bluuebunny/crossref_metadata_2025_split huggingface dataset:
schema: an open-source, distributed mobile platform for deploying mHealth research tools and interventions
Authors: Shatte Adrian B. R. , Teague Samantha J. 
Published: April 2020

Abstract
Background
Mobile applications for health, also known as ‘mHealth apps’, have experienced increasing popularity over the past ten years. However, most publicly available mHealth apps are not clinically validated, and many do not utilise evidence-based strategies. Health researchers wishing to develop and evaluate mHealth apps may be impeded by cost and technical skillset barriers. As traditionally lab-based methods are translated onto mobile platforms, robust and accessible tools are needed to enable the development of quality, evidence-based programs by clinical experts.

Results
This paper introduces schema, an open-source, distributed, app-based platform for researchers to deploy behavior monitoring and health interventions onto mobile devices. The architecture and design features of the platform are discussed, including flexible scheduling, randomisation, a wide variety of survey and media elements, and distributed storage of data. The platform supports a range of research designs, including cross-sectional surveys, ecological momentary assessment, randomised controlled trials, and micro-randomised just-in-time adaptive interventions. Use cases for both researchers and participants are considered to demonstrate the flexibility and usefulness of the platform for mHealth research.

Conclusions
The paper concludes by considering the strengths and limitations of the platform, and a call for support from the research community in areas of technical development and evaluation. To get started with schema, please visit the GitHub repository: https://github.com/schema-app/schema.
Efficacy of gastric decompression after pancreatic surgery: a systematic review and meta-analysis
Authors: Gao Jia , Liu Xinchun , Wang Haoran , Ying Rongchao 
Published: April 2020

Abstract
Background
Gastric decompression after pancreatic surgery has been a routine procedure for many years. However, this procedure has often been waived in non-pancreatic abdominal surgeries. The aim of this meta-analysis was to determine the necessity of routine gastric decompression (RGD) following pancreatic surgery.

Methods
PubMed, the Cochrane Library, EMBASE, and Web of Science were systematically searched to identify relevant studies comparing outcomes of RGD and no gastric decompression (NGD) after pancreatic surgery. The overall complications, major complications, mortality, delayed gastric emptying (DGE); clinically relevant DGE (CR-DGE), postoperative pancreatic fistula (POPF), clinically relevant POPF (CR-POPF), secondary gastric decompression, and the length of hospital stay were evaluated.

Results
A total of six comparative studies with a total of 940 patients were included. There were no differences between RGD and NGD groups in terms of the overall complications (OR = 1.73, 95% CI: 0.60–5.00; p = 0.31), major complications (OR = 2.22, 95% CI: 1.00–4.91; p = 0.05), incidence of secondary gastric decompression (OR = 1.19, 95% CI: 0.60–2.02; p = 0.61), incidence of overall DGE (OR = 2.74; 95% CI: 0.88–8.56; p = 0.08; I2 = 88%), incidence of CR-POPF (OR = 1.28, 95% CI: 0.76–2.15; p = 0.36), and incidence of POPF (OR = 1.31, 95% CI: 0.81–2.14; p = 0.27). However, RGD was associated with a higher incidence of CR-DGE (OR = 5.45; 95% CI: 2.68–11.09; p < 0.001, I2 = 35%), a higher rate of mortality (OR = 1.53; 95% CI: 1.05–2.24; p = 0.03; I2 = 83%), and a longer length of hospital stay (WMD = 5.43, 95% CI: 0.30 to 10.56; p = 0.04; I2 = 93%).

Conclusions
Routine gastric decompression in patients after pancreatic surgery was not associated with a better recovery, and may be unnecessary after pancreatic surgery.
Prevalence of molecular markers associated with drug resistance of Plasmodium vivax isolates in Western Yunnan Province, China
Authors: Wang Xiaoxiao , Ruan Wei , Zhou Shuisen , Feng Xinyu , Yan He , Huang Fang 
Published: April 2020

Abstract
Background
Plasmodium vivax is the most widely distributed malaria parasite, and its drug resistance poses unique challenges to malaria elimination. The Greater Mekong Subregion (GMS) is known as the global epicenter of multidrug resistance. Surveillance of molecular markers associated with drug resistance in this area will help to inform drug policy.

Methods
Dry blood spots from 58 patients out of 109 with P. vivax infection between 2017, December and 2019, March were obtained from Yingjiang County, Yunnan Province, along the China–Myanmar border. Pvdhfr, Pvdhps, Pvmdr1 and Pvcrt-o were amplified and sequenced to assess gene mutations. The polymorphism and prevalence of these molecular markers were analyzed.

