bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing breastfeeding experiences between mothers spending the traditional Chinese confinement period in a confinement centre and those staying at home: a cohort study
Authors: Foong Siew Cheng , Tan May Loong , Foong Wai Cheng , Ho Jacqueline J , Rahim Fairuz Fadzilah 
Published: October 2020

Abstract
Background Ethnic Chinese mothers in Malaysia adhere to 30 days of traditional post-partum practices (the “confinement period”) aimed at recuperation after delivery. Recently there has been an emergence of confinement centres (CCs) where mothers stay and receive traditional confinement care. Ethnic Chinese mothers have low breastfeeding rates. There are concerns that practices in CCs could contribute to this but no data exists. We described mother’s breastfeeding experience at CCs and identify areas for potential improvement in breastfeeding support.Methods Ethnic Chinese mothers intending to breastfeed their healthy infants were recruited post-delivery between August and October 2017 then, at 1 and 6 months, were telephone interviewed about their experience. For every participant going to a CC, another mother going home was recruited. Chi-square test was used to compare groups and multiple logistic regression was used to assess the effect of confinement place on exclusive breastfeeding. Results Of 187 mothers, 88(47%) went to CCs. Significantly more were primipara and fewer had previous breastfeeding experience. Response rates for the 1- and 6- month interviews were 88%(CC) versus 97%(home); and 77%(CC) versus 87%(home).Exclusive breastfeeding rates were similar between the groups: 62%(CC) versus 56%(home) at 1 month (p=0.4); and 37%(CC) versus 42%(home) at 6 months (p=0.5). Multiple logistic regression did not show that CCs were a factor affecting exclusive breastfeeding rates at 1 month, (adjusted odds ratio(aOR) 1.7, 95% confidence interval(CI) 0.9, 3.3), or 6 months (aOR 0.9, 95% CI 0.4, 1.7). However, significantly more CC participants only fed expressed breast milk. Despite 66% of CC participants reporting that their centre supported breastfeeding, only 6(8%) CC participants compared to 66(69%) of home participants slept with their baby (p<0.001). The proportion encountering breastfeeding difficulties were similar between groups. CC participants sought help for breastfeeding problems mainly from CC staff and support groups while home participants obtained help from friends and healthcare professionals. Conclusion Breastfeeding rates appeared to be similar at CCs and home but there were gaps in how CCs supported breastfeeding. Targeted training to CC staff to support breastfeeding may result in better outcomes for mothers staying in CCs. Trial registration National Medical Research Register NMRR-17-1174-36384S1
Demographic Features of Identified PLWHA Infected through Commercial and Nonmarital Noncommercial Heterosexual Contact in China from 2015–2018: A Retrospective Cross-Sectional Study
Authors: Dong Zhilong , Ma Liying , Cai Chang , Gao George Fu , Lyu Fan 
Published: October 2020

