bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation and Evaluation of Nonclinical Interventions for Appropriate Use of Cesarean Section in Low- and Middle-income Countries: Protocol for a Multisite Hybrid Effectiveness-implementation Type III Trial
Authors: Dumont Alexandre , Betrán Ana Pilar , Kabore Charles , De Loenzien Myriam , Lumbiganon Pisake , Bohren Meghan , Nhu Hung Mac Quoc , Ph.D. Newton , Carroli Guillermo , Annerstedt Kristi Sidney , Ridde Valery , Escuriet Ramon , Robson Michael , Hansen Claudia , group QUALI-DEC Research 
Published: June 2020

Abstract
Background: While cesarean sections (CSs) are a life-saving intervention, an increasing number are performed without medical reasons in low- and middle-income countries (LMICs). Unnecessary CS diverts scarce resources and thereby reduces access to healthcare for women in need. Argentina, Burkina Faso, Thailand and Vietnam are committed to reducing unnecessary CS, but many individual and organizational factors in healthcare facilities obstructthis aim. Nonclinical interventions can overcome these barriers by helping providers improve their practices and supporting women’s decision-making regarding childbirth. Existing evidence has shown only a modest effect of single interventions onreducing CS rates, arguably because of the failure to design multifaceted interventions effectively tailored to the context. The aim of this studyis to design, adapt and test a multifaceted intervention for the appropriate use of CS in Argentina, Burkina Faso, Thailand and Vietnam. Methods: We designed an intervention (QUALIty DECision-making - QUALI-DEC) with four components: (1) opinion leaders at heath care facilities to improve adherence to best practices among clinicians, (2) CS audits and feedback to help providers identify potentially avoidable CS, (3) a decisionanalysistool to helpwomen make an informed decision on the mode of birth, and (4) companionship to support women during labor.QUALI-DEC will be implemented and evaluated in 32 hospitals (8 sites per country) using a pragmatic hybrid effectiveness-implementation design to test our implementation strategy, and information regardingits impact on relevant maternal and perinatal outcomes will be gathered. The implementation strategy will involve the participation of women, healthcare professionals and organizations and account for the local environment, needs, resources and social factors in each country.Discussion:There is urgent need for interventions and implementation strategies to optimize the use of CS while improving health outcomes and satisfaction in LMICs. This can only be achieved by engaging all stakeholders involved in the decision-making process surroundingbirth and addressing their needs and concerns. The study will generate robust evidence about the effectiveness and the impact of this multifaceted intervention. It will also assess the acceptability and scalability of the intervention and the capacity for empowerment among women and providers alike. Trial registration: ISRCTN67214403
Asphericity of Tumor FDG Uptake in Non-Small Cell Lung Cancer: Reproducibility and Implications for Harmonization in Multicenter Studies
Authors: Rogasch Julian MM , Furth Christian , Bluemel Stephanie , Radojewski Piotr , Amthauer Holger , Hofheinz Frank 
Published: June 2020