Results
Mutations in Pvdhfr at codons 57, 58, 61, 99 and 117 were detected in 27.59, 48.28, 27.59, 32.76 and 48.28% of the isolates, respectively. Single mutant haplotype (I13F57S58T61S99S117I173) was the most frequent (29.31%, 17/58), followed by double mutant haplotype (20.69%, 12/58). Of three types of tandem repeat variations of Pvdhfr, deletion type was the most common. Pvdhps showed a lower prevalence among mutation genotypes. Single mutant was dominant and accounted for 34.48% (20/58). Prevalence of Pvmdr1 mutations at codons 958 and 1076 were 100.00% and 84.48%, respectively. The proportion of double and single mutant types was 84.48% (49/58) and 15.52% (9/58), respectively. Eleven samples (18.97%, 11/58) showed K10 “AAG” insertion in chloroquine resistance transporter gene Pvcrt-o.

Conclusions
There was moderate diversity of molecular patterns of resistance markers of Pvdhfr, Pvdhps, Pvmdr1 and Pvcrt-o in imported P. vivax cases to Yingjiang county in Western Yunnan, along the China–Myanmar border. Prevalence and molecular pattern of candidate drug resistance markers Pvdhfr, Pvdhps, Pvmdr1 and Pvcrt-o were demonstrated in this current study, which would help to update drug policy.
Individual and household correlates of Helicobacter pylori infection among Young Ethiopian children in Ziway, Central Ethiopia
Authors: Schacher Kayla , Spotts Hannah , Correia Caroline , Walelign Sosina , Tesfaye Mehret , Desta Kassu , Tsegaye Aster , Taye Bineyam 
Published: April 2020

Abstract
Background
Investigating distinct individual- and household-level risk factors for acquiring Helicobacter pylori (H. pylori) infection can inform disease prevention efforts and implicate possible routes of transmission. This study determined the magnitude of H. pylori infection among schoolchildren in Ziway, central Ethiopia and identified personal and household correlates of H. pylori infection in young Ethiopian children.

Methods
A total of 434 schoolchildren participated in this cross-sectional study. Infection status was assessed using antigen and antibody rapid tests. Demographic and lifestyle information was obtained from parents via an interviewer-led questionnaire. Univariate and multivariate logistic regressions were performed to assess the relationships between potential individual- and household-level risk factors and H. pylori infection.

Results
The prevalence of H. pylori infection was 65.7% (285/434). Of the personal variables assessed, the age group 10–14 years was found to be significantly associated with higher odds of H. pylori infection in univariate analysis (COR = 2.22, 95% CI: 1.06–4.66, p = 0.03) and remained positively correlated after adjusting for confounding factors. Of the household-level factors explored, having a traditional pit or no toilet was found to be significantly associated with 3.93-fold higher odds of H. pylori infection (AOR = 3.93, 95% CI: 1.51–10.3, p = 0.01), while the presence of smokers in the household was associated with 68% lower odds of infection (AOR = 0.32, 95% CI: 0.11–0.89, p = 0.03).

Conclusion
This study from a developing country provides additional evidence for older age as a personal risk factor for H. pylori infection and identifies correlations between socioeconomic and sanitation household factors and positive childhood infection status. The associations reported here support the hypothesized fecal-oralroute of transmission for H. pylori.
A quantitative MRI index for assessing the severity of hippocampal sclerosis in temporal lobe epilepsy
Authors: Dou Wanchen , Zhao Lei , Su Changbao , Lu Qiang , Liu Qi , Guo Jinzhu , Zhao Yuming , Luo Yishan , Shi Lin , Zhang Yiwei , Wang Renzhi , Feng Feng 
Published: April 2020

