bluuebunny/crossref_metadata_2025_split huggingface dataset:
Client perceived quality of postnatal care following a normal delivery provided by public sector specialized care institutions in Sri Lanka: A cross sectional study
Authors: Wickramasinghe Sashimali , Gunathunga Wasantha , Hemachandra Nilmini 
Published: October 2019

Abstract
Background:
Majority of the maternal and neonatal adverse events take place during the postnatal period. Provision of high-quality care during this period can minimize these events. Assessment of mothers’ perceptions of the quality of care received by them provides valuable feedback to improve the care and ultimately outcomes.
Methods:
A cross sectional survey was conducted in specialized institutions of Colombo district, Sri Lanka, to assess the maternal perceptions of the quality of regular postnatal care and its correlations, using an interviewer administered questionnaire. The questionnaire contained 23 items distributed under three main domains: technical and information domain, interpersonal care domain and ward facilities and cleanliness domain. Each item was given a score from 1 to 5 and total scores were calculated for the total questionnaire and for each domain. Descriptive statistics were used to assess the perceptions and multivariate analysis was conducted to assess the significant correlates of positive perceptions.
Results:
The median score obtained for the questionnaire was 108, (Inter Quartile Range 96-114). The median scores of the technical care and information domain, interpersonal care domain and ward facilities and cleanliness domain were 43 (IQR 38-45), 33 (IQR 30-35) and 32 (IQR 28-35) respectively. Attending teaching/ specialized hospitals (1.6, p<0.001), 20-35 age group (aOR=1.8, p=0.024), and services such as initiation of breast feeding within one hour of delivery (2.1, p=0.009), pain relief during episiotomy suturing (2.2, p<0.001), practicing Kangaroo Mother Care (1.4, p=0.035), receiving health advices by doctors or midwives (2.1, p<0.001) were significant correlates of positive perceptions.
Conclusions:
Majority of mothers had favourable perceptions of the quality of care received by them. However, the ward facilities and environment domain has obtained lower ratings compared to technical and interpersonal care domains. Several services were significantly associated with favourable perceptions. Authorities should consider these findings when attempting to improve care quality. Further, this assessment should be carried out regularly to obtain more current data.

Key words:
Client perceptions, Postnatal care, Quality of care, Client perceived care, institutional postnatal care
Clinical and histologic tissue responses of skin incisions closed with glycomer 631 and lactomer 9-1 using subcuticular technique in pigs
Authors: Plavec Tanja , Švara Tanja , Zdovc Irena , Gombač Mitja , Damjanovska Marija , Pintarič Tatjana Stopar , Cvetko Erika , Seliškar Alenka 
Published: October 2019

Abstract
Background: Glycomer 631 and lactomer 9-1 are absorbable suture materials indicated for soft tissue approximation in non-infected wounds. Pigs are often used as surgical models in translational research, however, the reports of tissue reactions to both suture materials in pigs are lacking. The aim of this study was to assess clinical and histologic responses of skin incisions closed with subcuticular technique using glycomer 631 and lactomer 9-1 in pigs.
Results: Skin incisions of 17 pigs were closed with glycomer 631 and lactomer 9-1 and clinical reactive score (CRS) including erythema, swelling, discharge, and dehiscence was calculated on postoperative days 7 and 14. Subcuticular tissue reaction was assessed histologically on postoperative day 14 (the presence of extravascular neutrophils, macrophages, multinucleated giant cells, lymphocytes, fibroblasts, bacterial colonies, overall severity of inflammatory response to suture material), and the cumulative score of variables calculated as aggregate tissue irritation score (ATIS). Tissue samples were examined for suture extrusion and evaluated microbiologically. Clinical reactive score did not differ between the suture materials. Only one variable of ATIS, overall severity of inflammatory response, was lower ( p = 0.029) when glycomer 631 was used. Suture extrusion was found in 10/17 of incisions closed by glycomer 631 and in 7/13 of incisions closed by lactomer 9-1. Trueperella pyogenes was isolated from the skin and from the area of tissue reaction in six pigs.
Conclusions: No difference in CRS between the suture materials was observed. Glycomer 631 induced less tissue reaction only in terms of overall severity of inflammatory response. Suture extrusion was observed in more than 50% of incisions regardless of the suture material. Trueperella pyogenes was the only pathogen isolated from the tissue surrounding the suture material.
Musculoskeletal Symptoms among Radiologists in Saudi Arabia: A Multi-Center Cross-Sectional Study
Authors: Shammari Malak Al , Hassan Ali , Dandan Omran Al , Gadeeb Mohammed Al , Bubshait Dalal 
Published: October 2019

