bluuebunny/crossref_metadata_2025_split huggingface dataset:
Awareness of basic knowledge of hand hygiene practices among Chinese healthcare workers: a questionnaire-based survey
Authors: YANG Jing , LONG Li , FENG Shu , SUN Wei , GAO Lifang , YANG Yamin , LIU Jie , ZHOU Junqing , ZHANG Fuyu , TIAN Jie , GAO Bin 
Published: December 2020

Abstract
Objectives

Hand hygiene is a key measure for the prevention and control of healthcare-associated infection. We investigated the level of awareness of the basic concepts surrounding hand hygiene among healthcare workers in China to inform future targeted hand hygiene promotion activities.
Methods

An online questionnaire survey comprising 10 single/multiple-choice questions was conducted from April to June 2018 in 30 provinces and municipalities in three regions of China. Logistic analysis was performed to identify differences between regions, types of hospitals, healthcare workers categories, clinical departments, and gender.
Results

A total of 52,286 responses were received. Among these, 45,455 (86.94%) were included in the final analysis. The overall correct response rate was 26.53%. Eastern China demonstrated a better knowledge than other regions. Respondents in primary care facilities had a higher correct response rate than other types of hospitals and logistics staff had the highest correct response rate than other professional groups. Among clinical departments, staff in the outpatient/emergency room had the highest rate of correct responses.
Conclusion

Large differences exist in the basic knowledge of hand hygiene across different regions in China and knowledge levels need to be specifically strengthened among secondary care facilities, nurse professionals, gynaecology/obstetrics/paediatric departments and infection control units.
Differential Diagnostic Value of SATB2 in Primary Pulmonary Enteric Adenocarcinoma and Pulmonary Metastases of Colorectal Carcinoma
Authors: Yuan Jingping , Xiong Lin , Zhou Ying , Luo Juan , He Huihua , Yan Honglin , Xu Li 
Published: December 2020

Abstract
Aims: Pulmonary enteric adenocarcinoma (PEA) is composed mainly of tall columnar cells arranged in an irregular acinar or cribriform pattern with extensive central necrosis, closely resembling the appearance of intestinal epithelial and colorectal carcinomas under the microscope. PEA is usually positive for CK7. However, some cases lack CK7 expression and are positive for intestinal differentiation markers, such as CDX2, villin, and CK20. It is difficult to distinguish between PEA and pulmonary metastases of colorectal carcinoma (MCRC), so new identification methods need to be explored. Methods and Results:We found that SATB2 was highly tissue-specific by bioinformatics analysis. It is highly expressed in intestinal tissues, and its expression level in lung tissues is very low. Then, according to the WHO diagnostic criteria, the cases of lung tumor were preliminary screened to obtain PEA and MCRC cases. In the preliminary screening process, immunohistochemical staining of common lung adenocarcinoma immunomarkers (CK7, TTF-1, and NapsinA) and common intestinal cancer immunomarkers (CK20, CDX2, and villin) were performed to aid identification. Then, after combined with clinical history, imaging examination and colonoscopy, 28 primary PEA specimens and 42 MCRC specimens were final included. The above process was independently reviewed by two pathologists. PEA and MCRC had differences in the number of tumor nodules. The positive rates of SATB2 in PEA and MCRC were 0.00% and 92.86%, respectively. The sensitivity, specificity and diagnostic accuracy of SATB2 for distinguishing MCRC from PEA were 92.86%, 100% and 95.71%, respectively. The diagnostic accuracy of CK7 was 88.57%, which was slightly inferior to SATB2, and the results of CK7 could be used as a reference for SATB2 differential diagnosis. Conclusions:Our study showed that SATB2 can be viewed as the best immunomarkers for distinguishing PEA from MCRC. At the same time, CK7 could be used as references for SATB2 differential diagnosis.
Proximate Determinants and Decomposition of Changes in Fertility Levels in Nigeria, 2003-2018
Authors: Olowolafe Tubosun Alex , Adebowale Ayo Stephen , Fagbamigbe Adeniyi Francis , Akinyemi Joshua Odunayo , Onwusaka Obiageli Chiezey 
Published: December 2020

