bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants and barriers of adequate antenatal care among Afghan women in Iran; findings from a community-based survey in Iran
Authors: Dadras Omid , Dadras Fateme , Taghizade Ziba , Seyedalinaghi Seyedahmad , Ono-Kihara Masako , Kihara Masahiro , Nakayama Takeo 
Published: April 2020

Abstract
Background: Almost a third of Afghan women living in Iran are at childbearing age. Antenatal care (ANC) is an inextricable part of healthy pregnancy and could prevent the adverse birth outcomes. There are several factors that affect the access and utilization of such services among Afghan women. Therefore, in the present study, we aimed to explore the sociodemographic determinates and potential barriers of adequate ANC among Afghan women in Iran.Methods: A cross sectional study was conducted between June 2019 and August 2019. Using time location sampling (TLS), we recruited 424 Afghan women aged 18-45 years old at three health centers in south Tehran. A questionnaire was developed based on a preceding qualitative study and literature review. The data were collected on sociodemographic characteristics and the reported reasons for inadequate ANC and analyzed applying bivariate, and multivariate analyses. Factor analysis was performed to reduce the number of potential reasons for inadequate ANC in order to improve the precision of regression analysis. The STATA software version 14 was used for data analysis.Results: Almost a third of Afghan women in this study had adequate ANC (≥ 8 visits). The respondent’s age, education, employment, family income, length of stay, and legal status were the most important determinates of adequate ANC among Afghan women. In multivariate analysis, after adjustment for other variables, only the poor knowledge and attitude toward ANC; poor quality of services; and to some extent, the difficulties in access were the main obstacles in having adequate ANC among the study population. Conclusion: Our study emphasized the important role of specific sociocultural and demographic characteristics on access to ANC among Afghan women in Iran. In fact, these factors need to be considered in future policies and interventions in order to improve the maternal and child health and reduce the birth complications among Afghan population. The collaboration between central government with international agencies should be directed toward enhancing the social support, promoting the awareness and knowledge, and expanding the safety net services for Afghan women in Iran.
Patterns of whole-body muscle activations following vertical perturbations during standing and walking
Authors: Porras Desiderio Cano , Jacobs Jesse V. , Inzelberg Rivka , Bahat Yotam , Zeilig Gabriel , Plotnik Meir 
Published: April 2020

Abstract
Background

Falls commonly occur due to losses of balance associated with vertical body movements (e.g. reacting to uneven ground, street curbs). Research, however, has focused on horizontal perturbations, such as forward and backward translations of the standing surface. This study describes and compares muscle activation patterns following vertical and horizontal perturbations during standing and walking, and investigates the role of vision during the standing postural responses.

Methods

Fourteen healthy participants (ten males; 27±4 years-old) responded to downward, upward, forward, and backward perturbations while standing and walking in a virtual reality (VR) facility containing a moveable platform with an embedded treadmill; participants were also exposed to visual perturbations in which only the virtual scenery moves. We collected bilateral surface electromyography (EMG) signals from 8 muscles (tibialis anterior, rectus femoris, rectus abdominis, external oblique, gastrocnemius, biceps femoris, paraspinals, deltoids). Parameters included onset latency, duration of activation, and activation magnitude. Standing perturbations comprised dynamic-camera (congruent), static-camera (incongruent) and eyes-closed sensory conditions. ANOVAs were used to compare the effects of perturbation direction and sensory condition across muscles.

Results

Vertical perturbations induced longer onset latencies and durations of activation with lower activation magnitudes in comparison to horizontal perturbations. Downward perturbations while standing generated faster activation of rectus femoris and tibialis anterior, whereas biceps femoris and gastrocnemius were faster to respond to upward perturbations. Initial responses to downward and upward perturbations activated trunk/hip flexors and extensors, respectively. Eyes-closed conditions induced longer durations of activation and larger activation magnitudes, whereas static-camera conditions induced longer onset latencies. During walking, downward perturbations promptly activated contralateral trunk and deltoid muscles, and upward perturbations triggered early activation of trunk flexors. Visual perturbations elicited muscle activation in 67.7% of trials.