Abstract
Background
Asphericity (ASP) of the primary tumor’s metabolic tumor volume (MTV) in FDG-PET/CT is independently predictive for survival in patients with non-small cell lung cancer (NSCLC). However, comparability between PET systems may be limited. Therefore, reproducibility of ASP was evaluated at varying image reconstruction and acquisition times to assess feasibility of ASP assessment in multicenter studies.
Methods
Retrospective study of 50 patients with NSCLC (female, 20; median age, 69 years) undergoing pretherapeutic FDG-PET/CT (median, 3.7 MBq/kg; 180 s/bed position). Reconstruction used OSEM with TOF4/16 (iterations, 4; subsets, 16; in-plane filter, 2.0, 6.4 or 9.5 mm), TOF4/8 (4 it; 8 ss; filter, 2.0/6.0/9.5 mm), PSF + TOF2/17 (2 it; 17 ss; filter, 2.0/7.0/10.0 mm) or Bayesian penalized likelihood (Q.Clear; beta, 600/1750/4000). Resulting reconstructed spatial resolution (FWHM) was determined from hot sphere inserts of a NEMA IEC phantom. Data with approx. 5 mm FWHM were retrospectively smoothed to achieve 7 mm FWHM. List mode data were rebinned for acquisition times of 120/90/60 s. Threshold-based delineation of primary tumor MTV was followed by evaluation of relative ASP/SUVmax/MTV differences between datasets and resulting proportions of discordantly classified cases.
Results
Reconstructed resolution for narrow/medium/wide in-plane filter (or low/medium/high beta) was approx. 5/7/9 mm FWHM. Comparing different pairs of reconstructed resolution between TOF4/8, PSF + TOF2/17, Q.Clear and the reference algorithm TOF4/16, ASP differences were lowest at FWHM of 7 vs. 7 mm. Proportions of discordant cases (ASP > 19.5% vs. ≤19.5%) were also lowest at 7 mm (TOF4/8, 2%; PSF + TOF2/17, 4%; Q.Clear, 10%). Smoothing of 5 mm data to 7 mm FWHM significantly reduced discordant cases (TOF4/8, 38% reduced to 2%; PSF + TOF2/17, 12–4%; Q.Clear, 10–6%) resulting in proportions comparable to original 7 mm data. Shorter acquisition time only increased proportions of discordant cases at < 90 s.
Conclusions
ASP differences were mainly determined by reconstructed spatial resolution, and multicenter studies should aim at comparable FWHM (e.g., 7 mm; determined by in-plane filter width). This reduces discordant cases (high vs. low ASP) to an acceptable proportion for TOF and PSF + TOF of < 5% (Q.Clear: 10%). Data with better resolution (i.e. lower FWHM) could be retrospectively smoothed to the desired FWHM resulting in a comparable number of discordant cases.
N-glycolyl chondroitin synthesis using metabolically engineered E. coli
Authors: Awofiranye Adeola E. , Baytas Sultan N. , Xia Ke , Badri Abinaya , He Wenqin , Varki Ajit , Koffas Mattheos , Linhardt Robert J 
Published: June 2020

Abstract
N -glycolylneuraminic acid (Neu5Gc) is a sialic acid missing in humans but commonly found in mammals and is the proposed cause of “xenosialitis” in humans, a “xenoautoimmune” inflammatory reaction believed to result from humans consuming Neu5Gc from red meat that human cells incorporate into some cell types, but is also recognized as a foreign antigen. The production of antibodies against Neu5Gc-containing glycans causes inflammation that is hypothesized to be an aggravating factor to multiple diseases associated with red meat consumption, including cancers arising from epithelial cells lining hollow organs and atherosclerosis involving vascular endothelial cells. The small amounts of Neu5Gc involved is glycosidically-linked at the reducing end of glycans but is difficult to quantitate because of its location on endothelial and epithelial cells. A more stable recently discovered metabolite of Neu5Gc, N-glycolyl chondroitin (Gc-CN), is present in the serum of humans who eat red meat and is more easily isolated and analyzed. Here, we present the biosynthesis of Gc-CN by feeding chemically synthesized N-glycolylglucosamine to Escherichia coli. A metabolically engineered strain of E. coli K4, fed with glucose supplemented with GlcNGc, converted it to N-glycolylgalactosamine (GalNGc) that could then be utilized as a substrate in the chondroitin biosynthetic pathway. The final product, Gc-CN was converted to disaccharides using chondroitin lyase ABC and analyzed by liquid chromatography-tandem mass spectrometry with multiple reaction monitoring detection. This analysis showed the incorporation of GalNGc into the backbone of the chondroitin oligosaccharide.
Determinants of Immediate Postpartum Contraception among Parturient Women with HIV in the Eastern Cape, South Africa; A Prospective Cross-sectional Study
Authors: Adeniyi Oladele Vincent , Ajayi Anthony Idowu , Somefun Oluwaseyi Dolapo , Lambert John Shearer 
Published: June 2020

Abstract
Background: Universal access to contraception is an important strategy adopted by the South African government in order to reduce the rate of unintended pregnancies in women with HIV. In this article, we describe the choices of contraception and also, examine the influencing factors of the choices of contraception in the immediate postpartum period in parturient women with HIV in the Eastern Cape, South Africa.Methods: In this prospective cross-sectional study, 1617 parturient women with HIV completed a survey on the choice of contraception received in the immediate postpartum period (within 72 hours) across three large maternity services in the Eastern Cape between September 2015 to May 2016. Additional information was extracted from their medical records. Choices of contraception were categorised as; short-acting, long-acting reversible and permanent contraception. Adjusted and unadjusted multinomial regression models were employed to determine the influencing factors of the choices of contraception received by the cohort. Results: Participants were predominantly single (69.1%), unemployed (75.1%), had a grade 7-12 level of education (88.4%) and were HIV positive before their index pregnancy (81.3%).The uptake rate of immediate postpartum contraception was high (n=1507; 93.2%) with injectables being the preferred choice in the majority of the participants (n= 1218; 75.3%). Caesarean delivery was associated with higher odds of initiating long-acting reversible (AOR: 7.79; 95% CI:4.04-15.04) and permanent contraception (AOR: 6.52; 95% CI: 3.48-12.22).Conclusions: We found a high uptake of immediate postpartum contraception with a preference for injectables in the study setting. Long-term monitoring of this cohort will elucidate on the loss to follow-up and risk of unintended pregnancies in the region.
Comprehensive genetic testing combined with citizen science reveals a recently characterized ancient MC1R mutation is associated with partial recessive red phenotypes in dog
Authors: Anderson Heidi , Honkanen Leena , Ruotanen Päivi , Mathlin Julia , Donner Jonas 
Published: June 2020

