bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lung ultrasound compared with bedside chest radiography in a paediatric cardiac intensive care unit
Authors: Hasan Tammam , Bonetti Simone , Gioachin Anna , Bulgarelli Ambra , Bartolacelli Ylenia , Ragni Luca , Gargiulo Gaetano D. , Donti Andrea 
Published: October 2020

AbstractAimPostoperative recovery of children with heart disease is encumbered by pulmonary complications like pneumothorax (PNX), pleural effusion (PLE), interstitial oedema and pulmonary consolidation (PC). Recently, lung ultrasound (LUS) has become an important diagnostic tool for evaluation of pulmonary diseases in the paediatric context. LUS is accurate in diagnosing pleural and parenchymal diseases. The aim of this study was to evaluate the accuracy of LUS in the identification of PNX, PLE and PC in a paediatric population of patients with congenital heart disease after heart surgery.MethodsFifty‐three patients aged 0‐17 years who underwent cardiac surgery were evaluated in the postoperative period by chest X‐ray (CXR) and LUS at the same time. The methods where compared for recognition of PNX, PLE and PC.ResultsLUS showed a good agreement for PNX and a moderate agreement for both PLE and PC. LUS also showed a significantly superior relative sensitivity than CXR for PC and PLE and a significantly inferior relative sensitivity for PNX.ConclusionThis study confirms that LUS has a sufficient agreement rate with the current clinical standard (CXR). Non‐inferiority in diagnosis together with the easiness of bedside performance makes LUS a very attractive tool for the paediatric cardiac intensive care unit.
Geographical and socioeconomic inequalities in dental attendance among children in Peru: Findings from the Demographic and Family Health Survey 2017
Authors: Aravena‐Rivas Yanela , Carbajal‐Rodríguez Gisselle 
Published: October 2020

AbstractObjectiveThe aim of the study was to explore the presence of inequalities in the use of dental services among <12‐year‐old children residing in Peru, according to their wealth quintile and natural region of residence.MethodsThis was a cross‐sectional secondary data analysis of the 2017 Demographic and Family Health Survey of Peru (n = 39 881 children). Generalized Poisson regression models, adjusted for gender, age, maternal ethnicity, place of residence and health coverage, were used to study the association between wealth quintile and use of dental services followed by stratified models by the natural region (Metropolitan Lima, coast, Andes mountains and jungle) and predicted probability graphs to study the effect of the natural region on inequalities in the use of dental services.ResultsInequalities in the use of dental services among children were observed according to the wealth quintile and natural region. A social gradient was present in the Andes mountains, coast and jungle regions. The greatest inequalities were observed in the coast (richest vs poorest quintile PR = 1.81 95% CI = 1.56‐2.11) and jungle regions (richest vs poorest quintile PR = 1.81 95% CI = 1.53‐2.14). The jungle presented the lowest proportion of children using dental services, while Metropolitan Lima had the highest proportion. No significant differences were observed between wealth quintiles among children from Metropolitan Lima.ConclusionsDifferences in socioeconomic inequalities in the use of dental services among natural regions were observed. The distribution of dental centres and personnel, and the geographical and demographic characteristics of each region, may play an important role in the presence of the inequalities observed.
Prospective evaluation of an assessment tool for technical performance of duodenoscopes
Authors: Bang Ji Young , Rösch Thomas , Kim Hyungjin Myra , Thakkar Shyam , Robalino Gonzaga Ernesto , Tharian Benjamin , Inamdar Sumant , Lee Linda S. , Yachimski Patrick , Jamidar Priya , Muniraj Thiruvengadam , DiMaio Christopher , Kumta Nikhil , Sethi Amrita , Draganov Peter , Yang Dennis , Seoud Talal , Perisetti Abhilash , Bondi Gayatri , Kirtane Sachin , Hawes Robert , Wilcox C. Mel , Kozarek Richard , Reddy D. Nageshwar , Varadarajulu Shyam 
Published: October 2020

