bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilization of dental services and associated factors among preschool children in China
Authors: Gao Xiaoli , Ding Min , Xu Mengru , Wu Huijing , Zhang Chunzi , Wang Xing , Feng Xiping , Tai Baojun , Hu Deyu , Lin Huancai , Wang Bo , Zheng Shuguo , Liu Xuenan , Rong Wensheng , Wang Weijian , Wang Chunxiao , Si Yan 
Published: December 2019

Abstract
Background: This study sought to evaluate dental utilization among 3-,4-, and 5-year-old children in China and to use Andersen’s behavioural model to explore influencing factors, thereby providing a reference for future policy making.
Methods: This study is a cross-sectional study. Data of 40,305 children aged 3-5 years were extracted from the Fourth National Oral Health Survey, which was performed from August 2015 to December 2016. Patient data were collected using a questionnaire, which was answered by the child’s parents, and clinical data were collected during a clinical examination. Stratification and survey weighting were incorporated into the complex survey design. Descriptive statistics, bivariate correlations and hierarchical logistic regression results were then analysed to find the factors associated with oral health service utilization.
Results : The oral health service utilization prevalence during the prior 12 months were 9.5% (95%CI: 8.1%-11.1%) among 3-year-old children, 12.1% (95%CI: 10.8%-13.5%) among 4-year-old children, and 17.5% (95%CI: 15.6%-19.4%) among 5-year-old children. “No dental diseases” (71.3%) and “dental disease was not severe” (12.4%) were the principal reasons why children had not attended a dental visit in the past 12 months. The children whose parents had a bachelor’s degree or higher(OR: 2.29, 95%CI: 1.97-2.67, p <0.001), a better oral health attitude ranging from 5 to 8(OR: 1.64, 95%CI: 1.43-1.89, p <0.001), annual per capital income more than 25,000 CNY (OR: 1.40, 95%CI: 1.18-1.65, p <0.001),think their child have worse or bad oral health(OR: 3.54, 95%CI: 2.84-4.40, p <0.001), and children who often have toothaches (OR: 9.72 , 95%CI: 7.81-12.09, p <0.001) were more likely to go to the dentist in the past year.
Conclusion: The prevalence of dental service utilization was relatively low among preschool children. It is necessary to strengthen oral health education for parents and children, thereby improving oral health knowledge as well as attitude, and promoting dental utilization.
Unique miRNAs and their targets in tomato leaf responding to combined drought and heat stress
Authors: Zhou Rong , Yu Xiaqing , Ottosen Carl-Otto , Zhang Tingling , Wu Zhen , Zhao Tongmin 
Published: December 2019

Abstract
Background: Both drought and heat stress are serious global problems, leading to agricultural production loss. MicroRNAs (miRNAs) play important roles in plant species responding to individual drought and heat stress. However, the miRNAs and mRNAs in association with combined drought and heat in crops like tomato remains unclear. Results: We studied the crosstalk of miRNAs and their target genes in tomato plants grown under simultaneous drought and heat stress that frequently happen in field conditions. In total, 335 known miRNAs representing 55 miRNA families and 430 potential novel miRNAs were identified in Solanum lycopersicum L. using small RNA deep sequencing. Through expression analysis, miRNAs in association with drought, heat and the combination of these were investigated. In total, 61, 74 and 37 miRNAs were differentially regulated for combination (of both stresses) vs control, combination vs drought and combination vs heat, respectively. Target genes with different expression levels were found using degradome sequencing, which were mainly involved in transcription factor activity, sequence-specific DNA binding, transcription, regulation of transcription, nucleus, DNA binding etc . The quantitative real-time polymerase chain reaction (qRT-PCR) results confirmed the accuracy of sequencing. Conclusions: Our study serves as valuable knowledge on how crop adapted to combined drought and heat stress by regulating miRNAs and mRNAs, which provide information for crop improvement to deal with future climate changes. Keywords: Solanum lycopersicum L.; miRNAs; degradome; functional analysis; combined abiotic stress
Comparison of metamizole and paracetamol effects on colonic anastomosis and fibroblast activities in Wistar rats
Authors: Purnomo Eko , Nugrahaningsih Dwi Aris Agung , Agustriani Nunik , Gunadi . 
Published: December 2019

