of the most rapid, convenient and inexpensive clinical examinations that can reflect a patient’s inflammatory status and other blood conditions, and the prognostic value of routine preoperative blood parameters in MIBC patients is still unclear, so we evaluated the prognostic value of routine preoperative blood parameters in muscle-invasive bladder cancer (MIBC) following radical cystectomy (RC). Methods Data on 272 patients with MIBC who underwent RC at our institution were retrospectively collected between March 2006 and August 2018. The median preoperative neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and hemoglobin (HGB) values were used as cutoffs to form the low and high NLR, low and high PLR, and low and high HGB groups, respectively. The clinicopathologic characteristics of each group were compared by chi-square and t tests. Kaplan-Meier survival and multivariate Cox regression analyses were used to analyze prognosis. Results The median NLR, PLR and HGB values were 2.48, 115 and 125, respectively. Kaplan-Meier results showed that the high NLR and low HGB groups had poor progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS). A high PLR correlated only with poor OS. Multivariate Cox analyses showed that pathologic T4 stage, positive lymph node status and low HGB were independent risk factors for PFS, CSS and OS, and pathologic T3 stage was an independent risk factor for PFS and CSS; however, age was the only independent risk factor for OS. Conclusion Preoperative peripheral blood HGB is an independent risk factor for the prognosis of MIBC patients. These data suggest that HGB may be a useful prognostic marker for MIBC patients undergoing RC.
The impact of prostate cancer upgrading and upstaging on biochemical recurrence and cancer-specific survival
Authors: Bakavicius Arnas , Drevinskaite Mingaile , Daniunaite Kristina , Barisiene Marija , Jarmalaite Sonata , Jankevicius Feliksas 
Published: November 2019

Abstract
Significant numbers of prostate cancer (PCa) patients experience tumour upgrading and upstaging between prostate biopsy and radical prostatectomy (RP) specimens. The aim of our study was to investigate the role of grade and stage increase on surgical and oncological outcomes.Methods Upgrading and upstaging rates were analysed in 676 treatment-naïve PCa patients who underwent RP with subsequent follow-up. Positive surgical margin (PSM), biochemical recurrence (BCR), overall (OS) and cancer specific survival (CSS) were analysed according to upgrading and upstaging.Results Upgrading was observed in 29% and upstaging in 22% of PCa patients. Patients undergoing upgrading or upstaging were 1.5-times more likely to have a PSM on RP pathology. Both upgrading and upstaging were associated with increased risk for BCR: 1.8 and 2.1-times, respectively. Mean time to BCR after RP was 2.1 years in upgraded cases and 2.7 years in patients with no upgrading (p < 0.001), while mean time to BCR was 1.9 years in upstaged and 2.8 years in non-upstaged cases (p < 0.001). Grade and stage increase after RP were associated with inferior ten-year CSS rates: 78% vs. 96% for upgrading (p = 0.002) and 77% vs. 95% for upstaging (p = 0.001).Conclusions Currently used risk stratification models are associated with a substantial number of misdiagnosis. Pathological upgrading and upstaging have been associated with inferior surgical results, substantial higher risk of BCR and inferior rates of important oncological outcomes, what should be considered when counselling PCa patients at the time of diagnosis or after definitive therapy.
Associations between Salivary Cytokines and Periodontal and Microbiological Parameters in Patients undergoing Fixed Orthodontic Appliance Treatment
Authors: Chen Yong , Kit Wong Wing , Seneviratne Jayampath C , Huang Shuying , McGrath Colman , Hagg Urban 
Published: November 2019

Abstract
Background: Orthodontic treatment can lead to microbial-induced gingival inflammation and aseptic periodontal inflammations. The aim of this study was to investigate the relationship between salivary pro-inflammatory cytokines levels with gingival health status and oral microbe loads among patients undergoing fixed orthodontic appliance treatment (FOAT). Methods: This was a cross-sectional study among a sample of 111 consecutive orthodontic patients (mean age 18.4 ± 4.4 years). Clinical examinations were conducted to assess the gingival health status employing the Modified Gingival Index (MGI), Gingival Bleeding Index (GBI) and Plaque Index (PI). Salivary microbiological assessments of total aerobic and anaerobic bacteria count, streptococci count and lactobacilli count were undertaken. Salivary immunological assessments included Interleukin-1Beta (IL-1β) and macrophage migration inhibitory factor (MIF) ELISA assays. Results: The mean ± standard deviation (SD) of salivary IL-1β was 83.52 ± 85.62 pg/ml and MIF was 4.12 ± 0.96 ng/ml. Positive significant correlations between salivary IL-1β levels and salivary bacteria counts (r=0.380~0.446, P<0.001), and between salivary MIF levels and total salivary aerobic and anaerobic bacteria counts (r=0.249~0.306, P<0.01) were observed. A significant positive correlation was found between salivary IL-1β levels and BI (r=0.216, p<0.05). Conclusions: The levels of salivary IL-1β and MIF correlate with oral bacterial load among patients undergoing fixed orthodontic therapy. This has implications in understanding gingival inflammation/ aseptic periodontal inflammation during orthodontic therapy.
Prevalence of stroke and stroke related risk factors: a population based cross sectional survey in southwestern China
Authors: Yi Xingyang , Luo Hua , Zhou Ju , Yu Ming , Chen Xiaorong , Tan Lili , Wei Wei , Li Jie 
Published: November 2019