Abstract
BackgroundThere is disparity in fertility level across the six geopolitical zones in Nigeria. Deeper uunderstanding about the drivers of fertility trends are necessary to prioritize zonal specific strategies for fertility reduction in Nigeria. Thus, this study examined the proximate determinants (PDs) of fertility and decomposed the change in its level across the six geo-political zones in Nigeria.MethodData from Nigeria Demographic and Health Surveys of 2003 and 2018 were analyzed. Fertility data were based on the report of full birth history from women of reproductive age. The Revised Bongaarts framework was used to estimate PDs and fertility levels. The contribution of each PDs to the observed changes in fertility levels was quantified using Das Gupta’s five- factor decomposition method.ResultAcross the zones, there was a change in the fertility inhibiting effect of Contraception (Cc) between 2003 and 2018. The fertility inhibiting effect of Postpartum Infecundability (Ci) and Abortion was the highest and smallest respectively across the zones. The Total fertility rate (TFR) in 2003 and 2008 across the zones are South-South (5.04 vs 4.36), South-West (4.88 vs 4.26), North West (7.25 vs 6.85), North East (6.87 vs 6.54), North Central (5.72 vs 5.48), South East (5.06 vs 4.86), Nigeria (6.00 vs 5.59). Delayed sexual exposure (Cm) and contraceptive use (Cc) contributed the most to the change across the regions. The percentage contribution of Cm in South-South, South West, and South East was 87.04%, 52.89%, and 172.85% respectively. Furthermore, most of the fertility change observed in North Central was attributable to Cc.ConclusionAbortion index was not an important inhibiting factor of fertility in Nigeria. Delayed sexual exposure and contraceptive use accounted for the largest change observed in fertility levels across the six geo-political zones in Nigeria between 2003 and 2018. Strategies that promote delayed sexual exposure, contraceptive use and breast feeding practices will enhance fertility transition in Nigeria.
The Prevalence of Varicocele in the Military Population
Authors: Wang Meng , Chang Yu-wei , Wu Hong-li 
Published: December 2020

Abstract
Objective: To analyse the prevalence and independent risk factors of varicocele in the soldiers population. Methods: The results of ultrasound examination and clinical physical examination in military outpatient clinic were collected and analysed in our hospital between July 2019 and July 2020. The results were compared with ordinary outpatient patients.Results: Finally, 1169 military patients and 818 general outpatients were included in this study. Totally 225 military cases (19.24%) and 119 outpatient cases (14.55%) developed varicocele. The incidence of varicocele in the military group was higher than that of the outpatients (P<0.05). The number of bilateral and single right varicocele in the two groups were 29, 14 and 13, 7, respectively. Military men were younger and had smaller testicular volumes than ordinary people (P<0.05). The analysis of the military population revealed that reduced left testicular volumes (P=0.000, OR=0.896), increased right testicular volumes (P=0.033, OR=1.052) and the disappearance of fluid around testicular (P=0.007, OR=0.505) were independent risk factors for varicocele. There was no correlation between testicular volume, age and the diameter of spermatic vein (P>0.05).Conclusions: The incidence of varicocele in the military population was 19.24%, and the rate was higher than ordinary patients. Reduced left testicular volumes, increased right testicular volumes and the testicular hydrocele disappears were independent risk factors.
Outcomes of tissue reconstruction in distal lower leg fractures: a retrospective cohort study
Authors: Aydogan Emrah , Langer Stefan , Josten Christoph , Fakler Johannes Maria Karl , Henkelmann Ralf 
Published: December 2020