Conclusion

Our results demonstrate that vertical (vs. horizontal) perturbations generate unique balance-correcting muscle activations with prioritized control of trunk/hip configuration for postural control after vertical perturbations. Availability of visual input appears to affect response efficiency, and incongruent visual input can adversely affect response triggering. Our findings have clinical implications for the design of robotic exoskeletons (to ensure user safety in dynamic balance environments) and for perturbation-based balance and gait rehabilitation.
Ultrasound-guided Quadratus Lumborum Block for Perioperative Analgesia in Robot-assisted Partial Nephrectomy: A Randomized Controlled Trial
Authors: Lai Jielan , Luo Quehua , Liu Yanling , Xue Ruifeng , Huang Yang , Li Yongchun , Lai Renchun 
Published: April 2020

Abstract
Background Recently, several case reports and limited randomized studies have shown that the quadratus lumborum block (QLB) is effective in providing pain relief after intra-abdominal and retroperitoneal operations. Robot-assisted partial nephrectomy (RAPN) has also been proposed as a promising operative treatment for renal carcinoma because it enables early recovery and ambulation. Therefore, we aimed to evaluate the analgesic and opioid-sparing effects of a single-injection QLB, which may paly an important role on early recovery program in RAPN.MethodsFifty-six patients undergoing elective RAPN under general anesthesia were randomised to two equally sized groups. Patients were randomly allocated to receive unilateral QLB (n=28) with 0.375% bupivacaine 0.5 mL/kg (QLB group) or a conventional scheme (n=28) group (Control group). The QLB technique was performed as first described by Blanco, termed QLB2. The primary outcome was the visual analogue scale (VAS) scores with movement at 6 hours postoperatively. The secondary endpoints were the morphine consumption at different time-period after surgery, morphine-related side effects and assessment of postoperative rehabilitation. ResultsBoth VAS pain score and cumulative opioid consumption were significantly lower in the QLB group at 6 hours after surgery as compared with the control group (all P<0.05). There was significant difference in pain scores at any other time-point except at 4 hours on movement and 48 hours at rest. However, no significant difference was observed in 12-48 hours cumulative opioid consumption, and in the duration of PACU and hospital stay between the two groups. The patient recovery scores was significantly higher in the QLB group.ConclusionsSingle-injection pre-emptive QLB applied to RAPN was effective and provided satisfactory analgesia and opioids-sparing in combination with a typical patient-controlled analgesia. In addition, it may provide an effective technique for early recovery in perioperative period.
Quality of life in the Elders has not Been Regarded as much as their Life Span: A Population-Based Study From Iran
Authors: Honarvar Behnam , Khaksar Elahe , Keshavarz Pedram , Movahednejad Yasaman , Banakar Morteza 
Published: April 2020

Abstract
Background

Quality of life (QOL) in the elderly people was not addressed as much as their life expectancy.

Aim

The aim of this study was to evaluate the QOL in the elders.

Method

In this cross-sectional study, the elders were selected by multi-stage cluster random sampling from health centers-covered population of Shiraz, Iran and interviewed individually. The Persian version of the Leiden-Padua (LIEPAD) questionnaire, consisting of core components (CCQOL) and moderators (MQOL) of QOL was used. SPSS software (version 25) was applied for data analysis.

Results

The mean age of 386 participants was 68.12 ± 6.24 years. The female to male ratio was 1.1 and 350 (90.7%) educated up to 12 years. The mean score of QOL (sum of CCQOL and MQOL) was 83.67 ± 13.75 (out of 147); consisting of 27 (6.9%) participants with low, 316 (81.8%) with moderate and 43 (11%) with high level of QOL. The mean scores of CCQOL and MQOL were 70.68 ± 9.42 (out of 93) and 14.14 ± 2.46 (out of 54), respectively. Multivariable analysis showed that sleep disorder (B = -0.15), osteoporosis (B = -0.14), female gender (B = -0.13), and not being the source of family income (B = -0.13) were significantly and inversely associated with QOL, while sleep disorder, facing to violence, female gender, migraine, psychological disease and not being the source of family income were inversely associated with CCQOL. Sexual problem, facing to violence, not having supplementary insurance, inability to walk and migraine had a significant and an inverse correlation with MQOL.