AbstractBackgroundHippocampal sclerosis (HS) is associated with post-surgery outcome in patients with temporal lobe epilepsy (TLE), and an automated method that quantifies HS severity is still lacking. Here, we aim to propose an MRI-based HS index (HSI) that integrates hippocampal volume and FLAIR signal to measure the severity of HS.MethodsForty-two pre-surgery TLE patients were included retrospectively, with T1-weighted (T1W) and FLAIR images acquired from each subject. Two experienced neurosurgeons (W.D. and C.S.) and one neurologist (Q.L.) rated HS severity with a four-class grading scale (normal, mild, moderate and severe) based on both hippocampal volume loss and increased FLAIR signal. A consensus of HS severity for each subject was made by voting among the three visual rating results. Regarding the automatic quantification, the hippocampal volume was quantified by AccuBrain on T1W image, and the FLAIR signal of hippocampus was calculated as the mean intensity of hippocampal region on the FLAIR image (normalized by the mean intensity of gray matter). To fit the HSI from visual rating, we applied ordinal regression with the voted visual rating as the dependent variable, and hippocampal volume and FLAIR signal as the independent variables. The HSI was calculated by weighting the predicted probabilities of the four-class grading scales from ordinal regression.ResultsThe intra-class correlation coefficient (single measure) of the three raters was 0.806. The generated HSI was significantly correlated with the visual rating scales of the three raters (W.D.: 0.823, Q.L.: 0.817, C.S.: 0.717). HSI scores well differentiated the different HS categories as defined by the agreed HS visual rating (normal vs. mild:p < 0.001, mild vs. moderate:p < 0.001, moderate vs. severe:p = 0.001).ConclusionsThe proposed HSI was consistent with visual rating scales from epileptologists and sensitive to HS severity. This MRI-based index may help to evaluate HS severity in clinical practice. Further validations are needed to associate HSI with post-surgery outcomes.
The fertility willingness and acceptability of preimplantation genetic testing in Chinese patients with autosomal dominant polycystic kidney disease
Authors: Sun Mingji , Xue Cheng , Lu Yunhui , Ma Yiyi , Pan Ting , Wang Xiaoliu , Fan Li , Shen Jiandong , Hao Yan , Zheng Danxia , Li Junhua , Li Mingxu , He Yaping , Mei Changlin 
Published: April 2020

Abstract
Background
With the development and progression of genetic technology, preimplantation genetic testing (PGT) has made it possible to block the inheritance of autosomal dominant polycystic kidney disease (ADPKD) as early as possible. However, we need to know the patients’ fertility intentions and their acceptance of PGT.

Methods
A questionnaire survey was conducted to collect data on the basic demographic data, quality of life, social support, fertility willingness, and level of understanding of genetic testing for blocking the inheritance of ADPKD among patients aged 18–45 years in seven hospitals from January 2018 to December 2018. After verification, statistics were calculated.

Results
A total of 260 patients with ADPKD were interviewed, including 137males (52.7%) and 123 females (47.3%). The overall fertility willingness rate was low (n = 117, 45.0%). The proportion of married patients aged 25–34 years that were at the optimal reproductive age but did not yet have children was relatively high (n = 77, 67.0%). The fertility intentions of ADPKD patients were significantly influenced by age (OR: 0.101, 95% CI 0.045–0.225, P < 0.001) and education level (OR: 2.134, 95% CI 1.162–3.917, P = 0.014). Among patients who are willing to have children, 207 (79.6%) of them would choose PGT technology. Among those who were not sure whether they would choose PGT technology, the first major concern was technical safety (49.2%).

Conclusions
The reproductive desire of childbearing ADPKD patients in China was low. Strengthening the health education of ADPKD genetic knowledge and reducing the cost of related technologies may improve the fertility intentions and reduce the barriers to acceptance of PGT.
Roles of peritoneal clearance and residual kidney removal in control of uric acid in patients on peritoneal dialysis
Authors: Xiao Xi , Ye Hongjian , Yi Chunyan , Lin Jianxiong , Peng Yuan , Huang Xuan , Wu Meiju , Wu Haishan , Mao Haiping , Yu Xueqing , Yang Xiao 
Published: April 2020

Abstract
Background
There have been few systematic studies regarding clearance of uric acid (UA) in patients undergoing peritoneal dialysis (PD). This study investigated peritoneal UA removal and its influencing factors in patients undergoing PD.

Methods
This cross-sectional study enrolled patients who underwent peritoneal equilibration test and assessment of Kt/V from April 1, 2018 to August 31, 2019. Demographic data and clinical and laboratory parameters were collected, including UA levels in dialysate, blood, and urine.