Abstract
Background : Leakage following colorectal anastomosis surgery causes various complications associated with high morbidity and mortality, especially in pediatric patients. It might be caused by the use of non-steroidal anti-inflammatory drugs (NSAIDs) as postoperative analgesics. This study aimed to compare the effect of metamizole and paracetamol on colonic anastomosis and fibroblast activities, including proliferation, migration, and collagen synthesis, in Wistar rats. Methods: Rats were divided into control, paracetamol and metamizole groups. The colonic anastomosis was evaluated by determining the integrity of the muscle layers, the formation of granulation tissue, and mucosal anastomosis. Fibroblast activities were analyzed by measuring the proliferation, migration, and collagen synthesis. Results: Metamizole caused more damage to muscle layer integrity, more inhibition of granulation tissue formation in the anastomosis area and lower mucosal anastomosis compared with paracetamol and control groups. Metamizole had a higher cytotoxic effect than paracetamol, which suppressed the proliferation and migration of fibroblasts. Furthermore, both drugs did not affect the synthesis of collagen. Conclusion: Metamizole shows worse effects on the integrity of muscle layers, inhibition of granulation tissue formation, mucosal anastomosis, fibroblast proliferation, and migration, but not collagen synthesis, than paracetamol in Wistar rat intestines following colonic anastomosis. These findings might indicate that paracetamol is safer than metamizole as analgesic following colonic anastomosis. Key Words: colonic anastomosis; fibroblast activities; metamizole; paracetamol; Wistar rat
Epidemiology of intestinal parasitic infections in preschool and school-aged Ethiopian children: A systematic review and meta-analysis
Authors: Chelkeba Legese , Mekonnen Zeleke , Alemu Yonas , Emana Daniel 
Published: December 2019

Abstract
Background : Numerous studies have been carried out on assessing the prevalence of intestinal parasites infections (IPIs) among preschool and school age children in Ethiopia, however, there was no study to gather and systematically analyze this information for policy makers.
Methods : We searched Medline via PubMed, Scopus, Science Direct, Web of Science (ISI), and Google Scholar and local peer-reviewed journals published from inception to 2019 for studies describing prevalence of IPIs among preschool and school age children. We conducted meta-regression to understand the trend and the source of heterogeneity and pooled the prevalence using ‘metaprop’ command using STATA software (Intercooled, version 14, STATA Corp, College Station, TX).
Results : Eighty three (83) studies examining 56,786 fecal specimens were included. The prevalence of IPIs was 48 %( 95%CI: 42% to 53%) and showed a gradual, but significantly decreasing trends 17% (95% CI: 2.5% to 32%) for each consecutive 6 years) and was similar in males and females. The pooled prevalence in years 1997–2002, 2003–2008, 2009–2014 and >2014 was 71% (95% CI: 57% to 86%), 42% (95% CI: 27% to 56%), 48% (95% CI: 40% to 56%) and 42% (95% CI: 34% to 49%), respectively. Poly-parasitism was observed in 16% (95% CI: 13% to 19 %,) of children while, single parasite infection was observed in 36 %( 95% CI: 30% to 41%).
Conclusion: IPIs are highly prevalent and well distributed across the regional states of Ethiopia. Southern and Amhara regional states carry the highest burden. We observed a gradual, but significant decreasing trends in prevalence of IPIs among Ethiopian children over the last two decades.
A systematic review of surgical margins utilized for removal of cutaneous mast cell tumors in dogs
Authors: Selmic Laura Elizabeth , Ruple Audrey 
Published: December 2019