Abstract
Background:Understanding the demographic characteristics of people living with HIV/AIDS (PLWHA) infected through commercial heterosexual contact (CHC) or nonmarital noncommercial heterosexual contact (NMNCHC) is important for HIV/AIDS prevention and control.Methods:Cases reported through the Chinese HIV/AIDS Case Reporting System (CRS) from 2015 to 2018 were analyzed. A descriptive and preliminary inferential analysis were performed for those demographic characteristics deemed of interest.Results:Overall, 523,121 identified PLWHA between 2015 and 2018 in the CRS were analyzed. The constituent ratio of heterosexual transmission increased from 66.25% in 2015 to 71.48% in 2018. The proportion of CHC heterosexual transmission decreased from 40.18% in 2015 to 37.99% in 2018, while that of NMNCHC increased from 46.33% in 2015 to 49.02% in 2018. Those who were infected through NMNCHC were significantly younger than people infected through CHC (Student’s t test, P<0.0001), with an average age gap ranging from 5.63 (2015) to 7.46 (2018) years. The frequency of newly identified PLWHA who were infected through CHC had a remarkable increase among the ages of 65 and above. During the study years, the average age of the two groups increased annually. Gender distribution was significantly different between CHC and NMNCHC (χ2 test, P<0.0001), and the ratio of men to women in the NMCHC group was 1.50:1 (2015), 1.51:1 (2016), 1.54:1 (2017), and 1.52:1 (2018), while in the commercial heterosexual contact (CHC) group, these ratios were 11.45:1 (2015), 12.08:1 (2016), 12.53:1 (2017), and 13.28:1 (2018). Marital status was significantly different between CHC and NMNCHC (χ2 test, P<0.0001), and the married proportion of NMNCHC increased from 49.1% (2015) to 51.02% (2018). As the educational level improved, the proportion of NMNCHC also increased (Cochran - Armitage test, P<0.0001).Conclusions:We found that heterosexual transmission was the primary mode of HIV transmission in China from 2015 to 2018. PLWHA infected through CHC and NMNCHC had different characteristics in age, gender, marital status, and educational level. The frequency of PLWHA infected through CHC increased substantially in the age group of 65 and above. This study provides useful baseline data for future studies on the heterosexual transmission of HIV in China.
Atraumatic Restorative Treatment compared to the Hall Technique for occluso-proximal carious lesions in primary molars; 36-month follow-up of a randomised control trial in a school setting
Authors: Araujo Mariana Pinheiro , Innes Nicola Patricia , Bonifácio Clarissa Calil , Hesse Daniela , Olegário Isabel Cristina , Mendes Fausto Medeiros , Raggio Daniela Prócida 
Published: October 2020

Abstract
Background:Atraumatic Restorative Treatment (ART) and the Hall Technique (HT) are both minimally invasive, non-aerosol generating procedures (non-AGPs). They seem to have never been directly compared, nor has the HT been studied in a non-clinical setting. This study compared the HT and ART restorations placed in a school setting after 36 months.Methods:Children (5-10 yo) who had a primary molar with an occluso-proximal carious lesion were allocated to the ART or HT arms. Primary outcome: restoration survival over 36-months (using Kaplan-Meier survival analysis, log rank test, and Cox regression). Secondary outcomes: 1) occlusal vertical dimension (OVD) (1, 2, 3, 4 weeks) and 2) child self-reported discomfort; 3) treatment acceptability (immediately following interventions); 4) Child Oral Health Related Quality of Life (OHRQoL), before treatment and after 6 months and 5) a post-hoc analysis of time to tooth exfoliation (1, 6, 12, 18, 24, 30, 36 months).Results:One-hundred and thirty-one children (ART=65; HT=66) were included (mean age=8.1±1.2). At 36 months, 112 (85.5%) children were followed-up. Primary outcome: restoration survival rates ART=32.7% (SE=0.08; 95%CI=0.17-0.47); HT=93.4% (0.05; 0.72-0.99), p<0.001; Secondary outcomes: 1) OVD returned to pre-treatment state within 4 weeks; 2) treatment discomfort was higher for the HT (p=0.018); 3) over 70% of children and parents showed a high acceptability for treatments, with crown aesthetics being a concern for around 23% of parents; 4) Child OHRQoL improved after six months; and 5) teeth treated with the HT exfoliated earlier than those in the ART group (p=0.007).Conclusions:Both ART and the HT were acceptable to child participants and their parents and all parents thought both restorations protected their child’s tooth. However, the crown appearance concerned almost a quarter of parents in the HT arm. Children experienced less discomfort in the ART group. Although both treatments can be performed in a non-clinical setting and have the advantage of being non-aerosol generating procedures (non-AGPs), the HT had almost three times higher survival rates (93.4%) for restoring primary molar occluso-proximal cavities compared to ART (32.7%).Trial registration: This trial was registered in ClinicalTrials.gov (NCT02569047), 5th October 2015. https://clinicaltrials.gov/ct2/show/study/NCT02569047?cond=Hall+Technique+Atraumatic+Restorative+Treatment&draw=2&rank=2 Protocol: Hesse D, de Araujo MP, Olegário IC, Innes N, Bonifácio CC, Raggio DP. Atraumatic Restorative Treatment compared to the Hall Technique for occluso-proximal cavities in primary molars: study protocol for a randomized controlled trial. Trials 2016 Mar 31;17:169.
What Factors Contribute to High Mechanical Strength of Tabia? Case Study of the Tabia from Coastal Forts Sites at Zhejiang, China
Authors: Zhang Cuisong , Zhang Bingjian , Cui Biao , Lin Guocong 
Published: October 2020