ObjectiveWhile single‐use and detachable‐tip duodenoscopes have been recently developed to overcome risks of infection transmission, there are no reliable tools to objectively assess their technical performance. We evaluated the reliability and validity of a newly developed tool to assess the technical performance of reusable duodenoscopes.MethodsAn assessment tool was developed to measure duodenoscope performance based on three distinct criteria: maneuverability, mechanical/imaging characteristics and ability to perform requisite interventions. The assessment tool was tested prospectively on duodenoscopes used in endoscopic retrograde cholangiopancreatography (ERCP) procedures at nine academic medical centers over a 6‐month period. The main outcome was reliability of the duodenoscope assessment tool, which was estimated using Cronbach’s coefficient alpha (α). The secondary outcome was validity of the assessment tool.ResultsThe assessment tool evaluated technical performance of reusable duodenoscopes in 1080 ERCP procedures. Indications were biliary in 92.8% and pancreatic in 7.2% procedures. The overall Cronbach’s coefficient α for maneuverability was 0.81, assessment of mechanical/imaging characteristics was 0.92, and ability to perform requisite interventions was 0.87. On multiple linear regression analysis, prolonged procedure duration, older patient age and pancreatic interventions were significantly positively associated with higher (worse) scores.ConclusionsThe newly developed assessment tool appears reliable and valid for evaluating the technical performance of duodenoscopes.Registration: ClinicalTrials.gov Identifier: NCT04004533.
Abortion services and ethico‐legal considerations in India: The case for transitioning from provider‐centered to women‐centered care
Authors: Basu Saurav 
Published: October 2020

AbstractNearly a million Indian women lack access to safe and dignified abortion services from public healthcare facilities and instead opt to induce abortions by themselves or with the help from unskilled and unauthorized practitioners. Unsafe abortions account for an estimated 9% of all maternal deaths in India despite the legalization of abortion on all grounds since 1971 via the MTP Act. However, the Act technically does not make any provision for abortion based on a woman’s request alone, subjecting her decision to the approval of her healthcare provider, limiting reproductive autonomy. Moreover, the problem of female feticide through sex‐selective abortions has also contributed to a conflicting public agenda that prioritizes preventing the former over allowing women access to abortion services for other reasons. Women who are socio‐economically, culturally, and educationally vulnerable and minors may experience further abortion related stigmatization. These ethico‐legal considerations highlight the need for transition from a provider‐centered to a woman‐centered abortion service model.
Estado nutricional de niños y niñas con parálisis cerebral que asisten a centros de rehabilitación
Authors: Ruiz Brunner María de las Mercedes , Cieri Maria E , Rodriguez Marco Maria P , Schroeder Andreas Sebastian , Cuestas Eduardo 
Published: October 2020

ObjetivoDescribir el estado nutricional de niños con parálisis cerebral (PC) en centros de rehabilitación y terapéuticos de Argentina, y analizar el riesgo de desnutrición en relación su nivel según el sistema de la clasificación de la función motora gruesa (GMFCS).MétodoEste fue un estudio transversal con datos recolectados de 321 niños (196 varones, 125 mujeres) con PC de 2 a 19 años (edad media 9 años 3 meses, DE 4 años) de 17 centros de rehabilitación y terapéuticos en cinco provincias argentinas. El estado nutricional se definió con puntajes z según peso, talla e índice de masa corporal para la edad utilizando patrones de crecimiento de la Organización Mundial de la Salud. Se utilizó Odds ratio para evaluar la asociación entre el nivel GMFCS y el estado nutricional.ResultadosDe los niños con PC estudiados, 52.4% tenían nivel IV y V de GMFCS. En cuanto al estado nutricional, 41,7% eran normales, 19,0% tenían desnutrición moderada, 33,9% desnutrición severa, 2,5 % sobrepeso, y 2,8% obesidad. En comparación con los niños con niveles I–III de GMFCS, los niños con niveles IV y V de GMFCS presentaron 4 veces más probabilidades de presentar desnutrición moderada y 14 veces más probabilidades de tener desnutrición severa.InterpretaciónExiste una alta prevalencia de desnutrición asociada a la PC (niveles IV y V de GMFCS) entre niños de centros de rehabilitación y terapéuticos en Argentina. El riesgo de desnutrición severa aumenta cuando aumenta el compromiso motor.
Utility of three‐dimensional transesophageal echocardiography to guide transseptal positioning of a single multistage venous cannula to provide both venous drainage and indirect left ventricular venting in veno‐arterial extracorporeal membrane oxygenation
Authors: Addis Dylan R. , Wang Bo , Prejean Shane P. , Watts Thomas Evans , Nanda Navin C. , Ahmed Mustafa I. 
Published: October 2020