Abstract
Background Traditionally, wide lateral surgical margins of 3cm and one fascial plane deep have been recommended for resection of canine cutaneous mast cell tumor (MCT). Several studies have been published assessing surgical margins of less than this traditional recommendation. The objective of this systematic review was to determine if resection MCT with lateral surgical margins < 3cm results in low rates of incomplete resection and local tumor recurrence. Systematic searches of digital bibliographic databases were performed with two authors screening abstracts to identify relevant scientific articles. Studies regarding surgical treatment of dogs with cutaneous MCT were reviewed. Data abstraction was performed and the quality of individual studies and the strength of the body of evidence for utilization of surgical margins < 3cm for removal of MCTs was assessed.Results From the initial 78 citations identified through the database searches, four articles were retained for data abstraction after both relevance screenings were performed. Two studies were retrospective observational studies, one was a prospective case series and one was a prospective clinical trial. Assessment of the quality level of the body of evidence identified using the GRADE system was low. Excision of MCT at 2cm and 3cm was associated with comparably low rates of incomplete excision and recurrence.Conclusions Despite the low quality of the overall body of evidence, a recommendation can be made that resection of canine cutaneous MCTs (< 4cm) of Patnaik grade I and II with 2cm lateral margins and 1 fascial plane deep results in low rates of incomplete excision and local tumor recurrence.
Determining Quantitative Diagnostic Test Cut-off in G6PD Heterozygous Women for Tafenoquine Therapy
Authors: Swastika Maria , Harahap Alida R , Panggalo Lydia V , Jusman Sri Widia A , Satyagraha Ari W 
Published: December 2019

Abstract
Background Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzyme disorder in the world. Its main function is to generate NADPH that is required for anti-oxidative pathway in the cells especially in red blood cells (RBC). G6PD deficiency is X-linked and thus subject to random X-chromosome inactivation in women giving them mosaic expression of G6PD activities in their individual cells. This phenomenon makes it difficult for diagnosis with the currently available G6PD qualitative diagnostic tests. With the rolling out of newly marketed anti-malarial drug tafenoquine which has a long half-life, screening for G6PD deficiency becomes a necessity where those with <70% G6PD activity cannot receive this drug. Thus, evidence for a quantitative cut-off for G6PD activity is needed to ensure safe drug administration.Methods RBC models were developed to analyze the effect of oxidant on RBC oxidative markers namely total glutathione (GSH) and malondialdehyde (MDA). G6PD activity was measured using quantitative assay from Trinity Biotech and was correlated with cytofluorometric assay. RBC from G6PD heterozygous women with different G6PD activities were also analyzed for comparison.Results There was a negative correlation between G6PD activity and CuCl concentration and a strong association between G6PD activities and proportion of G6PD normal RBC in CuCl-treated models and in ex vivo RBC. However, in terms of oxidative stress markers analyses, unlike the hypothesis where the lower G6PD activity, the higher MDA and the lower GSH level, our CuCl RBC model showed that in low G6PD activities (10-30%) cells, the MDA level is lower compared to the rest of the models (p<0.05). Our ex vivo model however were in line with the hypothesis, although the result was not significant (p=0.5). There was a significant difference between RBC with <60% and those with >80% G6PD activities in CuCl RBC model but not in ex vivo RBC (p=0.5). Genotyping heterozygous subjects showed G6PD Viangchan variant with 2.97 U/g Hb (33% activity) and 6.58 U/g Hb (74% activity).Conclusions The MDA and GSH analyses have pointed to the 60% G6PD activity cut-off. This provides an evidence of possible cut-off for tafenoquine administration in G6PD heterozygous women.
Opinions of key stakeholders on alternative interventions for malaria control and elimination in Tanzania
Authors: Finda Marceline Francis , Christofides Nicola , Lezaun Javier , Tarimo Brian , Chaki Prosper , Kelly Ann , Kapologwe Ntuli , Kazyoba Paul , Emidi Basiliana , Okumu Fredros O. 
Published: December 2019