Abstract
Tabia is one of the most widely used construction materials in ancient China. In this work, the tabia samples from three coastal defense fort sites at Zhejiang Province, China, we analyzed to determine their component composition and physiochemical properties. The results show that these tabia samples exhibited high compressive strength, which could be as high as 4-9 MPa. Furthermore, the systematic analysis demonstrated that the high compressive strength was related to the following factors: 1) a suitable mass ratio of sand, lime, and clay; 2) an appropriate sand particle size ratio; and 3) the formation of hydrated calcium silicate (C-S-H). Moreover, sticky rice was also detected in the tabia samples. These findings are fundamentally important, which could be beneficial to further study of the craftsmanship of the coastal defense forts and could further provide essential guidance for the protection and restoration of the tabia relics.
Association between post-traumatic stress disorder symptoms and bone fractures after the Great East Japan Earthquake in older adults: a prospective cohort study from the Fukushima Health Management Survey
Authors: Hayashi Fumikazu , Ohira Tetsuya , Nakano Hironori , Nagao Masanori , Okazaki Kanako , Harigane Mayumi , Yasumura Seiji , Maeda Masaharu , Takahashi Atsushi , Yabe Hirooki , Suzuki Yuriko , Kamiya Kenji 
Published: October 2020

Abstract
Background Psychological stress has been known to affect bone metabolism and increase fracture risk. However, the association between post-traumatic stress disorder (PTSD) and bone fractures remains unclear. The current study aimed to clarify the effects of disaster-induced PTSD symptoms on fracture risk in older adults.Methods This study analyzed responses from 17,474 individuals aged ≥65 without a history of fractures at the time of the Great East Japan Earthquake who answered the Mental Health and Lifestyle Survey component of the Fukushima Health Management Survey conducted in 2011. Obtained data were able to determine the presence or absence of fractures until 2016. Age, sex, physical factors, social factors, psychological factors, and lifestyle factors were subsequently analyzed. Survival analysis was then performed to determine the relationship between each factor and fractures. Thereafter, univariate and multivariate Cox proportional hazard models were constructed to identify fracture risk factors.Results A total of 2,097 (12.0%) fractures occurred during the follow-up period. Accordingly, univariate and multivariate Cox proportional hazard models showed that PTSD symptoms (total PTSD checklists scoring ≥ 44) [hazard ratio (HR): 1.26; 95% confidence interval (CI): 1.10–1.44; P = 0.001], history of cancer (HR: 1.49; 95% CI: 1.24–1.79; P < 0.001), history of stroke (HR: 1.25; 95% CI: 1.03–1.52; P = 0.023), history of heart disease (HR: 1.30; 95% CI: 1.13–1.50; P < 0.001), history of diabetes (HR: 1.23; 95% CI: 1.09–1.39; P < 0.001), current smoking (HR: 1.29; 95% CI: 1.02–1.63; P = 0.036), and high dissatisfaction with sleep or no sleep at all (HR: 1.33; 95% CI: 1.02–1.74; P = 0.035) promoted a significant increase in fracture risk independent of age and sex.Conclusions The present study indicates that disaster-induced PTSD symptoms and insomnia contribute to increased fracture risk among older adults residing in evacuation areas within Fukushima Prefecture.
The potential role of serum angiotensin-converting enzyme in coronavirus disease 2019
Authors: Zhu Zhe , Cai Ting , Fan Lingyan , Lou Kehong , Hua Xin , Huang Zuoan , Gao Guosheng 
Published: October 2020