Results
In total, 180 prevalent patients undergoing PD (52.8% men) were included. Compared with the normal serum UA (SUA) group, the hyperuricemia group showed significantly lower peritoneal UA clearance (39.1 ± 6.2 vs. 42.0 ± 8.0 L/week/1.73m2; P = 0.008). Furthermore, higher transporters (high or high-average) exhibited greater peritoneal UA clearance, compared with lower transporters (low or low-average) (42.0 ± 7.0 vs. 36.4 ± 5.6 L/week/1.73 m2; P < 0.001). Among widely used solute removal indicators, peritoneal creatinine clearance showed the best performance for prediction of higher peritoneal UA clearance in receiver operating characteristic curve analysis [area under curve (AUC) 0.96; 95% confidence interval [CI], 0.93–0.99]. Peritoneal UA clearance was independently associated with continuous SUA [standardized coefficient (β), − 0.32; 95% CI, − 6.42 to − 0.75] and hyperuricemia [odds ratio (OR), 0.86; 95% CI, 0.76–0.98] status, only in patients with lower (≤2.74 mL/min/1.73 m2) measured glomerular filtration rate (mGFR). In those patients with lower mGFR, lower albumin level (β − 0.24; 95%CI − 7.26 to − 0.99), lower body mass index (β − 0.29; 95%CI − 0.98 to − 0.24), higher transporter status (β 0.24; 95%CI 0.72–5.88) and greater dialysis dose (β 0.24; 95%CI 0.26–3.12) were independently associated with continuous peritoneal UA clearance. Furthermore, each 1 kg/m2 decrease in body mass index (OR 0.79; 95% CI 0.63–0.99), each 1 g/dL decrease in albumin level (OR 0.08; 95%CI 0.01–0.47), and each 0.1% increase in average glucose concentration in dialysate (OR 1.56; 95%CI 1.11–2.19) were associated with greater peritoneal UA clearance (> 39.8 L/week/1.73m2).

Conclusions
For patients undergoing PD who exhibited worse residual kidney function, peritoneal clearance dominated in SUA balance. Increasing dialysis dose or average glucose concentration may aid in controlling hyperuricemia in lower transporters.
Impact of the systematic use of the volume-viscosity swallow test in patients with acute ischaemic stroke: a retrospective study
Authors: Liu Zhu-Yun , Zhang Xiao-Pei , Mo Miao-Miao , Ye Ri-Chun , Hu Cai-Xia , Jiang Min-Qing , Lin Man-Qiu 
Published: April 2020

Abstract
Background
Dysphagia is common after stroke. Patients with dysphagia have a higher risk of stroke-associated pneumonia (SAP) and poor outcomes. Early detection of dysphagia is necessary to identify and manage patients at high risk of aspiration. The aim of the study was to assess the impact of the systematic administration of the volume-viscosity swallow test (V-VST) in patients with acute ischaemic stroke.

Methods
This was a retrospective observational study that enrolled patients with acute ischaemic stroke in two consecutive time periods: pre-V-VST, when the 30-mL water-swallowing test (WST) was systematically administered, and V-VST, when all patients underwent the WST and the V-VST test was systematically administered if the patient failed the WST.

Results
Two hundred and 42 patients were enrolled. The mean age of the participants was 68.8 ± 10.88 years, 61.2% were male, and the median National Institutes of Health Stroke Scale score was 3 (IQR, 1–6). A total of 147 patients were enrolled during the pre-V-VST period and 95 were enrolled during the V-VST period. There was a significant difference in the occurrence of SAP (21.8% vs. 10.5%, p = 0.024) and the rate of nasogastric tube feeding (25.9% vs. 14.7%, p = 0.040) between the two groups, and no differences were found in the length of hospital stay (p = 0.277) or the total cost of hospitalization (p = 0.846).

Conclusions
The V-VST was a better clinical screening tool, and it can also provide detailed suggestions regarding dietary modifications to prevent aspiration and SAP.
Predictors of prenatal iron folic acid supplement utilization in Wolaita, South Ethiopia: a community based cross-sectional study (quantitative and qualitative approach)
Authors: Wana Ermias Wabeto 
Published: April 2020

Abstract
Background
Effectiveness of prenatal iron supplementation program depends on utilization of the supplement by pregnant women. Nevertheless, in Ethiopia, regardless of increasing efforts, lower proportion of pregnant women use the supplementation for recommended 3 months and above but, the reason is not clear. This study aimed to identify the level and factors associated with utilization of prenatal iron supplementation.

Methods
A community based cross-sectional quantitative study complemented with qualitative component was carried out in January, 2016. A total of 411 pregnant women who gave birth 6 months preceding data collection were selected using multi-stage cluster sampling technique. Qualitative data were collected by conducting four focus group discussions (FGDs) of local pregnant mothers and interviewing district maternal and child health (MCH) focal, 3MCH heads of health centers and four health extension workers. Factors associated with appropriate utilization of supplementation were assessed using multivariate logistic regression. The outputs of analyses were presented using Adjusted Odds Ratio (AOR) with 95% confidence intervals (CI).