Abstract
Background: Stroke and its risk factors epidemiological survey can help identify individuals at higher risk and therefore promote stroke prevention strategies. The aim of this study was to estimate the current prevalence of stroke and high risk stroke population, and evaluate stroke associated risk factors in southwestern China. Methods: This was a multi-center, cross sectional survey in southwestern China from May 2015 to September 2015. The 8 communities were selected at random, and 17213 residents aged ≥ 40 years volunteered to participate in this survey. Data were collected through face-to-face survey using a structured questionnaire. 521 participants with incomplete questionnaires on stroke history or risk factors records were excluded. Results: A total of 16892 people included in analysis. The overall prevalence of stroke was 3.1% (95% CI 2.6% - 3.9%), 17.1% of participants were the high risk stroke population. After full adjustments, hypertension, diabetes, dyslipidemia, overweight, lack of exercise and family history of stroke were significantly associated with overall stroke and ischemic stroke. The largest contributor was hypertension (population-attributable risk 23.6%), followed by dyslipidemia, physical inactivity, family history of stroke, diabetes, and overweight. However, only hypertension only hypertension (OR = 3.66, 95% CI 1.82-8.23) was significantly associated with hemorrhagic stroke. Conclusions: The prevalence of stroke and high risk stroke population was high among adults aged ≥ 40 years in southwestern China. Hypertension, dyslipidemia and lack of exercise were stronger contributors for stroke, these findings suggest that individual-level and population-level interventions for these leading risk factors are necessary to prevent stroke.
Potential human rabies exposure in Nunavik: importance of age and dogs
Authors: Mediouni Sarah , Brisson Mario , Ravel André 
Published: November 2019

Abstract
Background In Nunavik, arctic rabies is still endemic with spillover from wildlife to dogs. The prevention of human exposure and the management of potential exposure is a high public health concern there.Methods The study retrospectively described cases of potential exposure to rabies in human reported to the Nunavik Public Health Board using the registry of declared cases. Multi-correspondence analysis as well as univariable and multivariable regression models were used to appraise the difference between children and adults and the importance of dogs.Results From 2008 to 2017, 320 cases of potential exposures to rabies were reported, 92% linked to dogs. The annual incidence rate was 2.5 per 1,000 population. The incidence increased significantly during the study period without clear explanation for that. Fifteen exposures actually were with rabid animals, mostly dogs (9 out of the 15). No human cases of rabies occurred thank to adequate medical case management. Two specific profiles for potential exposure to rabies were identified based on age and gender. Children (< 15 y/o), male or female, were more likely to be exposed through playing with dogs and more often injured in the head and/or the neck. Young male adult cases (aged 15 to 34 y/o) were more involved with wildlife than other age groups and mostly injured in the upper limbs and as a reaction from the animal.Conclusions Rabies being a serious and genuine public health threat in Nunavik, potential exposure to rabies needs to be prevented and prevention measures should be tailored to the two risk profiles identified based on age, gender and the animal involved.
Examining Trust as a Key Determinant of eHealth Adoption in Malawi
Authors: Gadabu Annabelle , Sunguh Kenneth , Arkorful Vincent Ekow , Uddin Mohammed Mahin , Lukman Sadia 
Published: November 2019

Abstract
The way technology is accepted and utilized may have significant hypothetical and concrete inferences. Thus, eHealth, like any other technology, has little value unless it is used. In this study, fundamental elements influencing consumers’ decision to utilize eHealth services in Malawi were assessed. Using the Unified Theory of Acceptance and Use of Technology (UTAUT) model as the primary model of inference, two new constructs were introduced to determine whether trust is a significant contributor in consumers’ decision to use eHealth. Through convenience sampling, a total of 400 responses were collected over a period of 6 weeks and evaluated using Structural Equation Modeling (SEM) technique. Outcomes of the analysis showed that Performance Expectancy, Effort Expectancy, Social Influence, and Facilitating Conditions, had an affirmative effect on Behavioral Intentions to use eHealth. Performance Expectancy indirectly had a positive effect on Behavioral Intentions to use eHealth services via Trust in internet and Trust in online healthcare providers. However, Trust of Internet had an insignificant effect while Trust in online healthcare providers had a positive effect. Thus, government and stakeholders in the health sector need to create platforms for engagement in health-related matters targeting the youth between 18 and 35 years who are the largest consumers of internet services.