bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and associations of active trachoma among rural preschool children in Wadla district, northern Ethiopia
Authors: Kassaw Mesfin Wudu , Abebe Ayele Mamo , Tegegne Kirubel Dagnaw , Getu Mikiyas Amare , Bihonegn Woldemichael Tadesse 
Published: March 2020

Abstract
Background ፡ Trachoma is a neglected eye problem and an important cause of preventable corneal blindness. In endemic areas, initial infection can occur in early childhood, and following recurrent episodes of infection, it progresses to scarring and blindness. In past decades, trachoma disappeared from developed countries through enhancements of hygiene and sanitation but the disease is still a problem in developing countries. In Ethiopia, data indicate that Amhara is the region with the highest prevalence of active trachome. The aim of this study was to asse{Birlie, 2016 #48}ss prevalence and association of active trachoma among rural preschool children in Wadla district, north Wollo zone, Amhara. Methods: A total of 596 children aged 1–5 years living in 30 of Wadla’s 150 rural villages were screened for signs of active trachoma using a cluster sampling technique. Following pre-testing of the survey instrument in a different district, questions about socio-demographic status were asked of heads of households by health informatics professionals. Integrated eye care workers, previously trained to undertake trachoma screening over one month, performed eye examination. Logistic regression was used to look for associations of active trachoma. Results: The prevalence of active trachoma among rural pre-school age children in Wadla district was 22%. Low economic status (adjusted odds ratio [AOR] 3.8 (95% CI 1.3–11.4), being 37– 48 months old (4.2;1.5–12.0), living in a house with thatched roof (4.4;1.4–13.6), presence of flies in the home (4.6;2.1–9.9), once-weekly face-washing frequency (8.6;2.5–29.3), having a face that had not been washed for longer than a week (10.6;2.9–37.7), and not using soap when washing hands (4.5;1.8–11.3) were associated with active trachoma Conclusion: The prevalence of active trachoma among rural pre-school children was high and it is still a major public health problem in Wadla. Thus, the woreda health office should create awareness for Wadla woreda communities. Keywords : Active Trachoma, Associations, Water, Sanitation, Hygiene
Patterns of regional lymph node failure of locally advanced hypopharyngeal squamous cell carcinoma after first-line treatment with surgery and/or intensity-modulated radiotherapy
Authors: Wang Dongqing , Yu Shui , Zhai Limin , Xu Jin , Li Baosheng 
Published: March 2020

Abstract
Background : To identify the spatial patterns of regional lymph node failure of locally advanced hypopharyngeal squamous cell carcinoma (SCC) after first-line treatment with surgery and/or intensity-modulated radiotherapy (IMRT). Methods : We retrospectively obtained the clinicopathological characters of 123 hypopharyngeal SCC patients, and investigated the patterns of regional lymph node failure. Univariate and multivariate logistic regression were used to determine the risk factors of regional lymph node failure. Results : Forty patients (32.5% of total patients) were suffered regional lymph node failure. In these patients, the ipsilateral neck level II nodal failure account for 55.0% (22/40) followed by level III 30.0% (12/40), level VIb 15.0% (6/40), level VII 15.0% (6/40), and level IV 5.0% (2/40). In addition, 17.5% (7/40) patients suffered contralateral neck level II nodal failure and 7.5% (3/40) patients suffered level III nodal failure. The common failure levels were the II (7/46, 15.2%), III (4/46, 8.7%), VIb (4/46, 8.7%), and VII (5/46, 10.9%) for treatment by surgery. The lymph node recurrence and persistent disease at levels II (19/77, 24.7%) and III (10/77, 13.0%) remained the major cause of failure following curative intent of IMRT. The postoperative radiation significantly decreased the risk of regional lymph node failure (OR=0.082, 95% CI: 0.007–1.000, P=0.049); and the radiologic extranodal extension significantly increased the risk of regional lymph node failure (OR=11.07, 95% CI: 2.870–42.69, P<0.001). Conclusions: Whatever the treatment modality, the lymph node failure at level II and III was the most popular pattern for hypopharyngeal SCC. Moreover, for patients who underwent surgery, the nodal failure at level VIb and VII was frequent. Thus, postoperative radiation of level VIb and VII may give rise to benefit to locally advanced hypopharyngeal SCC patients.
Adolescent physical activity: the role of parental social support and the level of physical activity. Social Support and Physical Activity of Parents and Adolescents.
Authors: Camargo Edina Maria de , López-Gil Jose Francisco , Piola Thiago Silva , Mota Jorge Augusto Pinto Silva , Campos Wagner de 
Published: March 2020