Abstract
Background : Musculoskeletal symptoms account for the majority of work-related illnesses resulting in a significant economic burden on society. Computer users are subject to unique repetitive strains that predispose them to musculoskeletal symptoms. In the digitalized field of radiology, radiologists spend long hours interpreting medical images on computers. This study aimed to determine the prevalence of musculoskeletal symptoms among radiologists in Saudi Arabia and their contributing factors.
Methods : An online survey was sent to radiologists in all hospitals (academic, public and private) in the major cities of the Eastern Province of Saudi Arabia covering demographic characteristics, workload (e.g. the time spent at a computer workstation), and workstation environments including the number of monitors as well as the adjustability of the height of the workstation and the viewing distance. This survey of 263 radiologists was conducted in April 2019. It included an evaluation of musculoskeletal symptoms using the Nordic Musculoskeletal Questionnaire. The study outcome was the presence of disabling musculoskeletal symptoms in any body region, which restricted the performance of normal activities in the last 12 months. Results were analyzed descriptively using a Chi-square test and logistic regression analysis to estimate the odd ratio of experiencing disabling musculoskeletal symptoms in the last 12 months.
Results : The survey was completed by 198 participants (111 men and 87 women) with a response rate of 75.3%. Most participants (71.2%) were aged below 40 years. A multivariate logistic regression analysis revealed being a female radiologist (OR = 2.7; 95% CI: 1.2–6.5), aged 30–39 years (OR = 4.1; 95% CI: 1.1–15.3), and predominantly reviewing computed tomography (CT) images (OR = 4.1; 95% CI: 1.4–12.3) or ultrasound scans (OR = 5.9; 95% CI: 1.4–25.3) were associated with higher prevalence of disabling musculoskeletal symptoms, compared to those aged below 30 years and those who reviewed various imaging modalities, respectively.
Conclusions : Musculoskeletal symptoms are common among radiologists with lower back and neck pain being the most frequent complaints. Being a female radiologist, aged 30–39 years, and reviewing CT or ultrasound scans were associated with higher rates of disabling musculoskeletal symptoms.
Assessment of factors affecting tourism satisfaction using K-nearest neighborhood and random forest models
Authors: Author) Leili Tapak(Former Corresponding , Author) Hamed Abbasi(New Corresponding , Mirhashemi Hamid 
Published: October 2019

Abstract
Objective

This study aimed to identify factors affecting the satisfaction of tourists traveling to the city of Hamadan as Asian urban tourism capital in 2018. The data a random sample of 300 tourists were collected using a designed questionnaire. We applied random-forest and K-nearest-neighborhood methods to analyze the data.Results

The variables of society behavior, municipal equipment and cost of services were the three top rank variables in predicting tourist satisfaction. Considering the capacity of the ancient city of Hamadan for tourism, policy-makers can use our results in planning for providing a sustainable development and flourishing tourism industry in this city.
Successful management of severe diabetic ketoacidosis in a patient with type 2 diabetes with insulin allergy: a case report
Authors: Nguyen Anh Dat , Luong Chinh Quoc , Chi Hieu Chu , Nguyen Van Khoa Dieu , Nguyen Chi Van , Nguyen Anh Tuan , Nguyen Quan Huu , Mai Ton Duy , Nguyen Dinh Van , Nguyen Bay Quang , Tran Thong Huu , Dao Phuong Viet , Nguyen Dat Tuan , Nguyen Nguyet Nhu , Do Son Ngoc 
Published: October 2019

