bluuebunny/crossref_metadata_2025_split huggingface dataset:
Response to treatment with Intra-articular triamcinolone hexacetonide and triamcinolone acetonide in oligo articular Juvenile Idiopathic arthritis
Authors: Masoud Rana , Jeelani Wajiha , Agbor Barbine Tchamba Agbor , Hennon Teresa , Wrotniak Brian H , Abdul-Aziz Rabheh 
Published: September 2020

Abstract
Background: Oligo-articular juvenile idiopathic arthritis (Oligo JIA) is the most common subtype of juvenile idiopathic arthritis. Intra-articular corticosteroid (IAC) injection is a mainstay treatment of oligo JIA providing pain relief, improving mobility and preventing further joint destruction in the majority of patients. In 2015, production of triamcinolone hexacetonide (TH) an intra-articular corticosteroid was discontinued in the United States leading to use of triamcinolone acetonide (TA) as an alternative. In this study, we compared response to treatment in children with oligo JIA who underwent therapy with intra-articular TA and TH injection. Methods: Our study is a retrospective chart review of children with oligo JIA who were treated with IAC injections with TH between January 2012 and June 2015 and TA between J uly 2015 and December 2018. The two groups were followed at John R. Oishei Children’s Hospital of Buffalo and were evaluated for response to treatment, side effects and predictors of response including duration of disease before treatment, erythrocyte sedimentation rate (ESR), and c-reactive protein (CRP). Response to treatment was defined as at least 6 months follow up without evidence of active arthritis in injected joints. Patients were considered to be non-responders if they continued to show active arthritis during their first follow up after joint injection. The primary objective was to evaluate whether there was a significant difference in rate of response between TH and TA. Results: Forty-nine patients, 38 female and 11 male with oligo JIA were included in the study. The average age was 6.7 years. A total of 111 joints were injected includin g 78 knees, 13 ankles, 9 wrists, 4 hips, 4 elbows, 2 TMJ and one subtalar joint. In the TA group, 49 % (29/59) did not show response to injection compared to 27 % (14/52) in the TH group. After 6 months, response rates were better for individuals injected with TH compared to TA (73 % vs. 51%). In general, response to intra-articular TH was superior to TA with P = .016 using chi-square test of independence. This difference in outcome was not influenced by other variables such as duration of illness before treatment (P value 0.784) or elevated ESR and CRP. No difference in side effects between the two groups were noted. Conclusion: Our results in conjunction with prior published data suggests that TH intra-articular joint injection in oligo JIA is superior to TA, although future controlled trials are necessary for confirmation. An effective, long lasting treatment can have a great impact on the outcome of these children.
Novel concepts in cervical cancer screening. A comparison of VIA, HPV DNA test and p16INK4a/Ki-67 dual stain cytology in Western Kenya.
Authors: Orang’o Elkanah Omenge , Were Edwin , Rode Oliver , Muthoka Kapten , Byczkowski Michael , Sartor Heike , Broeck Davy Vanden , Schmidt Dietmar , Reuschenbach Miriam , Doeberitz Magnus von Knebel , Bussmann Hermann 
Published: September 2020

Abstract
Background: Screening of unvaccinated women remains essential to mitigate the high morbidity/mortality of cervical cancer. Here, we compared visual inspection with acetic acid (VIA), recommended by WHO as the most cost-effective screening approach in LMICs, with HPV-based screening, and usage of p16INK4a/Ki-67 dual stain cytology.Methods: We prospectively enrolled women participating in a VIA-based cervical cancer screening program in two peri-urban health centers of Kenya. Consenting women had a VIA examination preceded by collection of a liquid-based cytology sample from the cervix stored in PreservCyt medium (Hologic®). Analysis of all samples included a hrHPV DNA test and evaluation of a p16INK4a /Ki-67 (CINtecPLUS®) dual stained slide that was prepared using the ThinPrep® 2000 Processor and evaluated by a pathologist trained in the methodology.Results: In 701 of a total of 800 women aged 18-64 years, all three investigations were performed and data could be analyzed. The HPV, VIA and dual stain cytology positivity were 33%, 7%, and 2% respectively. The HPV positivity rate of VIA positive cases was 32%. The five most common HPV types were HPV16, 52, 68, 58 and 35. The OR among HIV infected women of an HPV infection, VIA positivity and positive dual stain cytology were 2.6 (95%CI 1.5-4.3), 1.9 (95%CI 0.89-4.4) and 3.4 (95%CI 1.07-10.9) respectively. The sensitivity of VIA to detect a p16INK4a/Ki-67 positive transforming infection was 13% (95%CI 2-38). Conclusions: Primary HPV testing appears feasible and should be considered as a primary screening test also in LMICs. The poor sensitivity of VIA renders it unsuitable as a triage test for HPV positive women. The utility of p16INK4a/Ki-67 dual stain cytology as a triage test for HPV positive women in LMICs should be further studied.
Planning of births and childhood undernutrition in Nepal: evidence from a 2016 national survey
Authors: Tiwari Ishwar , Acharya Kiran , Paudel Yuba Raj , Sapkota Bhim Prasad , Kafle Ramesh Babu 
Published: September 2020