Abstract
Objective To explore the clinical significance of serum angiotensin-converting enzyme (ACE) activity in coronavirus disease 2019 (COVID-19).Methods In this retrospective study, a total of 136 consecutive patients with confirmed COVID-19 were recruited. Demographic and clinical data were recorded. The serum ACE activity was measured at baseline and during the recovery phase, and its relationship with clinical condition was analyzed.Results Of the 136 patients with confirmed COVID-19, the 16 severe patients were older and had a higher body mass index (BMI) and proportion of hypertension than the 120 nonsevere patients. In comparison to those of normal controls, the baseline serum ACE activities of subjects in the severe group and nonsevere group were decreased, with the lowest level in the severe group. However, the serum ACE activity increased in the recovery phase, and there were no significant differences among the severe group, nonsevere group and normal control group.Conclusion Serum ACE activity could be used as a marker to reflect the clinical condition of COVID-19 since low activity was associated with the severity of COVID-19 at baseline, and the activity increased with the remission of the disease.
Surgical treatment of 125 cases of congenital diaphragmatic eventration in a single institution
Authors: Zhao Shengliang , Pan Zhengxia , Li Yonggang , An Yong , Zhao Lu , Jin Xin , Fu Jian , Wu Chun 
Published: October 2020

Abstract
Backgrounds: This study sought to investigate the clinical characteristics of congenital diaphragmatic eventration (CDE) and to compare the efficacies of thoracoscopy and traditional open surgery in infants with CDE. Methods: This study sought to investigate the clinical characteristics of congenital diaphragmatic eventration (CDE) and to compare the efficacies of thoracoscopy and traditional open surgery in infants with CDE. Results: A total of 108 children in this group underwent surgery, of whom 67 underwent open surgery and 41 underwent thoracoscopic diaphragmatic plication. A total of 107 patients recovered well postoperatively, except for 1 patient who died due to respiratory distress after surgery. After 1-9.5 years of follow-up, 107 patients had significantly improved preoperative symptoms. During follow-up, the location of the diaphragm was normal, and no paradoxical movement was observed. Eleven of the 17 children who did not undergo surgical treatment did not have a decrease in diaphragm position after 1-6 years of follow-up. The index data on the operation time, intraoperative blood loss, chest drainage time, postoperative mechanical ventilation time, postoperative hospital stay and postoperative CCU admission time were better in the thoracoscopy group than in the open group. The difference between the two groups was statistically significant (P<0.05). Conclusions: The clinical symptoms of congenital diaphragmatic eventration vary in severity. Patients with severe symptoms should undergo surgery. Both thoracoscopic diaphragmatic plication and traditional open surgery can effectively treat congenital diaphragmatic eventration, but compared with open surgery, thoracoscopic diaphragmatic plication has the advantages of a short operation time, less trauma, and a rapid recovery.　Thus, thoracoscopic diaphragmatic plication should be the first choice for children with congenital diaphragmatic eventration.
Association of shared decision making with inpatient satisfaction: A cross-sectional study
Authors: Luo Huiwen , Liu Guohua , Lu Jing , Xue Di 
Published: October 2020

Abstract
Background: We assessed inpatient perceived shared decision making (SDM) and tested the association of SDM with inpatient satisfaction in public tertiary hospitals in Shanghai, China.Methods: A cross-sectional survey was of 2585 inpatients in 47 public tertiary hospitals in Shanghai in July and August 2018 was conducted. We assessed overall SDM and 4 aspects of SDM and tested the factors influencing SDM and the association of SDM with patient satisfaction (patient satisfaction with physician services, medical expenses, outcomes and overall inpatient care), by adopting linear or two-level regression models.Results: The positive response rate (PRR) and high positive response rate (HPRR) to overall SDM among the inpatients of public tertiary hospitals in Shanghai were relatively high (95.30% and 87.86%, respectively), while the HPRR to “My physician informed me of different treatment alternatives” was relatively low (80.09%). In addition, the inpatients who underwent surgery during admission had higher HPRRs and adjusted HPRRs to overall SDM than those who did not undergo surgery. The study showed that the adjusted high satisfaction rates (HSRs) with physician services, medical expenses, outcomes and overall inpatient care among the inpatients with high level of overall SDM were higher (96.50%, 68.44%, 89.50% and 92.60%) than those among the inpatients without a high level of overall SDM (71.77%, 35.19%, 57.30% and 67.49%). The greatest differences in the adjusted HSRs between the inpatients with and without a high level of SDM were found in inpatient satisfaction with medical expenses and informed consent in SDM. Moreover, 46.22% of the variances in the HSRs with overall inpatient care across the hospitals were attributed to the hospital type (general hospitals vs. specialty hospitals).Conclusions: Inpatient PRRs and HPRRs to SDM in public tertiary hospitals in Shanghai are relatively high overall but lower to information regarding alternatives. SDM can be affected by the SDM preference of both the patients and physicians and medical condition. Patient satisfaction can be improved through better SDM and should be committed at the hospital level.
Are lifestyle factors significantly associated with self-rated health among Japanese female healthcare students?
Authors: Ohtsuki Makoto , Wakasugi Yusuke , Narukawa Takuhiro , Uehara Shunsuke , Ohkubo Takeshi 
Published: October 2020