Abstract
BackgroundDiabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes that requires immediate treatment. Allergic reaction to insulin is rare, especially when using recombinant human insulin. The clinical presentation of insulin allergy can range from minor local symptoms to a severe generalized allergic reaction such as anaphylaxis. A limited number of cases have been reported on the treatment of severe DKA in patients with type 2 diabetes with insulin allergy. Here, we describe a patient with type 2 diabetes with insulin allergy in which severe DKA resolved after the initiation of continuous intravenous (IV) recombinant human insulin infusion.Case presentationA 58-year-old man with type 2 diabetes initiated subcutaneous insulin administration (SIA) after failure of oral antidiabetic treatment. Symptoms of an allergic reaction developed, including pruritic wheals appearing within 10 minutes of injection and lasting over 24 hours. Both skin prick and intradermal tests were positive with different types of insulin. Two days before admission, he stopped SIA because of allergic symptoms and then experienced weakness and upper abdominal pain. On admission, he was in severe metabolic acidosis with a pH of 6.984 and bicarbonate of 2.5 mmol/litre. The blood glucose level was 20.79 mmol/litre, BUN 4.01 mmol/litre, creatinine 128 µmol/litre, and urinary ketone 11.44 mmol/litre. Over 24 hours, metabolic acidosis was refractory to IV fluids, bicarbonate and potassium replacement, as well as haemodialysis. Ultimately, he received continuous IV recombinant human insulin infusion at a rate of 0.1 units/kg/hour, in combination with haemodiafiltration, and no further allergic reactions were observed. On day 5, ketonaemia and metabolic acidosis completely resolved. He had transitioned from IV insulin infusion to SIA on day 14. He was discharged on day 21 with SIA treatment. Three months later, he had good glycaemic control but still had allergic symptoms at the insulin injection sites.ConclusionsIn this patient, SIA caused an allergic reaction, in contrast to continuous IV insulin infusion for which allergic symptoms did not appear. Continuous IV recombinant human insulin infusion in combination with haemodiafiltration could be an option for the treatment of severe DKA in patients with diabetes with insulin allergy.
Association between ovarian reserve and preeclampsia: a cohort study
Authors: Erfani Hadi , Rahmati Maryam , Mansournia Mohammad Ali , Azizi Fereidoun , Montazeri Seyed Ali , Shamshirsaz Alireza A. , Tehrani Fahimeh Ramezani 
Published: October 2019

Abstract
Background

The risk of cardiovascular disease in women increases after menopause. It has been shown that women with lower pre-menopausal ovarian reserve may experience increased cardiovascular risk. We sought to determine whether there is any association between ovarian reserve, as assessed by Anti-Mullerian hormone (AMH), and preeclampsia (PE).Methods

Subjects of this study were selected from among participants of the Tehran Lipid and Glucose Study (TLGS), a population-based cohort with a 15-year follow-up (1998-2014). Out of 2412 women aged 20-50 years, there were 781 women who met eligibility criteria, including having comprehensive data on their reproductive assessment and ovarian reserve status, identified based on age-specific AMH levels according to the exponential–normal three-parameter model that was measured before pregnancy.

There were 80 and 701 participants in the preeclampsia and non-PE groups, respectively. The association between dichotomous outcome variable PE and age-specific AMH quartiles was evaluated using pooled logistic regression.Results

PE was observed in 23 (11.1%), 12 (6.4%), 26 (13.3%) and 19 (10%) women in the 1st, 2nd, 3rd and 4th quartiles of pre-pregnancy age-specific AMH, respectively (P = 0.16). Median and inter-quartile range of serum AMH levels was 1.05 (0.36 – 2.2) mg/L in women who experienced PE compared with 0.85 (0.28 – 2.1) mg/L in women with normotensive pregnancies (P = 0.53). Based on the pooled logistic regression analysis, the effect of age-specific AMH quartiles on PE progression (adjusted for age, BMI, smoking status, and family history of hypertension) were not significant (OR 1st vs 4th : 1.5, P-value: 0.1, CI: (0.9, 2.4))Conclusions

Age-specific AMH may not be a suitable marker for prediction of PE. Further longitudinal studies, considering pre-conception measurement of AMH, are recommended for better interpretation of the association between ovarian reserve status and PE.
Endoscopic transforaminal lumbar interbody fusion in the treatment of degenerative lumbar spondylolisthesis
Authors: Yan Denglu , Zhang Zaiheng , Zhang Zhi 
Published: October 2019