Abstract
Background: Open and closed fractures can be associated with posttraumatic or postoperative soft tissue defects caused by initial trauma, operative procedures, or infections. This study evaluated the postoperative outcomes in patients with open or closed lower leg fractures, related soft tissue defects, and subsequent flap coverage.Methods: We performed a retrospective single-center cohort study in a level 1 trauma center. We analyzed the patients treated from January 2012 through December 2017 and recorded demographics, treatment, and outcome data. The outcome data were measured via patient-reported Foot and Ankle Outcomes Scores (FAOS) and EQ-5D-5L scores.Results: We included 22 patients with complicated fractures (11 open and 11 closed) and subsequent soft tissue defects and flap coverages. The mean follow-up time was 41.2 months. Twenty-one patients developed infections, and necrosis at the site of surgery manifested in all closed fractures. Therefore, all patients needed soft tissue reconstructions. Preoperatively, 16 patients underwent arterial examinations via angiography and six underwent ultrasound examinations of the venous system. Ten patients had complications involving the flaps due to ischemia and consequent necrosis. The mean EQ-5D index was 0.62 ± 0.27, and EQ-5D VAS score was 57.7 ± 20.2. The mean FAOS was 60.7 ± 22.2; in particular, quality of life was 32.3 ± 28.8. The rate of returning to work in our patient group was 37.5% after one year.Conclusions: Distal tibial fractures often require revisions and soft tissue reconstruction. The evaluated patient population had poor outcomes in terms of function, quality of life, and return to work. Furthermore, patients suffering from flap ischemia have worse outcomes than those without flap ischemia.
Depressive symptoms and health service utilization among Chinese middle aged and older adults: A national population-based longitudinal survey
Authors: Guo Jing , Kong Dexia , Fang Liming , Zhang Anao , Zhu Yingxue , Zhang Bo 
Published: December 2020

Abstract
Objectives: This study aimed to 1) examine the cross-sectional and longitudinal relationships between depressive symptoms and health services utilization among Chinese middle-aged and older adults; and 2) evaluate whether there exists a rural-urban difference in such relationships. Methods: Data was obtained from China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2015, a nationally representative survey of 13,551 adults aged 45 years and above in China. Results: Depressive symptoms were positively associated with a greater likelihood of outpatient and inpatient health services utilization. This association was consistent across rural and urban settings, indicating the robustness of such findings across geographic areas. Conclusions: Findings indicate that depressive symptoms are significantly associated with both in-patient and out-patient health service utilization among Chinese adults. Screening for depressive symptoms needs to be incorporated in these care settings in China.
A Novel Missense Mutation in the Gene Encoding Major Intrinsic Protein (MIP) in a Giant Panda with Unilateral Cataract Formation
Authors: Bai Chao , You Yuyan , Liu Xuefeng , Xia Maohua , Wang Wei , Jia Ting , Pu Tianchun , Lu Yan , Zhang Chenglin , Li Xiaoguang , Yin Yanqiang , Liqin Wang , Zhou Jun , Niu Lili 
Published: December 2020

Abstract
Background: Cataracts are defects of the lens that cause progressive visual impairment and ultimately blindness in many vertebrate species. Most cataracts are age-related, but up to one third have an underlying genetic cause. Cataracts are common in captive zoo animals, but it is often unclear whether these are congenital or acquired (age-related) lesions. Results: Here we used a functional candidate gene screening approach to identify mutations associated with cataracts in a captive giant panda (Ailuropoda melanoleuca). We screened 11 genes often associated with human cataracts and identified a novel missense mutation (c.686G>A) in the MIP gene encoding major intrinsic protein. This is expressed in the lens and normally accumulates in the plasma membrane of lens fiber cells, where it plays an important role in fluid transport and cell adhesion. The mutation causes the replacement of serine with asparagine (p.S229N) in the C-terminal tail of the protein, and modeling predicts that the mutation induces conformational changes that may interfere with lens permeability and cell–cell interactions.Conclusion: The c.686G>A mutation was found in a captive giant panda with a unilateral cataract but not in 18 controls from diverse regions in China, suggesting it is most likely a genuine disease-associated mutation rather than a single-nucleotide polymorphism. The mutation could therefore serve as a new genetic marker to predict the risk of congenital cataracts in captive giant pandas.
Dispersal patterns and population genetic structure of Aedes albopictus (Diptera: Culicidae) in three different climatic regions of China
Authors: Gao Jian , Zhang Hengduan , Guo Xiaoxia , Xing Dan , Dong YanDe , Lan CeJie , Wang Ge , Li ChaoJie , Li ChunXiao , Zhao TongYan 
Published: December 2020