Abstract
Background
The Melanocortin 1 Receptor (MC1R) plays a central role in regulation of coat color determination in dogs and is commonly referred to as the “E (extension) Locus”. Allelic variation of the MC1R gene is associated with coat color phenotypes EM (melanistic mask), EG (grizzle/domino) and e1–3 (recessive red) in dogs. In addition, a previous study of archeological dog specimens over 10,000 years of age identified a variant p.R301C in the MC1R gene that may have influenced coat color of early dogs.
Results
Commercial genotyping of 11,726 dog samples showed the R301C variant of the MC1R gene was present in 34 breeds or breed varieties, at an allele frequency of 1.48% in the tested population. We detected no linkage disequilibrium between R301C and other tested alleles of the E locus. Based on current convention we propose that R301C should be considered a novel allele of the E locus, which we have termed eA for “e ancient”. Phenotype analysis of owner-provided dog pictures reveals eA allele has an impact on coat color and is recessive to wild type E and dominant to the e alleles. In dominant black (KB/*) dogs it can prevent the expression of the K locus, and the expressed coat color is solely determined by the A locus. In the absence of dominant black, eA/eA and eA/e genotypes result in the coat color patterns referred to in their respective breed communities as domino in Alaskan Malamute and other Spitz breeds, grizzle in Chihuahua, and pied in Beagle.
Conclusions
This study demonstrates a large genotype screening effort to identify the frequency and distribution of the MC1R R301C variant, one of the earliest mutations captured by canine domestication, and citizen science empowered characterization of its impact on coat color.
Mechanical Properties of TiO2 nanotubes investigated by AFM and FEM
Authors: Zhou Ji , Wang Zuozhang , Jiang Yunhong , Yang Zhongmei , Tian Qiong , Ding Yanhuai 
Published: June 2020

Abstract
The mechanical measurements of nanostructures are crucial to the development and processing of novel nanodevices. Herein, TiO2 nanotubes were synthesized from an electrospun method combined with subsequent heat-treatment. The elastic modulus and fracture strength of a single TiO2 nanotube were measured by atomic force microscopy (AFM). The effect of elastic modulus and dimensional size on the mechanical behaviors of the nanotubes was simulated by the finite element method (FEM).
Guided endodontic treatment of multiple teeth with dentin dysplasia: a case report
Authors: Krug Ralf , Volland Julian , Reich Sebastian , Soliman Sebastian , Connert Thomas , Krastl Gabriel 
Published: June 2020

Abstract
BackgroundTo report the outcome of guided endodontic treatment (GET) of a case of dentin dysplasia (DD) with pulp canal calcification (PCC) and apical periodontitis (AP) based on the use of a 3D-printed template designed by merging cone-beam computed tomography (CBCT) and surface scan data.Case presentationA 12-year old female with radicular dentin dysplasia type I (DD-1) presented for endodontic treatment. Radiography revealed PCC in all teeth and apical radiolucency in seven teeth (15, 12, 26, 36, 32, 31 and 46). Tooth 36 had the most acute symptoms and was thus treated first by conventional access cavity preparation and root canal detection. Despite meticulous technique, the distal and mesiolingual canals were perforated. The perforations were immediately repaired with mineral trioxide aggregate, and the decision was made to switch to guided endodontic treatment for the remaining 6 teeth. CBCT and intraoral surface scans were acquired and matched using coDiagnostix planning software (Dental Wings Inc.), the respective drill positions for root canal location were determined, and templates were virtually designed and 3D-printed. The template was positioned on the respective tooth, and a customized drill was used to penetrate the calcified part of the root canal and perform minimally invasive access cavity preparation up to the apical region. All root canals were rapidly and successfully located with the templates. At 1-year follow-up, clear signs of apical healing were present in all treated teeth. ConclusionsIn patients with dentin dysplasia, conventional endodontic therapy is challenging. GET considerably facilitates the root canal treatment of teeth affected by dentin dysplasia.
International Travel is Not a Significant Risk of Exposure for Patients at a Midwestern United States Travel Clinic
Authors: House Hans , Patel Pooja 
Published: June 2020