Abstract
Background There were no studies in literature of lumbar spondylolisthesis treated by endoscopic surgery. The purpose of this study was to evaluate the efficacy of endoscopic transforaminal lumbar interbody fusion (ELIF) in the treatment of degenerative lumbar spondylolisthesis by compare to the standard transforaminal lumbar interbody fusion (TLIF).Methods A total of 93 patients with lumbar spondylolisthesis who had surgery from February 2017 to January 2018 were categorized into different groups depending on the procedure by ELIF or TLIF. The ELIF and TLIF procedures was performed, and the clinical outcomes of blood loss, operation times, hospital stay days, pain index, ODI score, the spondylolisthesis rate and reduction rate, and the disk height and intervertebral foramen height were recorded.Results There was no intraoperative death in this series. In ends 86 cases had follow-up at least one year and 7 cases lost, and the follow-up rate and followed time were no difference between two groups (P > 0.05). The operational time was longer in ELIF than TLIF (P < 0.01).The hospital days and blood loss were significant less in endoscopic group than TLIF (P < 0.01). The pain index and ODI score, the spondylolisthesis rate and reduction rate, and the disk height and intervertebral foramen height were better than preoperational (P < 0.01), and there were no difference between two groups (P > 0.05). All patients achieved spinal fusion with no cases of cage extrusion, and no infection, and no dural tear of cerebrospinal fluid leakage complication. There were one case of radiculitis (man) at endoscopic group. CT-myelogram revealed the radiculitis patients had normal radiologic findings, and the patient was recovered by neurotrophy drugs and functional exercises after 3 months.Conclusions Endoscopic lumbar decompression and interbody fusion procedures was effective and safe measure in the treatment of the lumbar spondylolisthesis. Compare to open interbody fusion techniques, endoscopic lumbar interbody fusion was minimally invasive surgery with less bold loss and earlier postoperative recovery.
Factors associated with high-risk low-level viremia leading to virologic failure: 16-year retrospective study of a Chinese antiretroviral therapy cohort
Authors: Zhang Tong , Ding Haibo , An Minghui , Wang Xiaonan , Tian Wen , Zhao Bin , Shang Hong , Han Xiaoxu 
Published: October 2019

Abstract
Background: Low level viremia (LLV) often occurs during antiretroviral therapy (ART) against HIV-1. However, its impact on virologic failure (VF) is controversial because of non-uniform definitions of LLV and VF. Methods: A long-term first line regimen ART cohort from 2002–2018 from Shenyang, northeast China, was retrospectively studied. All participants were followed up every 3 to 6 months to evaluate the treatment effect. The high-risk LLV subgroups leading to VF (with strict standards) were explored with Cox proportional hazards model and linear mixed-effect model. The association factors of high-risk LLV were further explored using multivariate logistic regression analyses. Results: A total of 2155 HIV-1 infected participants were included; of these, 38.8% showed LLV. Both high level LLV (HLLV) and any other level LLV coupled with high level blip (HBL) showed higher risk of VF (hazards ratios, HRHLLV=5.93, and HRHBL=2.84, p<0.01 respectively). Moreover, HR increased with prolonged duration of LLV. Independent factors associated with high-risk LLV included the zenith baseline viral load (VL) above 6 log copies/ml (aOR=3.49, p=0.002), nadir baseline CD4+T cell counts below 200 cells/ml (aOR=1.78, p=0.011), Manchu (aOR=2.03, p=0.003), ART over 60 months (aOR=1.81, p=0.004), AZT+3TC+NVP (aOR=2.26, p<0.001) or DDI-based regimen (aOR=9.96, p<0.001), and subtype B’ infection (aOR=8.22, p=0.001). Conclusions: In case of VF with strict standards, high-risk LLV leading to VF includes VL above 400 copies/ml, occurring at least once. Serious laboratory indicators or advanced stage of infection, long term ART and subtype B’ infection might also predict the occurrence of high-risk LLV.
Transcriptome profiling of developing testes and spermatogenesis in Mongolian horse
Authors: LI Bei , He Xiaolong , Zhao Yiping , Bai Dongyi , Du Ming , Song Lianjie , Liu Zhuang , Yin Zhenchen , Manglai Dugarjaviin 
Published: October 2019

Abstract
Introduction: The development of horse testis and spermatogenesis is a complex physiological process. Methods: To study those physiological processes, 3 immature and 3 mature testes of Mongolian horse were collected, and six libraries were established using a high-throughput RNA sequencing technology (RNA-Seq) to screen for genes that were related to Mongolian horse testis development and spermatogenesis.Results & Discussion: A total of 16,237 upregulated genes and 8,641 downregulated genes in the testis of Mongolian horse were detected. These genes play important roles in different developmental stages of spermatogenesis and testicular development. Five alternative splicing (AS) event genes were detected, and different AS events can also influence both spermatogenesis and developing of testis. GO (Gene ontology) and KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway analyses were performed for functional annotation of the differentially expressed genes during testis development and spermatogenesis. For example, oocyte meiosis pathways were significantly involved in different stages of testis development and spermatogenesis.Conclusion: These genes were associated with spermatogenesis, male gamete generation, spermatid development, and oocyte meiosis.The finding that gene is a vital element in horse testis development improves our understanding of horse testis development and spermatogenesis.
Heart rate and heart rate variability comparison between postural orthostatic tachycardia syndrome versus healthy participants; a systematic review and meta-analysis.
Authors: Swai Joel Dominic , Hu Zixuan , Zhao Xiexiong , Rugambwa Tibera , Ming Gui 
Published: October 2019