Result
From the study participants, 11.5% (95% CI = 9.9–13.1%) took the supplement for the recommended duration of 3 months or above. Pregnant women who could not read and write had 77% reduced odds of using iron supplementation than their counterparts (AOR = 0.23(95% CI: 0.07–0.75)). As compared to women who had four or more antenatal care (ANC), women with 2 and 3 ANC visits had 78% (AOR = 0.22(0.07–0.63)) and 66% (AOR = 0.34(0.14–0.81)) reduced odds of using the supplementation, respectively. As compared to women who were aware of benefits of taking the supplement for maternal and child health, the counterparts had 90% (AOR = 0.10 (0.10–0.63)) reduced odds of using the supplement. Women who were not knowledgeable of anemia had 85% (AOR = 0.15(0.04–0.62) reduced odds of using the supplement than those who were knowledgeable. The qualitative study indicated that there was no problem in the supply and logistic system of iron supplement and leading reasons for not taking the supplement were late initiation of Antenatal Care, lack of awareness and occurrence of side effects; unpleasant taste, nausea, vomiting.

Conclusion
In the study area utilization of prenatal iron supplementation is very low. Improving maternal education, ensuring early and frequent ANC, educating pregnant women about the benefits of service and ensuring comprehensive knowledge of anemia expected to improve the utilization of prenatal iron supplementation.
Improving pregnant women’s diet and physical activity behaviours: the emergent role of health identity
Authors: Morris T. , Strömmer S. , Vogel C. , Harvey N. C. , Cooper C. , Inskip H. , Woods-Townsend K. , Baird J. , Barker M. , Lawrence W. 
Published: April 2020

AbstractBackgroundWomen who gain too much weight in pregnancy are at increased risk of disease and of having children with increased risk. Interventions to improve health behaviours are usually designed for a general population of pregnant women, and trial outcomes show an average impact that does not represent the differences between individuals. To inform the development of future interventions, this study explored the factors that influenced women’s diet and physical activity during pregnancy and aimed to identify the needs of these women with regards to lifestyle support.MethodsWomen who completed a trial of vitamin D supplementation and nurse support in pregnancy were invited to take part in an interview. Seventeen women were interviewed about their lifestyles during pregnancy, the support they had, and the support they wanted. Interview transcripts were coded thematically and analysed to understand the factors that influenced the diets and physical activity levels of these women and their engagement with resources that could provide support.ResultsWomen identified barriers to eating well or being physically active, and pregnancy-specific issues like nausea and pain were common. Women’s interest in maintaining a healthy lifestyle and their engagement with lifestyle support was related to the extent to which they self-identified as healthy people. Health-disengaged women were disinterested in talking about their lifestyles while health-focused women did not feel that they needed extra support. Women between these ends of the ‘health identity’ spectrum were interested in improving their health, and were able to identify barriers as well as sources of support.ConclusionsLifestyle interventions in pregnancy should be adapted to meet the needs of individuals with different health identities, and encouraging a change in health identity may be one way of supporting sustained change in health behaviours.
Bimanual examination for clot evacuation: a retrospective cohort study of women with postpartum haemorrhage after vaginal delivery
Authors: Koh Pui Ru , Di Filippo Daria , Bisits Andrew , Welsh Alec W. 
Published: April 2020

Abstract
Background
Bimanual clot evacuation (BCE) is a simple clinical manoeuvre that may reduce need for surgical intervention in the management of severe postpartum haemorrhage (PPH). We sought to determine whether performing BCE in cases of severe PPH after vaginal birth reduces the need for surgical intervention.

Methods
A retrospective chart review of women who delivered vaginally with a severe PPH between January 1, 2011 and December 31, 2014 in a single tertiary women’s hospital in Sydney, Australia was conducted. Severe PPH was classified as a blood loss ≥1000mls. The need for surgical management (including operating theatre uterine exploration or evacuation, intrauterine balloon tamponade, repair of significant trauma, uterine or internal iliac artery ligation, B-Lynch suture insertion or hysterectomy) was the primary outcome measure, as expressed by need for operating theatre utilisation.

Results
From a cohort of 438, 149 women (34.0%) had BCE, of whom 29 (19.5%) required surgical management compared to 103 of 289 women with no BCE (35.6%); an odds ratio (OR) of 0.38 for BCE (confidence interval 0.20–0.72; p = 0.003). Early BCE (< 1 h of delivery) was associated with a further reduction in surgery (OR 0.24; confidence interval 0.08–0.70; p = 0.009) compared to late BCE (> 1 h of delivery). There was no reduction in estimated blood loss (p = 0.86) or blood transfusion (p = 0.71) with BCE.

Conclusion
Our study suggests BCE reduces theatre utilisation in the context of severe PPH following vaginal delivery. Prospective trials are needed to determine whether BCE should be endorsed as a treatment modality for PPH post-vaginal delivery.