Abstract
Background: Childhood undernutrition is a significant public health issue in low-and middle-income countries, including Nepal. However, there is limited evidence showing the association between the planning of birth (PoB) and childhood undernutrition (stunting and underweight). We aimed to investigate the relationship between PoB and childhood undernutrition in the current study.Methods: We used the Nepal Demographic and Health Survey 2016 data, which is a nationally representative cross-sectional household survey. We used two common anthropometric indicators of childhood undernutrition as the outcome of this study. PoB is the main predictor of interest. Binary logistic regression with sampling weights was used to estimate adjusted odds ratios (OR) and 95% confidence intervals to examine the association between the PoB and childhood undernutrition.Results: The overall prevalence of stunting was 35.8%, and underweight was 27.1% in under-five children in Nepal. We found a higher rate of stunting (52.7%) and underweight (41.1%) in children with birth order >3 and <2 years of interval between birth and subsequent birth (IBBSB). The association between the birth order of children and the prevalence of undernutrition had strong statistical significance (p<0.001). Mother’s age at marriage (p=0.001), underweight mother (p<0.001), mother’s education (p<0.001), father’s education (p<0.001), wealth quintile (p<0.001), no exposure to mass media (p<0.001), children’s age (p<0.001), and place of residence(p=0.001) were significantly associated with childhood undernutrition. The result of the multiple logistic regression showed that children with birth order one and 12-24 months of interval between marriage and first birth (IBMFB) had significantly decreased odds of stunting as compared to those children with birth order one and <12 months of IBMFB (OR 0.6, 95% CI 0.4-0.9). Conclusion: The findings of the study demonstrate that PoB has a protective effect on childhood undernutrition. Delaying of childbirth until 12-24 months after marriage was found to be associated with reduced odds of childhood stunting. To mitigate childhood undernutrition, Nepal's government needs to promote delayed childbearing after marriage while focusing on uplifting the household economics status and wide coverage of and utilization of mass media.
The Prevalence and Causes of Visual Impairment among Children in Kenya – The Kenya Eye Study
Authors: Muma Shadrack , Obonyo Stephen 
Published: September 2020

Abstract
Background: Visual impairment is the partial or complete loss of vision and it is attributed to uncorrected refractive error. In Kenya, little attention has been directed towards children vision and causes of visual impairment. Therefore, this study was designed to investigate the prevalence and causes of visual impairment in the children population of Kenya.Methods: This cross-sectional population-based study included 3400 (1800, 52.9% female) randomly selected children with a mean age of 12 ± 2 years (range 5–16 years). Visual acuity was taken using Snellens chart at 6 meters. Anterior and posterior segment was assessed using slit lamp and indirect ophthalmoscope. The World Health Organization definition formed the baseline for calculating the mean prevalence of visual impairment.Results: Visual acuity measurements were available for 3240 (95.3%) participants. The mean prevalence of visual impairment, based on pin-hole value, using World Health Organization definition, was 1.7 ± 0.3%. The prevalence of visual impairment, based on presenting visual acuity value, was 2.4 ± 0.7%, using the World Health Organization definition. Multivariate analysis demonstrated that the presence of visual impairment on pin-hole, according to World Health Organization definition increased significantly with increasing age (odds ratio 1.230, P=.021) and increased uncorrected refractive error (odds ratio 0.834, P = .032). Cases of uncorrected refractive error remained the main cause for presenting visual impairment. Causes of visual impairment due to presenting visual acuity were nystagmus (14%), amblyopia (24%) and uncorrected refractive error (62%).Conclusion: The prevalence of visual impairment in Kenya is associated with age. Uncorrected refractive error remains the major causes of visual impairment.
Gut microbiota and fecal metabolites in captive and wild North China leopard (Panthera pardus japonensis) by comparsion using 16s rRNA gene sequencing and LC/MS-based metabolomics
Authors: Hua Yan , cao Heqin , Wang Jiao , He Fengping , Jiang Guangshun 
Published: September 2020