Abstract
Background:Aedes albopictus is an indigenous primary vector for dengue and Zika viruses in China. Compared with its insecticide resistance, biology, and vector competence, little is known about its genetic variation, which corresponds to environmental variations. Thus, the present study examines how Ae. albopictus varies among different climatic regions in China and deciphers its potential dispersal patterns.Methods:The genetic variation and population structure of 17 Ae. albopictus populations collected from three climatic regions of China were investigated with 11 microsatellite loci and the mitochondrial coxI gene.Results:Of 44 isolated microsatellite markers, 11 pairs were chosen for genotyping analysis and had an average PIC value of 0.713, representing high polymorphism. The number of alleles was high in each population, with the ne value increasing from the temperate region (3.876) to the tropical region (4.144). Twenty-five coxI haplotypes were detected, and the highest diversity was observed in the tropical region. The mean Ho value (ca. 0.557) of all the regions was significantly lower than the mean He value (ca. 0.684), with nearly all populations significantly departing from HWE and displaying significant population expansion (p-value < 0.05). Two genetically isolated groups and three haplotype clades were evaluated via STRUCTURE and haplotype phylogenetic analyses, and the tropical populations were significantly isolated from those in the other regions. Most genetic variation in Ae. albopictus was detected within populations and individuals at 31.40% and 63.04%, respectively, via the AMOVA test, and a relatively significant positive correlation was observed among only the temperate populations via IBD analysis (R2 = 0.6614, p = 0.048). Recent dispersions were observed among different Ae. albopictus populations, and four major migration trends with high gene flow (Nm > 0.4) were reconstructed between the tropical region and the other two regions. Environmental factors, especially temperature and rainfall, may be the leading causes of genetic diversity in different climatic regions.Conclusions:Continuous dispersion contributes to the genetic communication of Ae. albopictus populations across different climatic regions, and environmental factors, especially temperature and rainfall, may be the leading causes of genetic variation.
The mating rate of Drosophila suzukii reduction due to reproductive interference from Drosophila melanogaster
Authors: Chen Yongzhuo , Zhang Min , Hu Wei , Li Jing , Liu Pengcheng , Hu Hao-Yuan 
Published: December 2020

Abstract
Background Drosophila suzukii is widely distributed. Research has revealed that the presence of Drosophila melanogaster can reduce the emergence and egg laying of D. suzukii. However, the reasons for these phenomena have not yet been reported. To investigate this issue, we sought to answer three questions: Can the presence of D. melanogaster reduce the longevity of D. suzukii? Does D. melanogaster dominate in larval interspecific competition with D. suzukii? Does reproductive interference occur between these species; i.e., do individuals of one species (e.g., D. suzukii) engage in reproductive activities with individuals of the other (e.g., D. melanogaster) such that the fitness of one or both species is reduced? Results The results showed that the adult offspring number of Drosophila suzukii was significantly reduced when this species was reared with Drosophila melanogaster. The larval interspecific competition had no significant effects on Drosophila suzukii longevity or population size. Surprisingly, Drosophila melanogaster imposed reproductive interference on males of Drosophila suzukii, which led to a significant decline in the rate of successful mating of the latter species. Conclusions The presence of Drosophila melanogaster causes the population size of Drosophila suzukii to decrease through reproductive interference, and the rate of successful mating in Drosophila suzukii is significantly reduced in the presence of Drosophila melanogaster.
Reconstruction of massive tibial bone and soft tissue defects by trifocal bone transport combined with soft tissue distraction: experience from 31 cases
Authors: Xu Yong-Qing , Fan Xin-Yu , He Xiao-Qing , Wen Hong Jie 
Published: December 2020