Abstract
Background: Maximising the level of physical activity in adolescents has been a concern for many researchers given the benefits provided by physical activity. Aim: To verify the relationship between the level of moderate vigorous physical activity (MVPA) of parents or legal guardians and that of social support (SS) with the level of MVPA in adolescents. Methods: Cross-sectional study that selected 1390 (59.6% female) adolescents. The questionnaires IPAQ, QAFA and ASAFA were used. Results: In relation to boys, receiving incentives from parents who “assist always” (OR=1.96 – CI95%=1.16–3.32) and having parents/legal guardians who meet the MVPA recommendations (OR=2.78 – CI95%=1.76–4.38) was associated with meeting the MVPA recommendations. The probability increases when adjusted by socioeconomic status (OR=3.47 – CI95%=1.73–6.96) or education level (OR=4.20 – CI95%=1.96–9.02). Regarding girls, parents who “encourage sometimes” was associated negatively (OR=0.61 – CI95%=0.37–0.98) and meet the MVPA recommendations (OR=2.04 – CI95%=1.46–2.87) was associated positively with meeting the recommendations for adolescents. The likelihood raises when adjusted by socioeconomic status (OR=2.11 – CI95%=1.36–3.29) or education level (OR=4.30 – CI95%=2.41–7.69). Conclusions: Having parents who meet with the physical activity recommendations demonstrated higher results in adolescents engaging 60 minutes of MVPA daily when compared to receiving social support, for both boys and girls.
Knowledge About Diabetic Retinopathy, Eye Check-Up Practice And Associated Factors Among Adult Patients With Diabetes Mellitus Attending At Debark Hospital, Northwest Ethiopia
Authors: Tegegne Mebratu Muusew , Assem Abel Sinshaw , Alemu Destaye Shiferaw , Woredekal Asamere Tsegaw , Tefera Tsehay Kassa 
Published: March 2020

Abstract
Background:Routine eye examination plays a vital role in detecting diabetic retinopathy in its earliest stage before the onset of blindness. Patients’ knowledge about the nature and the consequences of diabetic retinopathy and routine eye checkup helps in timely identification and early treatment. However, there is limited evidence on knowledge of patients with diabetes mellitus on diabetic retinopathy and their eye check-up practices in Ethiopia.The aim of this study was to assess knowledge, eye check-up practice and associated factors of diabetic retinopathy among adult diabetic patients at Debark hospital, Northwest Ethiopia.Methods: Institution based cross – sectional study was conducted at Debark hospital, Northwest Ethiopia, from April 20/2018- May 20/2018. A pretested interviewer administered structured questionnaire was used to collect data among 230 diabetic patients aged 18 years and above. Data were entered in to Epi Info version 7 and exported to SPSS version 20 for analysis. Bivariable and multivariable binary logistic regression analyses were done. Odds ratio with 95% confidence level was determined and variables with p–value of < 0.05 were considered as statistically significant.Result: Out of 238 sample 230 were participated, among this, 119 (51.7%) were males. The mean age of the respondents was 49 (SD ±17.6) years. One hundred nine (47.4%) participants had good knowledge and 91 (39.6%) had good eye check-up practice. Urban residence [AOR= 2.65;95% CI: 1.16-6.07)]), monthly income of 3501-8000 birr [AOR=4.54;(1.31-15.7)], type II diabetes mellitus [AOR=3.9;(1.6-9.6)], duration of diabetes (6-12 years[AOR=4.4;(1.4-13.5)]), history of eye disease [AOR=5.5;(2.3-13.0)] were associated with good knowledge. Similarly, longer duration of diabetes (13-25 years [AOR=3.77; (1.05-13.5)]) and history of eye disease [AOR=2.47; (1.09-5.62)] were associated with good eye check-up practice. Conclusion: The proportion of good knowledge about diabetic retinopathy among diabetic patients at Debark hospital was fair (47.4%) and good eye check-up practice (eye examination at least once in the past year) was low (39.6%). Longer duration of diabetes and history of eye disease were identified as positive factors for good knowledge and eye check-up practice. Knowledge and regular eye check-up practice needs to be enhanced through provision of appropriate health education.
Why women chose unassisted home birth in Malaysia: A qualitative study
Authors: Tajuddin Nur Amani @ Natasha Ahmad , Suhaimi Julia , Ramdzan Siti Nurkamilla , Malek Khasnur Abd , Ismail Ilham Ameera , Shamsuddin Nurainul Hana , Bakar Ahmad Ihsan Abu , Othman Sajaratulnisah 
Published: March 2020