Abstract
Background: Gut microbes significantly contribute to nutrient digestion and absorption, intestinal health and immunity, and are essential for the survival and environmental adaptation of wild animals. However, there are few studies on the gut microbiota of captive and wild North China leopard (Panthera pardus japonensis). Results: A total of 10 mainly bacterial phyla were identified in the fecal microbiota of North China leopard, Lachnoclostridium (p = 0.003), Peptoclostridium (p = 0.005), Bacteroides (p =0.008), Fusobacterium (p = 0.017) and Collinsella (p = 0.019) were significantly higher than those of wild North China leopard. Distinct differences in the fecal metabolic phenotypes of captive and wild North China leopard were found, such as content of l-methionine, n-acetyl-l-tyrosine, pentadecanoic acid and oleic acid. Differentially abundant gut microbes were associated with fecal metabolites, especially the bacteria in Firmicutes and Bacteroidetes, involved in the metabolism of N-acetyl-L-alanine and D-quinovose.Conclusion: This study reports for the first time the differences in gut microbiota abundance between captive and wild North China leopard, as well as significant differences in fecal metabolic phenotypes between two groups.
Effects of the anesthesiologist's experience on postoperative hoarseness after double-lumen endotracheal tube intubation: A single-center propensity score-matched analysis
Authors: Kamimura Yuji , Nakanishi Toshiyuki , Sato(Boku) Aiji , Osaga Satoshi , Kako Eisuke , Sobue Kazuya 
Published: September 2020

Abstract
Background: Postoperative hoarseness after general anesthesia is associated with patient discomfort and dissatisfaction. A recent large retrospective study showed that single-lumen endotracheal tube intubation by a trainee did not alter the incidence of postoperative pharyngeal symptoms compared with intubation by a senior anesthesiologist. However, there is limited information about the relationship between the anesthesiologist’s experience and hoarseness after double-lumen endotracheal tube intubation. We tested the hypothesis that double-lumen endotracheal tube intubation performed by a trainee increases the incidence of postoperative hoarseness compared to intubation by a senior anesthesiologist.Methods: This retrospective observational study included patients who underwent lung resection between April 2015 and March 2018 at a university hospital. Double-lumen endotracheal tube intubation was carried out with a Macintosh laryngoscope. We divided the patients into two groups - one group comprised of patients who were intubated by a trainee anesthesiologist with < 2 years of experience, and the other group comprised of those who underwent intubation by a senior anesthesiologist with ≥ 2 years of experience. The primary outcome was the incidence of postoperative hoarseness 24 h after surgery and we collected data on postoperative hoarseness using a checklist of postanesthetic adverse events. One-to-one propensity score matching was conducted and P values <0.05 were considered statistically significant.Results: There was a total of 256 eligible patients, of which 153 underwent intubation by trainee anesthesiologists, and the remaining 103 patients were intubated by a senior anesthesiologist. The one-to-one propensity score matching resulted in 96 pairs of patients for the groups. The incidence of postoperative hoarseness 24 h after surgery was significantly higher in patients who were intubated by a trainee anesthesiologist than in patients who were intubated by a senior anesthesiologist (9.4% vs. 2.1%, respectively; P = 0.03).Conclusions: Double-lumen endotracheal tube intubation by trainee anesthesiologists with < 2 years of experience increased the incidence of postoperative hoarseness 24 h after surgery compared to intubation by senior anesthesiologists with ≥ 2 years of experience.
Contributing factors to severe complications after liver resection: an aggregate root cause analysis in 105 consecutive patients.
Authors: Houssaini Kholoud , Lahnaoui Oumayma , Souadka Amine , Majbar Mohamed-Anass , Ghannam Abdelilah , Ahmadi Brahim El , Belkhadir Zakaria , Amrani Leila , Mohsine Raouf , Benkabbou Amine 
Published: September 2020