Conclusion

Four out of five elders in the Shiraz region have moderate level of QOL, while the elder females and the elders with chronic diseases, as well as the elders who are not the source of their family income had a lower level of QOL. Quality of life in the elders can be improved through an integrated care program in the health centers.
Comparative analysis of maca (Lepidium meyenii) proteome profiles reveals insights into response mechanisms of herbal plants to high-temperature stress
Authors: Fan Wei , Wang Zhan Qi , Zhao Qi Ming , Zhong Xueting , Xiao Li , Xuan Li , Wu Chou Fei , Zhang Li Qin , Tian Yang 
Published: April 2020

Abstract
Background High-temperature stress (HTS) is one of the main environmental stresses that limit plant growth and crop production in agricultural systems. Maca ( Lepidium meyenii ) is an important high-altitude herbaceous plant adapted to a wide range of environmental stimuli such as cold, strong wind and UV-B exposure. However, it is an extremely HTS-sensitive plant species. Thus far, there is limited information about gene/protein regulation and signaling pathways related to the heat stress response in maca. In this study, proteome profiles of maca seedlings exposed to HTS for 12 h were investigated using a tandem mass tag (TMT)-based proteomic approach. Results In total, 6,966 proteins were identified, of which 379 showed significant alterations in expression following HTS. Bioinformatics analyses indicated that protein processing in endoplasmic reticulum was the most significantly up-regulated metabolic pathway following HTS. Quantitative RT-PCR (qRT-PCR) analysis showed that the expression levels of 21 genes encoding proteins mapped to this pathway were significantly up-regulated under HTS. These results show that protein processing in the endoplasmic reticulum may play a crucial role in the responses of maca to HTS. Conclusions Our proteomic data can be a good resource for functional proteomics of maca and our results may provide useful insights into the molecular response mechanisms underlying herbal plants to HTS.
Factors affecting bone maturation in 423 Chinese girls aged 4-8 years with isolated premature thelarche
Authors: Su Huiping , Su Zhe , Pan Lili , Wang Li , Xu Zhongwei , Peng Gang , Li Xianglei 
Published: April 2020

Abstract
Background: In isolated premature thelarche (IPT) girls, bone age (BA) is considered consistent with chronological age, but IPT girls requiring further investigations show another trend. We analysed BA and possible potentiating factors in girls aged 4-8 years with IPT. Methods: IPT girls aged 4-8 years hospitalized from January 2015 to April 2018 at Shenzhen Children's Hospital were divided into two groups with advanced BA of 2 years as the cutoff. Body mass index (BMI) and hormone levels were the main outcome measures, and regression analysis was used to identify independent risk factors. IPT girls were divided into subgroups seperately according to the levels of BMI standard deviation score (SDS), insulin-like growth factor-1 (IGF-1) SDS and dehydroepiandrosterone sulfate (DHEAS) SDS to compare BA. Results: Overall, 423 subjects were classified into the advanced BA (48.7%, n=206) and control groups (51.3%, n=217). The advanced BA group had significantly higher BMI SDS, DHEAS SDS, IGF-1 SDS, androstenedione and serum fasting insulin and significantly lower sex hormone binding globulin (all p<0.001). IGF-1 SDS (OR=1.642, p＜0.001) and DHEAS SDS (OR=1.125, p=0.021) were independent risk factors for advanced BA. In the multiple linear regression model, IGF-1 SDS, BMI SDS and DHEAS SDS were the strongest predictors of advanced BA, accounting for 18.9% of the variance. According to BMI, 423 patients were classified into three groups: normal weight (56.03%, n=237 ), overweight (19.15%, n=81) and obesity (24.82%, n=105). The proportion of BA advancement in obesity was significantly higher than that of normal weight (χ2=18.088, P＜0.001). In a subgroup with normal weight, higher IGF-1 SDS (p=0.009) and DHEAS SDS (p=0.003) affect BA advancement independent of BMI SDS. Conclusions: Chinese girls aged 4-8 years with IPT requiring further investigations might have significantly advanced BA. Obesity was highly associated with advanced BA. Age-specific serum IGF-1 SDS and DHEAS SDS were risk factors for BA advancement independent of BMI.
Influence of biofilm growth age, media and antibiotics exposure time on Staphylococcus aureus and Pseudomonas aeruginosa biofilm removal in vitro
Authors: Chen Xiaofeng , Xu Yijuan , Winkler Heinz , Thomsen Trine Rolighed 
Published: April 2020