Abstract
Background A number of published literatures have reported that, physiologically, heart rate variability in patients with postural orthostatic tachycardia (POTS) to be greatly confounded by age, sex, race, physical fitness and circadian rhythm. The purpose of this study was to compare between postural orthostatic tachycardia syndrome (POTS) patients versus healthy patients, in terms of heart rate (HR) and heart rate variability (HRV) after Head-Up tilt test, by systematic review and meta-analysis of available published literature.Methods MEDLINE (using PubMed interphase), EMBASE and SCOPUS were systematically searched for observational studies comparing between POTS patients versus healthy patients, in terms of heart rate (HR) and heart rate variability (HRV). HRV was grouped into Time and frequency domain outcome measurements. Time domain was measured as mean RR- interval and mean square root of mean of squares of successive R-R waves (rMSSD) in milliseconds. Frequency domain was measured as mean values of Low frequency power (LF), High frequency power (HF), LF/HF-ratio, LF-normalized units (LF(n.u)) and HF-normalized units (HF(n.u)). Demographic data, comorbidities, and mean values of HR, RR- interval, rMSSD, LF, HF, LF/HF-ratio, LF-(n.u) and H.F-n.u were extracted from each group and compared, by their mean differences as overall outcome measure. Computer software, RevMan 5.3 was utilized, at 95% significance level.Results Twenty (20) eligible studies were found to report 717 POTS and 641 healthy participants. POTS group had higher mean heart rate (p<0.05), lower mean RR-Interval (p<0.05), lower rMSSD (p<0.05) than healthy participants. Furthermore, POTS group had lower mean HF(p>0.05), lower mean LF(p>0.05), and lower mean HF(n.u) (p>0.05), higher LF/HF-Ratio (p>0.05) and higher LF(n.u) (p>0.05) as compared to healthy participants.Conclusion Despite massively supported fact that POTS patients have higher heart rate than healthy patients after HUTT, POTS patients have lower heart rate variability in terms of time domain measure but not in terms of frequency domain measure.
Relationship between fluoroquinolones and the risk of aortic diseases: a meta-analysis of observational studies
Authors: Dai Xiao-ce , Yang Xin-xin , Ma Lan , Tang Guan-min , Pan Yan-yun , Hu Hui-lin 
Published: October 2019

Abstract
Background Our aim was to find possible risk associated between fluoroquinolones and aortic diseases.Methods PubMed, Embase and the Web of Science were searched from inception to July 6, 2019 to identify observational studies that evaluated the risk for aortic diseases associated with users of fluoroquinolones compared with non-users or users of other antibiotics. Primary outcome was the first occurrence of aortic diseases. We used Newcastle Ottawa Scale to assess quality among cohort and case-control studies and the GRADE approach was used for rating strength of evidence and used inverse variance method random-effect model to estimate odds risks (ORs) with 95% CIs and statistical heterogeneity were assessed by the I 2 statistic.Results Five observational studies that enrolled 2,829,385 patients were reported the relationship between fluoroquinolones and the risk for aortic diseases. Compared with non-users or users of other antibiotics, current fluoroquinolone use had association with a significantly increased risk of occurrence of aortic diseases (adjusted OR, 2.15; 95% CI, 1.66-2.64; P=.000). The risk of past fluoroquinolone use remained high in aortic dissection (adjusted OR, 1.98; 95% CI, 0.97-2.99; P=.000) and aortic aneurysm (adjusted OR, 1.77; 95% CI, 0.98-2.57; P=.000). The quality of evidence was moderate and the Number Need to Treat to Harm (NNTH) for aortic diseases among elderly patients above the age of 50 were current users of fluoroquinolones was estimated to be 1245.Conclusions The current fluoroquinolones use within elderly patients significantly increased the risk for the first occurrence of aortic diseases. Clinicians need to pay attention to these severe adverse events when considering fluoroquinolone use.