Abstract
Background: The aggregate root cause analysis (AggRCA) was designed to improve the understanding of system vulnerabilities contributing to patient harm, including surgical complications. It remains poorly used due to methodological complexity and resource limitations. This study aimed to identify the main patterns contributing to severe complications after liver resection using an AggRCA.Methods: This was a retrospective qualitative study aimed to identify the main patterns contributing to severe complications, defined as strictly higher than grade IIIa according to the Clavien-Dindo classification within the first 90 days after liver resection. All consecutive severe complications that occurred between January 1st, 2018 and December 31st, 2019 were identified from an electronic database and included in an AggRCA. This included a structured morbidity and mortality review (MMR) reporting tool based on 50 contributory factors adapted from 6 ALARM categories: “Patient”, “Tasks”, “Individual staff”, “Team”, “Work environment”, and “Management and Institutional context”. Data resulting from individual-participant root cause analysis (RCA) of single-cases were validated collectively then aggregated. The main patterns were suggested from the contributory factors reported in more than half of the cases.Results: In 105 consecutive liver resection cases, 15 patients (14.3%) developed severe postoperative complications, including 5 (4.8%) who died. AggRCA resulted in the identification of 36 contributory factors. Eight contributory factors were reported in more than half of the cases and were compiled in three entangled patterns: (1) Disrupted perioperative process, (2) Unplanned intraoperative change, (3) Ineffective communication.Conclusion: A pragmatic aggregated RCA process improved our understanding of system vulnerabilities based on the analysis of a limited number of events and a reasonable resource intensity. The identification of patterns contributing to severe complications lay the rationale of future contextualized safety interventions beyond the scope of liver resections.
Coal petrology analysis and implications in depositional environments from Upper Cretaceous to Miocene: a study case in the Eastern Cordillera of Colombia
Authors: Guatame Clara , Rincón Marco 
Published: September 2020

Abstract
The Piedemonte Llanero basin is located on the eastern side of the Eastern Cordillera of the Colombian Andes. It has been the subject of numerous geological studies carried out for the oil sector, mainly. This study presents the coal-petrographical features of 15 coal seams of four geological formations from Late Cretaceous to Middle Miocene (Chipaque Formation, Palmichal Group, Arcillas del Limbo Formation, and San Fernando Formation). Analysis of 33 samples indicates enrichment in vitrinite, while liptinite and inertinite concentrations vary according to the stratigraphic position. Reflectance indicates that the coal range gradually decreases from highly volatile bituminous C (Chipaque Formation) to subbituminous C (San Fernando Formation). The microlithotypes with the highest concentrations are clarite and vitrinertoliptite.Maceral composition and coal facies indicate changes in the depositional conditions of the sequence. The precursor peat from Late Cretaceous to Late Paleocene accumulated under limnic conditions followed by telmatic in Late Eocene- Early Miocene. The coal facies indices show wet conditions in forest swamps with variations in the flooding surface, influxes of brackish water and good tissue preservation. The tectonic conditions along the Piedemonte Llanero basin is evident, from post-rift to foreland basin, evidenced by oxic and anoxic periods reflected in the maceral composition and its morphology. The coal environment corresponds to an estuarine system started in the Chipaque Formation evolving to the lacustrine conditions in the San Fernando Formation.
Potential Association Between Bacterial Infections and Ischemic Stroke Based on Fifty Case-Control Studies: A Systematic Review and Meta-Analysis
Authors: Keikha Masoud , Karbalaei Mohsen 
Published: September 2020

Abstract
Background: Stroke is considered as one of the most concerns in health services facilities worldwide, and occurs in two types, ischemic stroke and hemorrhagic stroke. However, almost the three quarters of stroke cases are ischemic stroke which occur in effect of several risk factors such as hypertension, obesity, atherosclerosis, diabetes mellitus, arteritis, and inflammatory response. In recent years, infectious diseases are considered as one of the most important risk factors of ischemic stroke. In this regard, some bacteria causing the chronic infections in particular Chlamydia pneumonia, Helicobacter pylori, Mycoplasma pneumonia, and Mycobacterium tuberculosis get more attended. Methods: In the present meta-analysis, we studied 50 case-control studies and evaluated potential relevance of these infections with creation and development of ischemic stroke. Results: We surveyed the information of 33,978 participants in several nested case-control studies and demonstrated that bacterial infections can increase the risk of ischemic stroke.Conclusions: In this meta-analysis we demonstrated a meaningful relationship between infection by three bacteria C. pneumoniae, H. pylori, and M. tuberculosis with occurrence of ischemic stroke.
Pre-HAART CD4+ T-Lymphocytes as Biomarkers of Post-HAART Immune Recovery in HIV-Infected Children with or without TB Co-Infection
Authors: Gopalakrishnan Vivek , Bose Eliezer , Nair Usha , Cheng Yuwei , Ghebremichael Musie 
Published: September 2020