Abstract
The Novel Coronavirus (SARS-CoV-2) was introduced into the United States due to travel from Asia and Europe, although the extent of the spread of the disease was limited in the early days of the Pandemic. International travel may have played a role in the transmission of the disease into Iowa. Persons planning international travel likely modified their travel plans as a result of the viral outbreak. This study, documenting the travel destinations of patients from a clinic in Bettendorf, Iowa, seeks to determine how preferences for international travel changed as Coronavirus Disease (COVID-19) spread throughout the world and if any of these patients developed COVID-19 as a result of their travel. From October 2019 to March 2020, four hundred twelve (n=412) patients presented for pre-travel advice. Intended travel to the Western Pacific region (China, Japan, Korea, etc.) decreased dramatically during the study period. Of the 412 patients, only three (3) presented for COVID-19 testing during the follow-up period. Two (2) tested positive, and both of these infections were linked to workplace exposures and not due to travel. News of the growing pandemic and travel warnings likely altered patient’s travel plans and fewer intended travel to the most affected regions of the world in the early months of the COVID-19 pandemic. Travel was not a significant source of COVID-19 exposure for patients seen at this clinic.
Reconstruction for massive proximal tibial bone defects using patient-customized three-dimensional-printed metaphyseal cones in revision total knee arthroplasty
Authors: Li Yang , Wang Xinguang , Tian Hua 
Published: June 2020

Abstract
Background
The reconstruction of massive bone defects is one of the main challenges in revision total knee arthroplasty (RTKA). Although several methods are available, each of them has its prominent shortcomings. The purpose of this study is to review the clinical outcomes of RTKA with massive proximal tibial bone defects using patient-customized three-dimensional (3D)-printed highly porous metaphyseal cones.
Methods
We retrospectively reviewed seven RTKAs with Anderson Orthopaedic Research Institute (AORI) type III tibial defects using patient-customized 3D-printed highly porous metaphyseal cones, which have been performed at a single institution between 2016 and 2018. The mean length of follow-up was 25.3 months (19–36).
Results
The mean age at diagnosis of the patients was 68 years old (61–77). At the latest follow-up, no aseptic loosening or prosthetic joint infection has been determined. The mean HSS increased from 49 (39–63) to 78 (70–83) (P < 0.01); the mean WOMAC increased from 59 (46–73) to 26 (12–38) (P < 0.01). All patients obtained the range of motion and mechanical alignment improvement postoperatively.
Conclusion
The patient-customized 3D-printed metaphyseal cone could be a promising technique in addressing severe tibial defects in RTKA. Our study shows encouraging short-term clinical and radiological outcomes with no aseptic loosening, periprosthetic infection, or fracture. Nevertheless, further follow-up and the expansion of sample size are needed to demonstrate the advantage of this innovative technique fully.
Acute Encephalopathy in Children with Tuberous Sclerosis Complex
Authors: Numoto Shingo , Kurahashi Hirokazu , Sato Atsushi , Kubota Masaya , Shiihara Takashi , Okanishi Tohru , Tanaka Ryuta , Kuki Ichiro , Fukuyama Tetsuhiro , Kashiwagi Mitsuru , Ikeno Mitsuru , Kubota Kazuo , Akasaka Manami , Mimaki Masakazu , Okumura Akihisa 
Published: June 2020