Abstract
Biofilm is known to be tolerant towards antibiotics and difficult to eradicate. Numerous studies have reported Minimum Biofilm Eradication Concentration (MBEC) values of antibiotics for many known biofilm pathogens. However, the experimental parameters applied in these studies differ considerably, and often the rationale behind the experimental design are not well described. This makes it difficult to compare the findings. To demonstrate the importance of experimental parameters, we investigated the influence of biofilm growth age, antibiotic treatment duration and growth media on biofilm eradication in this study.
The commonly used biofilm model Calgary biofilm device was used to grow 24 h and 72 h biofilms of Staphylococcus aureus and Pseudomonas aeruginosa , which were treated with time-dependent vancomycin and concentration-dependent tobramycin, respectively. Two common bacteriological growth media Tryptic Soy Broth (TSB) and Cation-adjusted Mueller Hinton Broth (CaMHB) were tested. We found for both species that biofilms were more difficult to kill in TSB than in CaMHB. Furthermore, young biofilms (24 h) were easier to eradicate than old biofilms (72 h). In agreement with vancomycin being time-dependent, extension of the vancomycin exposure increased killing of S. aureus biofilms. Tobramycin treatment of 24 h P. aeruginosa biofilms was found concentration-dependent and time-independent, however, increasing killing was indicated for 72 h P. aeruginosa biofilms.
This study demonstrated biofilm removal efficacy was influenced by media, biofilm age and antibiotics treatment duration. It is therefore necessary to taking these parameters into consideration when designing experiments.
­­ A modified frozen elephant trunk technique for acute Stanford type A aortic dissection
Authors: Song Shi-bo , Hu Po-yuan , Wu Xi-jie , Sun Yong , Cai Shi-hao , Qiang Feng Hai 
Published: April 2020

Abstract
Background Acute Stanford type A aortic dissection is a lethal event with a high mortality rate and requires emergency intervention. The goal of salvage surgery is to keep the patient alive by addressing the problems of severe aortic regurgitation, tamponade, primary tear and malperfusion of organs,and, if possible, to prevent the late dissection-related complications in the proximal and downstream aorta. No standard treatment or techniques have been determined for this disease. We aim to describe a modified elephant trunk technique for acute type A aortic dissection and report the short-term outcomes of this surgical technique. Methods From February 2018 to August 2019, 16 patients who were diagnosed with acute Stanford type A aortic dissection underwent surgery with the modified frozen elephant trunk technique procedure at Xiamen Heart Centre (9men; age, 59.21±11.67 years). All perioperative variables were recorded and analyzed. We measured the diameters of the ascending aorta, aortic arch and descending aorta on the bifurcation of the pulmonary and abdominal aortas and compared the diameters at admission, before discharge, and 3 months after discharge. Results Fifteen patients (93.8%)had hypertension and poor blood control management. Operative mortality was 6.25%. The primary tears were located in the lesser curve of the aortic arch in 5 patients (31.3%), in the ascending aorta in 9 patients (56.3%), and no entry was found in 2 patients (12.5%). The dissection extended to the iliac artery in 14 patients (87.6%) and to the distal descending aorta in 2 patients (12.5%). The time of cardiopulmonary bypass(CPB),cross-clamping and cerebral perfusion were 215± 40.5,140.8±32.3, and 23±6 minutes, respectively. Aortic valve plasty was performed in 15 patients (93.8%). Additionally, the Bentall procedure and coronary artery repair were performed in 1 patient each (6.3%), respectively. The diameters at all levels were greater before discharge than those when on admission to the hospital, except for the diameter of the aortic arch. After 3 months, the diameters at the aortic arch, descending aorta of the diaphragm, bifurcation of the pulmonary artery had increased, but the diameter at the bifurcation level of the common iliac artery had changed little. Only the diameter of the distal stent aorta had increased significantly. Conclusion The modified frozen elephant trunk technique for acute Stanford type A aortic dissection is safe and feasible, and it could be used for organ malperfusion as well. Short-term outcomes are encouraging, but long-term outcomes require further investigation.
Global identification of genes associated with xylan biosynthesis in cotton fiber
Authors: Chen Feng , Guo Yanjun , Chen Li , Gan Xinli , Liu Min , Li Juan , Xu wenliang 
Published: April 2020