Abstract
Background Malaria control in Tanzania currently relies primarily on long-lasting insecticidal nets and indoor residual spraying, alongside effective case management and behaviour change communication. This study explored opinions of key stakeholders on suitability and potential of six alternative vector control interventions for supplementing ongoing malaria control and elimination efforts in Tanzania.Methods Focus group discussions were held with policy-makers, regulators, research scientists and community members, each group having 6-10 participants. Alternative interventions discussed included: a) improved housing, b) larval source management, c) mass drug administration (MDA) with ivermectin to reduce vector densities, d) modified mosquitoes including genetically-modified or irradiated mosquitoes, e) targeted spraying of mosquito swarms, and f) spatial repellents. Discussions focused on stakeholder opinions on comparative value of these interventions for supplementing efforts towards the 2030 malaria elimination target.Results Larval source management and spatial repellents were widely supported across all stakeholder groups, while insecticide-spraying of mosquito swarms was least preferred. Support for MDA with ivermectin was high among policy makers, regulators and research scientists, but encountered opposition among community members due to perceptions that it requires significant efforts and compliance. Community members expressed strong desire and support for programmes to improve housing for poor people in high transmission areas, while policy makers challenged sustainability of this strategy given its high costs. Techniques of mosquito modification, specifically those involving gene drives, were viewed positively by community members, policy makers and regulators, but encountered high degrees of scepticism among scientists. Overall, policy-makers, regulators and community members trusted scientists to provide appropriate advice for decision making.Conclusion Stakeholder opinions regarding alternative malaria interventions were divergent, except for larval source management and spatial repellents for which there was universal support. MDA with ivermectin, house improvement and modified mosquitoes were also widely supported though each faced concerns from at least one stakeholder group. While policy-makers, regulators and community members all noted their dependence on scientists to make informed decisions, their reasoning on benefits and drawbacks of specific interventions included factors beyond technical efficiency. This study suggests the need to encourage and strengthen dialogue between scientists, policy makers, regulators and communities regarding new interventions.
Which mechanisms explain motivation of primary health workers? Insights from realist evaluation of a maternal and child health programme in Nigeria
Authors: EBENSO Bassey E. , Mbachu Chinyere , Etiaba Enyi , Huss Reinhard , Manzano Ana , Onwujekwe Obinna , Uzochukwu Benjamin , Ezumah Nkoli , Ensor Tim , Hicks Joseph Paul , Mirzoev Tolib 
Published: December 2019

Abstract
Background: Well-trained, adequately skilled and motivated primary healthcare (PHC) workers are essential for attaining universal health coverage and the Sustainable Development Goal 3 of ensuring healthy lives and promoting well-being for all. While there is abundant literature on drivers of workforce motivation, published knowledge on the mechanisms of how motivation works within different contexts is limited, particularly from low- and middle-income countries. This paper contributes to health workforce literature by reporting on how motivation works among PHC workers in a maternal and child health (MCH) programme in Nigeria. Methods: We adopted a realist evaluation design including scoping review of literature, document review of policies and MCH programme handbook, and in-depth interviews of PHC workers (n=25), facility managers (n=16), policymakers (n=12) and programme managers (n=10) to assess the impact of the MCH programme in Anambra State, Nigeria. A realist process of theory development, testing, verification and consolidation was used to understand how and under what circumstances the MCH programme impacted on workers’ motivation and which mechanisms helped explain how motivation works. The developed programme theory drew upon Herzberg’s two-factor and Adam’s equity theories to unpack the influences of contextual conditions on worker motivation. Results: A complex and dynamic interaction between the MCH programme and organizational, societal and policy contexts triggered five mechanisms which explain PHC worker motivation: i) feeling supported, ii) feeling valued and committed to work, iii) morale and confidence to perform tasks, iv) companionship and v) feeling comfortable with work environment. Some mechanisms were mutually reinforcing while others operated in parallel. Further analysis showed that the conditions that enabled worker motivation to occur were organisational values of fairness, recognition of health workers’ contributions and a culture of task-sharing and teamwork. Conclusions: Policy designs and management strategies for improving performance of health workers, particularly in resource-constrained settings should create working environments that foster feelings of being valued and supported while enabling workers to apply their knowledge and skills to improve healthcare delivery. Future research can test the explanatory framework generated by this study and explore differences in motivational mechanisms among different cadres of PHC workers to inform cadre-related motivational interventions.
Coordinating Health Workforce Management in a Devolved Context: Lessons from Kenya
Authors: Thuku Mathew Kariuki , Muriuki Janet , Adano Ummuro , Oyucho Linet , Nelson David 
Published: December 2019