AbstractA patient with heart failure due to dilated ischemic cardiomyopathy presented in cardiogenic shock for institution of veno‐arterial extracorporeal membrane oxygenation as a bridge to cardiac transplantation. To provide adequate venous drainage and simultaneous decompression of the left atrium (indirect left ventricular venting), a single venous cannula was placed across the interatrial septum so that the distal orifice and side ports were located within the left atrium and the proximal set of side ports were positioned at the cavoatrial junction. Three‐dimensional transesophageal echocardiography demonstrated utility in guiding cannula placement and appropriate positioning within the left atrium.
Strong impacts of smoke polluted air demonstrated on the flight behaviour of the painted lady butterfly (Vanessa cardui L.)
Authors: Liu Yanan , Wooster Martin J. , Grosvenor Mark J. , Lim Ka S. , Francis Robert A. 
Published: October 2020

1. A major component of biomass burning smoke is fine particulate matter (PM2.5), which has been shown to generate impacts on insect population dynamics and development. However, little is known about its effect on insect flight behaviour, even though this will influence insect dispersal and distribution, and potentially migration and ecosystem services such as pollination.2. Here we use a tethered flight mill setup to examine the behaviour of adult painted lady butterflies (Vanessa cardui L.) flying in different levels of combustion‐generated airborne PM2.5, comparison this to TFM flying under ‘clean air’ conditions.3. Descriptive statistics and paired sample t‐tests indicate that the smoke had a significantly deleterious impact on flight behaviour, with for example total flight distance covered declining by 65% during the first 20 min of flying in the least smoke contaminated air compared to ‘clean air’ control conditions, whilst average speed declined by 54% and flight duration by 32%. A strongly negative and highly significant linear correlation between flight speed and PM2.5 concentration was also observed.4. This study represents the first time that smoke effects on insect flight behaviour have been experimentally tested, and the longer the butterflies were exposed to the elevated PM2.5 concentrations the more obviously their flight behaviour declined. We conclude that the month(s)‐long episodes of air pollution often associated with agricultural burning and deforestation fires in the tropics may well be significantly affecting the behaviour of the flying insects living in those regions and/or who migrate through them.
A new equine peripheral caries grading system: Are the caries likely active or inactive?
Authors: Jackson Kirsten , Kelty Erin , Tennant Marc 
Published: October 2020

AbstractBackgroundEquine peripheral caries can be a significant welfare issue in affected horses. Recent work has shown that complete reversal of the condition may be possible if the primary risk factor can be identified and corrected. Determining whether caries are active (deteriorating) or inactive (improving) is of vital importance when formulating a management and treatment plan. A new grading system is proposed that looks at whether caries are likely active or inactive to assist clinicians deciding whether intervention is required.ObjectivesTo examine the reliability of an alternative grading method for equine peripheral caries.Study designOnline survey of veterinary surgeons.MethodsReviewers (n = 22) graded images of peripheral caries using three methods: the traditional grading system, a new research grading system and a new clinical grading system. Percentage agreement and Fleiss' kappa were used to examine the participant's agreement of the severity of caries.ResultsAll percentage agreements and Fleiss' kappa values were significantly greater than zero (P < .001). The Fleiss' kappa for the new methods were higher (ranging from 0.48 to 0.58), but not significantly different from the traditional method (0.40). There was a high level of consistency in the assessment of caries as either active or inactive with both grading systems reporting over 80% agreement. Feedback on the grading systems was positive with over 90% of reviewers saying they were likely to use the system.Main limitationsThe use of photographs provided some difficulties with image quality and judging whether the dentin was affected without an occlusal image.ConclusionsThe new grading system produced a consistent estimate of caries severity and provided high levels of agreement on whether the caries were likely ‘active’ or ‘inactive’. This is likely to be very useful clinically to assist practitioners to determine whether intervention is required.
Associations between Helicobacter pylori with nonalcoholic fatty liver disease and other metabolic conditions in Guatemala
Authors: Alvarez Christian S. , Florio Andrea A. , Butt Julia , Rivera‐Andrade Alvaro , Kroker‐Lobos María F. , Waterboer Tim , Camargo Maria Constanza , Freedman Neal D. , Graubard Barry I. , Lazo Mariana , Guallar Eliseo , Groopman John D. , Ramírez‐Zea Manuel , McGlynn Katherine A. 
Published: October 2020