Abstract
Background: Mature cotton fiber secondary wall comprises largely of cellulose (>90%) and small amounts of xylan and lignin. Little is known about the cotton fiber xylan biosynthesis by far. Results: To comprehensively survey biosynthetic enzymes involved in xylan biosynthesis in cotton fiber, the combination of the phylogenetic analysis with expression profile analysis and co-expression analyses allowed us to identify five IRX9, five IRX10, one IRX14, six IRX15, two FRA8, one PARVUS, eight GUX, four GXM, two RWA, two AXY9, 13 TBL genes. In addition, we also identified two GT61 members, two GT47 members, and two DUF579 family members whose homologs in Arabidopsis were not functionally characterized. These 55 genes were regarded as the most probable genes to be involved in fiber xylan biosynthesis. Further experimental validation of one IRX10 like and two FRA8 related genes by complementation analysis indicated that these three genes are able to partially recover the irregular xylem phenotype conferred by the xylan deficiency in the respective Arabidopsis mutant. We presume that these genes are functional orthologs of respective genes that are implicated in GX biosynthesis. Conclusion: The list of 55 cotton genes presented here provides a solid basis to uncover the biosynthesis of xylan in cotton fiber, leading to optimization of the cell wall architecture for fiber improvement.
Evolving Global and National Criteria for Identifying a Suspected Case of COVID-19
Authors: atsawarungruangkit Amporn , Yuan Jin , Kodama Takamitsu , Cheng Ming-Tai , Mansouri Mohammad , Han Boram , Kongkamnerd Jarinrat , Riegg Fabian , Menon Anupama , Moss Steven F. 
Published: April 2020

Abstract
Background: The outbreak of coronavirus disease 2019 (COVID-19) began in December 2019 and is spreading rapidly. Rapid and accurate identification of suspected cases is critical in suppressing viral spread. We aimed to highlight the discrepancies in the varying criteria used by international agencies and highly impacted individual countries worldwide.Methods: The criteria from two international agencies and ten countries across Asia, Europe, and North America were reviewed. Each included information on the clinical causes of illness and epidemiology risk factors. Non-English language guidelines were translated into English by one of the co-authors who was fluent in that language. Results: Although the majority of criteria are modified from the World Health Organization recommendations, the specific clinical features and epidemiological risks for triggering evaluation of COVID-19 in suspected patients differed widely among nations. The rationale for these differences may be linked to each individual country’s resources, politics, experience with previous outbreaks or pandemics, health insurance systems, severity of the COVID-19 situation, and other undetermined factors. Conclusion: There was no consensus on the single best criteria for identifying a suspected case of COVID-19.
Sensitive marker for Evaluation of Hypertensive Heart Disease: Extracellular Volume and Myocardial Strain
Authors: Niu Junqiao , Mu Zeng , Wang Yan , Liu Jun , Wang Jia , Wang Shanshan , Zhou Xiaoyue , Li Hui , Li Yanyu , Hou Feng 
Published: April 2020

Abstract
Background : Evaluation of tissue fibrosis and myocardial hypertrophy in left ventricular (LV) remodeling is the basis of post-treatment evaluation of hypertensive heart disease（HHD). Extracellular volume (ECV) and myocardial strain parameters can indirectly reflect the changes of both. Our objective was to analyze the characteristics of ECV and strain parameters in LV myocardium of HHD with varying degrees of systolic dysfunction, and to explore the changes of both after treatment for hypertension.Methods: A total of 62 HHD patients were divided into 3 groups according to ejection fraction (EF<30%, 30%≦EF<50%, EF≧50%). Twenty-one of these patients underwent cardiac magnetic resonance（CMR）reexamination more than six months after receiving antihypertensive medication. The initial T1 time and post-enhancement T1 time of each segment were measured, and the ECV was calculated. Radial strain (RS), circumferential strain (CS) and longitudinal strain (LS) of LV were measured by cvi42 software, and the differences in CMR parameters between different groups and before and after treatment were compared.Results: ①The mean, basal and middle ECV value of HHD groups with different EF were all higher than that of the control group ( p <0.05), but the difference between HHD groups was not statistically significant. ② With the decrease of EF, the absolute value of both the global or local strain decreased. Strain is related to LVMI and ECV. ③In general, ECV, global RS (GRS) and global CS（GCS） improved after treatment, but the improvement of LS impairment in HHD patients is difficult.Conclusions: ECV and myocardial strain parameters are more sensitive to myocardial abnormalities, and ECV, GRS and GCS are more sensitive to treatment. Although it is difficult to improve longitudinal strain impairment in HHD patients, it is more important for prognosis evaluation. ECV and myocardial strain parameters can be used as good makers for long-term monitoring of the efficacy of HHD patients.