Abstract
Background Infection with the Human Immunodeficiency Virus (HIV) dramatically increases the risk of developing active tuberculosis (TB). Several studies have indicated that co-infection with TB increases the risk of HIV progression and death. Sub-Saharan Africa bears the brunt of these dual epidemics, with about 2.4 million HIV-infected people living with TB. The main objective of our study was to assess whether the pre-HAART CD4+ T-lymphocyte counts and percentages could serve as biomarkers for post-HAART treatment immune-recovery in HIV-positive children with and without TB co-infection. Methods The data analyzed in this retrospective study were collected from a cohort of 305 HIV-infected children being treated with HAART. A Lehmann family of ROC curves were used to assess the diagnostic performance of pre- HAART treatment CD4+ T-lymphocyte count and percentage as biomarkers for post-HAART immune recovery. The Kaplan–Meier estimator was used to compare differences in post-HAART recovery times between patients with and without TB co-infection.Results We found that the diagnostic performance of both pre-HARRT treatment CD4+ T-lymphocyte count and percentage was comparable and achieved accuracies as high as 74%. Furthermore, the predictive capability of pre-HAART CD4+ T-lymphocyte count and percentage were slightly better in TB-negative patients. Our analyses also indicate that TB-negative patients have a shorter recovery time compared to the TB-positive patients. Conclusions Pre-HAART CD4+ T-lymphocyte count and percentage are stronger predictors of immune recovery in TB-negative pediatric patients, suggesting that TB co-infection complicates the treatment of HIV in this cohort. These findings suggest that the detection and treatment of TB is essential for the effectiveness of HAART in HIV-infected pediatric patients.
Molecular characterization and serodiagnostic potential of two serpin proteins in Psoroptes cuniculi
Authors: Gu Xiaobin , Chen Yuhang , Zhang Chongyang , Xie Yue , Shen Nengxing , Wang Ce , Zhou Xuan , Yang Guangyou , He Ran , Peng Xuerong , Yang Deying , He Zhi , Zhong Zhijun 
Published: September 2020

Abstract
Background: Psoroptes cuniculi is a global common ectoparasite of wild and domestic rabbits and causes an economically devastating loss and serious welfare issues of commercial rabbit husbandry. Serine proteinase inhibitor (Serpin) is present in almost all organisms that are involved in host-pathogen interactions, inflammatory responses, and reproductive development, etc. However, the research on P. cuniculi serpins is still limited.Methods: In this study, two serpin genes of P. cuniculi (Pso c 27 and PsoSP2 cDNAs) were cloned, and the molecular characterization was analyzed. The transcriptional profiles and tissue localization of these two serpins in P. cuniculi were investigated by quantitative real-time PCR and immunohistochemistry, respectively. The potential function of recombinant Pso c 27 and PsoSP2 (rPso c 27and rPsoSP2) in the serodiagnosis of P. cuniculi infestation in rabbits were evaluated by indirect enzyme-linked immunosorbent assay (iELISA). Results: Both of the 523 residue Pso c 27 and the 240 residue PsoSP2 proteins contained typical serpin domains and signatures. Both Pso c 27and PsoSP2 cDNAs expressed throughout the life cycle, more specifically, significantly higher expression in female mites than the larva, nymph, and male mites (p < 0.001). The native Pso c 27 and PsoSP2 localized in ovary and mouthpart of adult female mites, respectively. Compared to rPsoSP2, the rPso c 27 displayed better diagnostic efficiency with higher values of sensitivity, specificity and the area under the receiver operating characteristic curve (AUC) (rPso c 27 - rPsoSP2: 96.0% - 90.0%; 90.91% - 78.18%; 0.988 - 0.964, respectively). Moreover, the rPso c 27 showed seropositive in 80% rabbits as early as the 2nd week post-infestation (p.i.), prior to visible clinical signs and microscopy-positive of skin scrapings. Conclusions: These results suggested that these two serpins may play essential roles in reproductive development, serum-feeding, and pathogenicity of P. cuniculi. Compared to PsoSP2, Pso c 27 appeared as a potential antigen for serodiagnosis of P. cuniculi infestation in rabbits, especially at the early stage of infestation.