Abstract
Introduction Kenya began strengthening national inter-sectoral coordination for human resources for health (HRH) planning and governance in 2010, in alignment with the World Health Organization’s Country Coordination and Facilitation approach. In 2013, however, the country fully and rapidly devolved health services to 47 county governments under Kenya’s new constitution. It soon became evident that the coordination mechanism to manage the health workforce at county level was inadequate. This case study describes how Kenya created an inter-county, multi-stakeholder HRH coordination framework that promotes consensus, commitment, and cooperation in devolved HRH management. Case Presentation Through USAID funding, IntraHealth International built the HR management capacity of county public service boards and county health departments by strengthening coordination mechanisms at national and county levels. Informed by stakeholder mapping, Kenya’s 47 counties were grouped into nine clusters with similar geographic contexts and HRH challenges. Inter-county cluster HRH stakeholder coordination forums are hosted by a rotating county-led secretariat and meet quarterly to address gaps, share successes and challenges, and track implementation of action plans. They link to the national level for capacity building, policy formulation, HRH regulation, and provision of standards. Counties have assumed ownership of the forums and contributed about US$85,000 to date toward expenses. Conclusions As a mechanism for transforming Kenya’s national HRH agenda into action at the county level, the HRH coordination framework has been instrumental in 1) expediting development, customization, and dissemination of policies, 2) enabling national HRH officers to mentor their county counterparts, and 3) providing collaborative platforms for multiple stakeholders to resolve HRH challenges and harmonize HR practices nationwide. Successes catalyzed through the inter-county forums include hiring over 20,000 health workers to address shortages; expanding the national HR information system to all 47 counties; developing guidelines for sharing specialist providers; and establishing professionalized HRH units in 43 counties. Kenya has made great strides in strengthening its health system through the HRH coordination framework, which supports standardization of county health operations with national goals while enabling national policy to address HRH gaps in the counties. Transitioning to fully local funding of inter-county forums is important for sustaining progress.
Distribution of Macrolide-Lincosamide-Streptogramin B antibiotics resistance genes in clinical isolates of Staphylococci
Authors: Nagarkoti Dharma , Prajapati Krishna , Sharma Ajay Narayan , Gyawali Arrogya , Manandhar Sarita 
Published: December 2019

Abstract
Background Staphylococci are the most commonly isolated pathogen from clinical specimen. These isolates are posing threat due to increasing trend of antimicrobial resistance particularly methicillin. Macrolide-lincosamide streptogramin B family of antibiotics is commonly used to treat such infections. This study was aimed to detect the prevalence of inducible clindamycin resistance and observation of erm and msr genes among Staphylococci isolated from tertiary care hospital of Nepal.Methods Staphylococci from different clinical specimen were identified and antibiotic susceptibility profile were determined following Kirby Bauer disc diffusion method. The double disc diffusion or D-zone test as outlined in CLSI document M100-S24 was performed to examine inducible clindamycin resistance isolates. Multiplex PCR was performed for detection of erm and msr gene in isolates using specific primers for ermA , ermB, ermC, msrA and msrB genes.Results Of the 60 Staphylococci isolates, 39 (65%) were Staphylococcus aureus ( S. aureus ) and 21 (35%) were coagulase negative Staphylococci (CNS) with 25 (64%) and 15 (71%) representing methicillin resistant S. aureus and CNS respectively. Constitutive and inducible MLS B phenotype was observed among 24 (40%) and 14 (23%) isolates respectively by D test. The most prevalent resistant gene was ermC gene (37%) followed by msr B (12%), erm B (10%) and msr A (10%). None of the isolates were found to possess erm A gene.Conclusions The resistant genes were detected more among CNS than S. aureus. The presence of constitutive and inducible MLS B as well as resistant genes among Staphylococci necessitates detection of such isolates to minimize treatment failure. The presence of resistant characteristic varies with hospital settings, geographical locations, patients’ demography etc. The result from this study may help elucidate the predominant resistant characteristics in clinical Staphylococci isolated from tertiary care hospital of Nepal.