Abstract
Background: Incidences of unassisted home birthing practices have been increasing in Malaysia despite the accessibility to safe and affordable child birthing facilities. We aimed to explore the reasons for women to make such decisions. Methods: Twelve women participated in in-depth interviews. They were recruited using a snowballing approach. The interviews were supported by a topic guide which was developed based on the Theory of Planned Behaviour and previous literatures. The interviews were audio recorded, transcribed verbatim and analysed using thematic analysis. Results: Women in this study described a range of birthing experiences and personal beliefs as to why they chose unassisted home birth. Four themes emerged from the interviews; i) preferred birthing experience, ii) birth is a natural process, iii) expressing autonomy and iv) faith. Such decision to birth at home unassisted was firm and strong despite the possible risks and complications that can occur. Giving birth is perceived to occur naturally regardless of assistance, and unassisted home birth provides the preferred environment which health facilities in Malaysia may lack. They believed that they were in control of the birth processes apart from fulfilling the spiritual beliefs. Conclusions: Women may choose unassisted home birth to express their personal beliefs and values, at the expense of the health risks. Apart from increasing mothers’ awareness of the possible complications arising from unassisted home births, urgent efforts are needed to provide better birth experiences in healthcare facilities that resonate with the mothers’ beliefs and values.
High Dose and Low Dose Oxytocin Regimens as Determinants of Successful Labor Induction: A multicenter comparative study
Authors: TESEMMA MELESE GEZAHEGN , Sori Demisew Amenu , Gemeda Desta Hiko 
Published: March 2020

Abstract

Background: Induction of labor by Oxytocin is a routine obstetric procedure. However, little is known regarding the optimal dose of oxytocin so as to bring successful induction. This study was aimed at comparing the effects of high dose versus low dose oxytocin regimens on success of labor induction. Methods: Hospital-based comparative cross-sectional study was conducted in four selected hospitals in Ethiopia prospectively from October 1, 2017 to May 30, 2018. A total of 216 pregnant women who undergo induction of labor at gestational age of 37 weeks and above were included. Data were entered into Epi-data version 3.1 and then exported to SPSS version 20 for cleaning and analysis. Chi-square test and logistic regression were done to look for determinants of successful induction. The result was presented using 95% confidence interval of crude and adjusted odds ratios. P-value < 0.05 was used to declare statistical significance. Result: The mean “Induction to delivery time” was 5.9 hours and 6.3 hours for participants who received high dose Oxytocin and low dose Oxytocin respectively. Higher successful induction (72.2% versus 61.1%) and lower Cesarean Section rate (27.8% vs. 38.9) were observed among participants who received low dose Oxytocin compared to high dose. Favourable bishop score [AOR 4.0 95% CI 1.9, 8.5], elective induction [AOR 0.2 95% CI 0.1, 0.4], performing artificial rupture of membrane [AOR 10.1 95% CI 3.2, 32.2], neonatal birth weight of < 4Kg [AOR 4.3, 95% CI 1.6, 11.6] and being parous [AOR 2.1 95% CI 1.1, 4.0] were significantly associated with success of induction. Conclusions: In this study, Different oxytocin regimens didn’t show significant association with success of induction. But, high dose oxytocin regimen was significantly associated with slightly shorter induction to delivery time. Favourable bishop score, emergency induction, performing artificial rupture of membrane and delivery to non-macrosomic fetuses were positive determinants of successful induction. We recommend researchers to conduct multicenter research on a large number of patients that controls confounders to see the real effects of different oxytocin regimens on success of labor induction.
Perfluoroalkyl Substances Exposure in Early Pregnancy and Preterm Birth in Singleton Pregnancies: A Prospective Cohort Study
Authors: Huo Xiaona , Zhang Lin , Huang Rong , Feng Liping , Wang Weiye , Zhang Jun 
Published: March 2020