AbstractBackgroundPrevious studies have suggested an association between Helicobacter pylori (H pylori) and nonalcoholic fatty liver disease (NAFLD). The aim of the current study was to examine the association in Guatemala, a region with elevated prevalences of both H pylori and NAFLD. Associations between H pylori and other metabolic conditions were also examined, as were associations between H hepaticus and H bilis and the metabolic conditions.Materials & MethodsThe analysis included 424 participants from a cross‐sectional study in Guatemala. H pylori seropositivity was defined as positivity for ≥ 4 antigens. Seropositivities for H bilis and H hepaticus were defined as positivity for ≥ 2 antigens. NAFLD was estimated using the Fatty Liver Index and the Hepatic Steatosis Index. Other conditions examined were obesity, central obesity, hypercholesterolemia, low HDL, diabetes and metabolic syndrome (MetSyn). Prevalence odds ratios (POR) and 95% confidence intervals (CIs) were estimated.ResultsNo overall associations between H pylori,H hepaticus, or H bilis and NAFLD or related metabolic conditions were found. Seropositivity for H pylori antigens CagA and VacA and H hepaticus antigen HH0713 was each significantly associated with NAFLD, however. In addition, associations were observed between the H pylori antigens HyuA, HP1564, and UreA and specified metabolic conditions.ConclusionsWhile no overall associations between H pylori or Helicobacter species with NAFLD or related conditions were observed, some selected Helicobacter spp. antigens were associated with NAFLD. Further research is warranted to examine whether H. species are associated with any metabolic condition.
Prevalence of antimitochondrial antibodies in subacute cutaneous lupus erythematosus
Authors: Pelka Karolina , Stec‐Polak Magdalena , Wojas‐Pelc Anna , Pastuszczak Maciej 
Published: October 2020

AbstractBackgroundIn approximately 13% of systemic lupus erythematosus (SLE) patients, a hallmark of primary biliary cirrhosis (PBC) can be detected: antimitochondrial M2 antibodies (AMA‐M2). It has not been determined if the presence of AMA‐M2 in SLE patients results in a higher risk of PBC in comparison to those with AMA but no SLE. Until now, there have been no such analyses among individuals with subacute cutaneous lupus erythematosus (SCLE).MethodsTo assess the seropositivity rates for AMA‐M2 and autoantibodies associated with autoimmune hepatitis in patients with newly diagnosed SCLE and to determine the coexistence and risk of development of autoimmune liver disease in these patients within 1 year of follow‐up, data from 33 patients with newly diagnosed SCLE were analyzed.ResultsAMA‐M2 was found in 20% of SCLE patients. Patients from the AMA‐M2‐positive group were characterized by significantly higher levels of cholestatic liver enzymes when compared to those without AMA‐M2 (P < 0.05). After introducing therapy with hydroxychloroquine and prednisone, the levels of hepatocellular enzymes increased significantly only in AMA‐M2 positive patients (P < 0.05).ConclusionsA high prevalence of AMA‐M2 was found in patients with SCLE. Patients with SCLE and AMA‐M2 had significantly higher values of cholestatic enzymes than patients without AMA. Newly diagnosed patients with SCLE should be screened for the presence of AMA and should be clinically followed up. Avoiding drugs with potential liver toxicity should be recommended in patients with SCLE and AMA.
Future needs of young people receiving botulinum toxin A in paediatric rehabilitation services of New South Wales: focus on transition
Authors: Paget Simon P. , de Groot Anne , Hanns Kerry , Burnett Heather , Ho Jane 
Published: October 2020

AbstractYoung people (YP) with neurological disabilities such as cerebral palsy are increasingly living into adulthood and require healthcare transition for services including for botulinum toxin A (BoNT‐A). We analysed medical records in the three children's hospitals in New South Wales (NSW) and identified 253 YP who are expected to transition from paediatric to adult BoNT‐A services in NSW and Australian Capital Territory during 2018–2023. A substantial proportion of these YP have additional needs that will require paediatric and adult health services to work together to improve their life‐long health outcomes.
Care to the end: a retrospective observational study of aged care facility residents transferred to hospital in the last day of life
Authors: Brownstein Hannah , Hayes Barbara , Simadri Amrita , Tacey Mark , Holbeach Edwina 
Published: October 2020