Abstract
Background: Self-rated health (SRH), a subjective perception of an individual’s overall health, is widely used in public health assessment. The transition from adolescence to young adulthood is a critical period involving substantial changes in lifestyle and dietary habits. Therefore, it is important to understand SRH among young Japanese females. The present study aimed to investigate the relationships between SRH among female healthcare students and their lifestyle factors, such as living status (living with others or living alone), smoking habit, alcohol consumption, frequency of breakfast consumption (FBC), physical activity, insomnia, and physique recognition.Methods: A cross-sectional survey was conducted among a total of 1101 female healthcare students in Japan. Body mass index was calculated from body height and weight using data from periodic health examinations. Lifestyle habits, physical activity, and SRH were self-reported using several previously validated scales. Participants were classified as having either good SRH (excellent, very good, or good) or impaired SRH (fair or poor). Multivariate logistic regression analysis was performed to investigate independent relationships between SRH and lifestyle factors after adjusting for grade level.Results: We observed that 11.4% of the participants demonstrated impaired SRH. Participants with grade ≥3 showed a significantly higher percentage (13.9%) of impaired SRH compared with those with grades 1-2 (p < 0.05). Logistic regression analysis revealed that grade level, smoking habit, FBC, University of California Los Angeles activity score, Athens Insomnia Scale, and physique recognition were associated with SRH.Conclusions: Our results suggest that young Japanese females believe that skipping breakfast, smoking, lack of exercise, and insomnia are unhealthy, whereas a slender physique is healthy.
Application of Ex Vivo Liver Resection Followed by the Autotransplantation Technique in Radical Resection of Gastric Cancer Liver Metastases: A Case Report
Authors: Wang Hong , Zhang Chengcheng , Ou Yanjiao , Zhang Leida 
Published: October 2020

Abstract
Background: Radical resection of gastric cancer liver metastases can increase the 5-year survival rate of GCLM patients. However, patients may lose the theoretical feasibility of surgery due to the critical location of liver metastasis in some cases.Case presentation: A 29-year-old female had a chief complaint of chronic abdominal pain for one year. Abdominal CT and MRI examinations suggested a mass of unknown pathological nature located between the first and second hila and the margin of the lower segment of the right lobe of the liver. The anterior wall of the gastric antrum was unevenly thickened. The diagnosis of (gastric antrum) intramucosal well-differentiated adenocarcinoma was histopathologically confirmed by puncture biopsy with gastroscopy guidance. She underwent radical resection（excision of both gastric tumors and ELRA simultaneously）followed by XELOX adjuvant chemotherapy. Without serious postoperative complications, the patient was successfully discharged on the 20th day after the operation. Pathological examination of the excised specimen indicated that gastrectomy with D2 lymph node dissection for primary gastric tumors and R0 resection for liver metastases were achieved. The resected mass was confirmed to be poorly differentiated gastric carcinoma (hepatoid adenocarcinoma with neuroendocrine differentiation) with liver metastases in segments VIII. No recurrence or metastasis within the liver was found during a 7.5-year follow-up review that began one month after surgery.Conclusions: Application of ELRA in radical resection for GCLM can help selected patients with intrahepatic metastases located in complex sites obtain a favorable clinical outcome.