Abstract
ObjectiveWe examined the clinical manifestations of acute encephalopathy (AE) and identify risk factors for AE in children with tuberous sclerosis complex (TSC).MethodsThe clinical data of 11 children with TSC associated with AE and 109 children with TSC alone aged 4 years or older were collected from 13 hospitals.ResultsOf the 11 children with AE, 5 had histories of febrile seizures (FS), and all had histories of febrile status epilepticus (FSE). AE developed within 24 h after fever onset in all children with seizures lasting 30 min or longer. All children developed coma after seizure cessation. Head magnetic resonance imaging (MRI) revealed widespread abnormalities in the cerebral cortex, subcortical white matter, corpus callosum, basal ganglia, and thalamus. One child died; seven had severe neurological sequelae; and the other three, mild sequelae. Logistic regression analysis revealed that a history of FSE was correlated with the development of AE.SignificanceAE in children with TSC was characterized by sudden onset after fever, followed by coma, widespread brain edema evident on MRI, and poor outcomes. A history of FSE was a risk factor for the development of AE.
Management of life-threatening acute respiratory syndrome and severe pneumonia secondary to COVID-19 in pregnancy: a case report and literature review
Authors: Yaqoub Salwa , Ahmad Shamsa , Mansoori Zeena , Pallivalapila Abdulrouf , Kassem Wessam El , Maslamani Muna , Jubara Mahmoud Abu , Minisha Fathima , Tarannum Asma , Babarinsa Isaac , Abdussalam Ahmed , Sayed Hamdy , Rivero Teresa , Mohammad Aftab , Thomas Binny , Hail Moza Al 
Published: June 2020

Abstract
BackgroundAs COVID-19 continues to infect women of all gestational ages; gravida in labor and the acutely ill parturient are particularly at higher risk of infection. No therapeutic agent or vaccine is approved to treat COVID-19 till date. Thus, managing COVID-19 and associated complications during pregnancy is often challenging and requires a multidisciplinary approach to treatment. Case PresentationWe narrate our perspectives on managing a 32-year-old, critically ill obstetric patient at 32-week gestation, diagnosed with acute respiratory distress syndrome (ARDS) secondary to COVID-19 pneumonia. Upon confirmation of COVID-19, as per the local protocol antivirals, antimalarial, and antibiotics were commenced. Due to rapidly exacerbating maternal respiratory functions, and potential chances of fetal hypoxemia emergency caesarian was performed. Following delivery, the maternal respiratory functions further deteriorated as she required prolonged mechanical ventilation and initiation of extracorporeal membrane oxygenation until she was clinically stable on day 23. The patient also received convalescent plasma and tocilizumab as a part of the treatment protocol. The newborn was shifted to neonatal intensive care for intubation for respiratory distress and was found negative for SARS-CoV-2 and COVID-19 immunoglobulin (Ig). At day 25, the patient was clinically stable and was transferred to step down unit and discharged thereafter. Conclusion Through this case, we present the thought process, multidisciplinary team-based strategy and sequel of managing a complex, critically ill obstetric patient with ARDS and COVID-19 pneumonia. We anticipate that this case report will assist other healthcare institutions to manage critically ill patients with COVID-19 pneumonia.Key words: COVID-19, maternal, pandemic, perinatal, ECMO, convalescent plasma, pharmacological interventions.
Clinical course and outcome of patients with acute pulmonary embolism rescued by veno-arterial extracorporeal membrane oxygenation: a retrospective review of 21 cases
Authors: Chen Yen Yu , Wu Chia-Chen , Yen Hsu-Ting , Huang Kwan-Ru , Sheu Jiunn-Jye , Lee Fan-Yen 
Published: June 2020

Abstract
Background

Veno-arterial extracorporeal membrane oxygenation (ECMO) is increasingly being utilized in patients with massive pulmonary embolism (PE). However, the efficacy and the safety remain uncertain. This study aimed to investigate clinical courses and outcomes in ECMO-treated patients with acute PE.
Methods

Twenty-one patients with acute PE rescued by ECMO from January 2012 to December 2019 were retrospectively analysed. Clinical features, laboratory biomarkers, and imaging findings of these patients were reviewed, and the relationship with immediate outcome and clinical course was investigated.
Results

Sixteen patients (76.2%) experienced refractory circulatory collapse requiring cardiopulmonary resuscitation (CPR) or ECMO support within 2 hours after the onset of cardiogenic shock, and none could receive definitive reperfusion therapy before ECMO initiation. Before or during ECMO support, more than 90% of patients had imaging signs of right ventricular (RV) dysfunction. In normotension patients, the computed tomography (CT) value was a valuable predictor of rapid disease progression compared with cardiac troponin I level. Ultimately, in-hospital death occurred in 10 patients (47.6%) and 90% of them died of prolonged CPR-related brain death. Cardiac arrest was a significant predictor of poor prognosis (p = 0.001).
Conclusions

ECMO appears to be a safe and effective circulatory support in patients with massive PE. Close monitoring in intensive care unit is recommended in patients with RV dysfunction and aggressive use of ECMO may reduce the risk of sudden cardiac arrest and improve clinical outcome.