Abstract
Background Large post-traumatic tibial bone defects combined with soft tissue defects are a common orthopedic clinical problem associated with poor outcomes when treated using traditional surgical methods. The study was designed to investigate the safety and efficacy of trifocal bone transport (TFT) and soft-tissue transport with the Ilizarov technique for large posttraumatic tibial bone and soft tissue defects. Methods We retrospectively reviewed 31 patients with massive posttraumatic tibial bone and soft tissue defects from May 2009 to May 2016. All of the eligible patients were managed by TFT and soft-tissue transport. The median age was 33.4 years (range, 2-58 years). The mean defect of bone was 11.87cm ± 2.78cm (range, 8.2-18.2cm) after radical resection performed by TFT. The soft tissue defects ranged from 7cm x 8cm to 24cm x 12cm. The observed results included bone union time, wound close time and true complications. The Association for the Study and Application of the Method of Ilizarov (ASAMI) scoring system was used to assess bone and functional results and postoperative complications were evaluated by Paley classification. Results The mean duration of follow-up after frame removal was 32 months (range, 12-96 months). All cases achieved complete union in both the elongation sites and the docking sites, and eradication of infection. The mean bone transport time was 94.04 ± 23.33 days (range, 63.7-147 days). The mean external fixation time was 22.74 ± 6.82 months (range, 14-37 months), and the mean external fixation index (EFI) was 1.91 ± 0.3 months/cm (range, 1.2–2.5 months/cm). The bone results were excellent in 6 patients, good in 14 patients, fair in 8 patients and poor in 3 patients. The functional results were excellent in 8 patients, good in 15 patients, fair in 5 patients and poor in 3 patients. Conclusion: TFT, in conjunction with soft tissue transport technique, can give good results in most patients (in this article, good and excellent results were observed in 64% of patients). Soft tissue transport is a feasible method in providing good soft tissue coverage on the bone ends. Although it has no advantages over microvascular techniques, it might be an good alternative in the absence of an experienced flap surgeon. Nonetheless, high-quality controlled studies are needed to assess its long-term safety and efficacy.
The hidden secrets of a neutral pH – Blood-Gas-Analysis of postoperative patients according to the Stewart approach
Authors: Janssen Joost , Fessem Joris M.K. van , Ris Tijmen , Stolker Robert Jan , Klimek Markus 
Published: December 2020

Abstract
Background: The superiority of either the traditional or Stewart based approach to acid-base balance has focused primarily on analyzing metabolic acidemia, with little attention given to patients with neutral pH. In this study, we evaluate metabolic disturbances in patients in the immediate postoperative period focusing on patients with neutral pH, while comparing the Stewart and traditional approach. Methods: We conducted a single center retrospective observational cohort study. Over a 17 month period, data on arterial blood gas analysis, electrolytes and albumin on the morning after surgery were retrieved from patients admitted to the postsurgical high dependency unit (HDU). Albumin corrected anion gap (AG), apparent (SIDa) and effective strong ion difference (SIDe) and strong ion gap (SIG) were calculated.Results: Out of 1207 HDU admissions, 400 cases had a complete set of laboratory-data including albumin of which 281 presented with neutral pH (7.35 ≤ pH ≤ 7.45), 64 with acidemia (pH < 7.35) and 55 with alkalemia (pH > 7.45). In pH neutral patients the following acidifying disturbances were found: SIDa was lowered in 101 (36%), SIG was raised in 60 (21%). Base excess (BE) was decreased in 16 (6%) and corrected AG raised in 107 (38%). The alkalizing effect of hypoalbuminemia was present in 137 (49%). Out of 134 cases with normal BE and corrected AG, SIDa was lowered in 58 (43%). Out of 136 cases with normal SIDa and SIG, none had lowered BE and 28 increased AG (21%). Length of stay was significantly longer in patients with hypoalbuminemia, lowered SIDa and increased corrected AG, but not decreased BE (Hypoalbuminemia: 16 days vs. 10 days, P < 0.001. Low SIDa: 15 days vs. 12 days, P = 0.015. Increased AG: 16 days vs. 11 days, P < 0.001. Low BE: 14 days vs. 13 days, P = 0.736).Conclusions: Metabolic disturbances, characterized mainly by the presence of lowered SIDa, increased AG and hypoalbuminemia, are frequent in our population with apparent neutral acid-base balance based on pH and base excess. These changes on the morning after surgery are associated with increased length of stay.