Abstract
Background: Preterm birth (PTB, < 37 completed weeks’ gestation) is one of the global public health concerns. Epidemiologic evidence on the potential impact of perfluoroalkyl substances (PFAS) on PTB is still limited and inconsistent. We aimed to investigate the associations between prenatal PFAS exposure and PTB among singleton live births.Methods: We studied 2849 mother-infant pairs in the Shanghai Birth Cohort (SBC) from 2013 to 2016. Ten PFAS in maternal plasma in early pregnancy (gestational age, median (interquartile range): 15 (13 - 16) weeks) were measured. Primary outcomes were duration of gestation, PTB, spontaneous PTB and clinically indicated PTB. A linear regression model was used to assess the associations between ln-transformed PFAS and duration of gestation (in weeks). Logistic regression models were applied to estimate the relative risks of these outcomes. Results: The incidence of overall PTB was 4.8% (95% confidence limit: 4.0% - 5.6%, n = 136) in this study population. In the linear regression analyses, PFAS were not associated with the duration of gestation after controlling for potential confounders. In the multiple logistic models, no significant associations were observed between PFAS and overall PTB, spontaneous or indicated PTB. Conclusion: Our prospective cohort study shows that maternal plasma PFAS concentrations in early pregnancy was not associated with gestational length, overall PTB, spontaneous or indicated PTB.
Genome wide identification and characterization of cucumber bHLH family genes and the functional characterization of CsbHLH041 in NaCl and ABA tolerance in Arabidopsis and cucumber
Authors: Li Jialin , Wang Ting , Han Jing , Ren Zhonghai 
Published: March 2020

Abstract
Background: The basic/helix-loop-helix (bHLH) transcription factor family exists in all three eukaryotic kingdoms as important regulatory components in biological growth and development. To date, there has been relatively little effort to systematically carry out comprehensive genomic and functional analyses of bHLH genes in cucumber ( Cucumis sativus L.). Results: Here, a total of 142 bHLH genes were identified in the recently released cucumber genome and further classified into 32 subgroups based on the phylogenetic analysis, conserved motifs and gene structures. Multiple sequence alignment analyses showed that the sequences of CsbHLH proteins were highly conserved. The chromosomal distribution, synteny analysis, and gene duplications of these 142 CsbHLHs were further analysed. A cis-element analysis revealed many elements related to stress responsiveness and plant hormones in the promoter regions of CsbHLH genes. Phylogenetic comparison of the bHLH members between cucumber and Arabidopsis , revealed that cucumber bHLH proteins were clustered into the different functional clades of Arabidopsis bHLH members. The transcript abundance analysis of selected CsbHLHs under abiotic stresses (NaCl, ABA and low-temperature treatments) identified five CsbHLH genes that could simultaneously respond to the three abiotic stresses. Tissue-specific expression profiles of these five genes were also analysed. In addition, 35S : CsbHLH041 enhanced the tolerance to salt and ABA in transgenic Arabidopsis and in cucumber seedlings, suggesting CsbHLH041 is an important regulator in response to abiotic stresses. Finally, the functional interoperability network among the CsbHLH proteins was analysed. Conclusion: This study provided a good foundation for further research into the functions and regulatory mechanisms of CsbHLH proteins and identified candidate genes for stress resistance in cucumber.
Serum Levels of Neutrophil Gelatinase Associated Lipocalin (NGAL) Predicts Hemodialysis After Coronary Angiography in High Risk Patients with Acute Coronary Syndrome.
Authors: Reyes Luis Felipe , Severiche-Bueno Diego Fernando , Bustamante Carlos A. , Murillo Sixta , Soni Nilam J. , Poveda Marcela , Gomez Efrain , Buitrago Ricardo , Rodriguez Alejandro 
Published: March 2020