AbstractBackgroundWhile transfer of aged care facility (ACF) residents to an acute hospital is sometimes necessary, for those at end of life this can cause fragmented care and disruption.AimTo explore the characteristics of ACF residents transferred to hospital in the last 24 h of life and factors that might influence this decision, including access to medical review, advance care planning (ACP) and pre‐emptive symptom management prescribing, an area not previously researched.MethodsA retrospective observational audit of ACF residents transferred to a metropolitan hospital between 2012 and 2017 who died within 24 h of transfer.ResultsA total of 149 patients met the criteria. The median age was 87 years, and 63 (42%) were male. Eighty‐three (56%) were transferred ‘out‐of‐hours’, the majority (71%) having no medical review in the 24 h prior, and 43 (29%) died within 4 h of arrival. The most common reasons for transfer were dyspnoea (46%) and altered conscious state (32%), and the most common cause of death was pneumonia (37%). Some form of ACP documentation was available in 48%. Of the 86 (58%) patients who required injectable opioid for symptom management in hospital, only 7 (8%) had this pre‐emptively prescribed on their ACF medication chart.ConclusionsAppropriate decision‐making around hospital transfers and end‐of‐life care for ACF residents may be influenced by access to professionals able to diagnose dying and access to appropriate symptom management medications. ACP is important, but often requires the aforementioned to be enacted. Further research is needed to better inform how we can identify and meet the end‐of‐life care needs of this cohort.
Application of virtual reality (VR) technology for medical practitioners in type and screen (T&S) training
Authors: Tang Yuk Ming , Ng George Wing Yiu , Chia Nam Hung , So Eric Hang Kwong , Wu Chun Ho , Ip Wai Hung 
Published: October 2020

AbstractNowadays, patients' safety is the top priority for medical services around the world. However, it is believed that many of the adverse events in hospitals are preventable. Type and screen (T&S) procedures require intense practical training by each medical practitioner in each hospital. This study applied an interactive Virtual Reality (VR) technology to supplement the traditional approach to facilitate procedural training. The VR system made use of the Unity3D for application development. To investigate the reliability and validity of the conceptual medical training model, a survey was conducted to measure the content, motivation and enhanced readiness of practitioners. The partial least squares (PLS) modelling was carried out to investigate the correlation between each pair of measured variables. The study results indicated that the learning model has good reliability for each measurement factor and validates the survey study. The PLS modelling also indicated a significant correlation between each pair of measured variables. The project developed a VR training program for training in T&S procedures. The study provides important implications on the development of a practical VR training program for medical practitioners, as well as valuable insights for the development of similar VR training programs in the future.
How will surface conditioning methods influence the translucency and color properties of CAD‐CAM resin‐matrix ceramics with different thicknesses?
Authors: Günal Abduljalil Burcu , Ongun Salim , Önöral Özay 
Published: October 2020

AbstractObjectiveIt was aimed to evaluate the effect of various surface‐conditioning methods on the translucency and color properties of resin‐matrix ceramics (RMCs) with different types and thicknesses.Materials and methodsRectangle‐shaped RMCs were prepared from Voco Grandio, Brilliant Crios, Lava Ultimate, GC Cerasmart, and Vita Enamic blocks at 0.5 and 1.0 mm thicknesses. Specimens were divided into four groups: control, airborne‐particle abrasion (APA), 2 and 3 W Er, Cr:YSGG laser irradiations (L2W, L3W) (n = 15). The color values of specimens were recorded before and after surface‐conditioning using a spectrophotometer. The translucency parameter (RTP00) and color difference (ΔE00) values were calculated. Data were statistically analyzed using three‐way ANOVA and Tukey post hoc tests.ResultsThe translucencies of RMCs decreased after all surface‐conditioning procedures. L caused more decline in translucency of materials than APA. All ΔE00 values were under the acceptability threshold except for APA‐applied Voco Grandio at 0.5 mm. Differences in ΔE00 values between APA and L3W groups were significant (P˂0.05); while differences between L2W and L3W groups were insignificant (P > .05). In all experimental groups, ΔE00 values decreased with increasing thickness of RMCs.ConclusionsL and APA significantly affected the translucency and color properties of RMCs. APA was found more favorable than L.Clinical significanceClinicians should carefully use surface conditioning methods, considering their impact on the optical characteristics of RMCs, especially when the restoration is thin.