Abstract
Background: Contrast-induced nephropathy (CIN) following a percutaneous coronary intervention (PCI) is the third most common cause of acute kidney injury (AKI) worldwide. Patients who require hemodialysis secondary to CIN have an elevated mortality rate as high as 55%. The current definition of CIN is based on an elevation of creatinine and decrease in urinary output. Creatinine typically increases 48 hours after the contrast exposure, which delays the diagnosis and treatment of CIN. The neutrophil gelatinase associated lipocalin (NGAL) has emerged as a sensitive and specific biomarker of renal injury. Limited data exists about the effectiveness of NGAL to predict CIN in high-risk patients with acute coronary syndrome (ACS) that underwent PCI. The primary aim of this study was to determine the association of serum NGAL levels and the need for hemodialysis after PCI. Methods: This is a prospective, observational study. NGAL levels were measured using ELISA. Blood samples were obtained within the first 6 hours of hospital admission, and 12 and 24 hours after contrast exposure from angiography. The primary outcome was the requirement of hemodialysis. The non-parametric Mann-Whitney U test was used to test for differences in median serum levels of NGAL. A receiver operating characteristic (ROC) curve was developed to assess the accuracy of NGAL to predict the need for hemodialysis after PCI. Results: A total of 2,875 were screened; however, 45 patients with ACS that underwent PCI were included. All patients were at high risk of developing CIN defined by Mehran score >11 points. The median (IQR) serum concentration of NGAL was significantly higher in patients that required versus did not require hemodialysis (340 [83-384] vs. 169 [100-210], p=0.01). Elevated serum levels of NGAL with a cut-off at 6 hours post PCI of 281 mg/dL predicted the need for hemodialysis with an area under the curve of 0.86 (95% CI: 0.66-1.00). Conclusions: In patients with ACS undergoing PCI; and high risk of developing CIN, an elevated serum level of NGAL 6 hours after contrast exposure predicts the development of acute kidney injury requiring hemodialysis.
Towards Improving the Identification of Anterior Cruciate Ligament Tears in Primary Point-of-Care Settings
Authors: Whittaker Jackie L , Chan Michelle , Pan Bo , Hassan Imran , Defreitas Terry , Hui Catherine , Macedo Luciana , Otto David 
Published: March 2020

Abstract
Background: Only a small proportion of anterior cruciate ligament (ACL) tears are diagnosed on initial healthcare consultation. Current clinical guidelines do not acknowledge that primary point-of-care practitioners rely more heavily on a clinical history than special clinical tests for diagnosis of an ACL tear. This research will assess the accuracy of combinations of patient-reported variables alone, and in combination with clinician-generated variables to identify an ACL tear as a preliminary step to designing a primary point-of-care clinical decision support tool.
Methods: Electronic medical records (EMRs) of individuals aged 15-45 years, with ICD-9 codes corresponding to a knee condition, and confirmed (ACL + ) or denied (ACL - ) first-time ACL tear seen at a University-based Clinic between 2014 and 2016 were eligible for inclusion. Demographics, relevant diagnostic indicators and ACL status based on orthopaedic surgeon assessment and/or MRI reports were manually extracted. Descriptive statistics calculated for all variables by ACL status. Univariate between group comparisons, clinician surveys (n=17), availability of data and univariable logistic regression (95%CI) were used to select variables for inclusion into multivariable logistic regression models that assessed the odds (95%CI) of an ACL-tear based on patient-reported variables alone (consistent with primary point-of-care practice), or in combination with clinician-generated variables. Model performance was assessed by accuracy, sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios (95%CI).
Results: Of 1,512 potentially relevant EMRs, 725 were included. Participant median age was 26 years (range 15-45), 48% were female and 60% had an ACL tear. A combination of patient-reported (age, sport-related injury, immediate swelling, family history of ACL tear) and clinician-generated variables (Lachman test result) were superior for ACL tear diagnosis [accuracy; 0.95 (90,98), sensitivity; 0.97 (0.88,0.98), specificity; 0.95 (0.82,0.99)] compared to the patient-reported variables alone [accuracy; 84% (77,89), sensitivity; 0.60 (0.44,0.74), specificity; 0.95 (0.89,0.98)].
Conclusions: A high proportion of individuals without an ACL tear can be accurately identified by considering patient-reported age, injury setting, immediate swelling and family history of ACL tear. These findings directly inform the development of a clinical decision support tool to facilitate timely and accurate ACL tear diagnosis in primary care settings.