bluuebunny/crossref_metadata_2025_split huggingface dataset:
A register-based observational cohort study on persistent frequent users of emergency services in a Finnish emergency clinic.
Authors: Levola Jonna , Sailas Eila , Säämänen Timo , Turunen Leena , Thomson Annika 
Published: November 2019

Abstract
Abstract
Background: The focus of emergency room (ER) treatment is on acute medical crises, but frequent users of ER services often present with various needs. The objectives of this study were to obtain information on persistent frequent ER service users and to determine reasons for their ER service use. We also sought to determine whether psychiatric diagnoses or ongoing use of psychiatric or substance use disorder treatment services were associated with persistent frequent ER visits.
Methods: A cohort (n=138) of persistent frequent ER service users with a total of 2585 ER visits during a two-year-period was identified. A content analysis was performed for 10% of these visits. Register data including International Classification of Primary Care 2 (ICPC-2) –codes and diagnoses were analyzed and multivariable models were created in order to determine whether psychiatric diagnoses and psychosocial reasons for ER service use were associated with the number of ER visits after adjusting for covariates.
Results: Patients who were younger, had a psychiatric diagnosis and engaged in ongoing psychiatric and other health services, had more ER visits than those who were not. Having a psychiatric diagnosis was associated with the frequency of ER visits in the multivariable models after adjusting for age, gender and ongoing use of psychiatric or substance use disorder treatment services. Reasons for ER-service use according to ICPC-2 –codes were inadequately documented.
Conclusions: Patients with psychiatric diagnoses are overrepresented in this cohort of persistent frequent ER service users. More efficient treatments paths are needed for patients to have their medical needs met through regular appointments.
Group B Streptococcus detection in pregnant women: comparison of real-time PCR assay, culture, and the Xpert GBS rapid test
Authors: Vieira Laura , Perez Amanda Vilaverde , Machado Monique M , Kayser Michele L , Vettori Daniela V , Alegretti Ana Paula , Ferreira Charles Francisco , Vettorazzi Janete , Valério Edimárlei G 
Published: November 2019

Abstract
Background Group B Streptococcus (GBS) is one of the most important causative agents of neonatal sepsis. As administration of prophylactic antibiotics during labor can prevent GBS infection, routine screening for this bacterium in prenatal care before the onset of labor is recommended. However, many women present in labor without having undergone such testing during antenatal care, and the turnaround time of detection methods is insufficient for results to be obtained before delivery. Methods Vaginal and anorectal specimens were collected from 270 pregnant women. Each sample was tested by Xpert GBS, PCR, and culture for GBS detection. Results The overall prevalence of maternal GBS colonization was 30.7% according to Xpert GBS, 51.1% according to PCR, and 14.3% according to cultures. Considering the PCR method as the reference, the Xpert GBS had a sensitivity of 53% and specificity of 93%. Positive Xpert GBS results were associated with marital status (married or cohabitating) and with prematurity as a cause of neonatal hospitalization. Positive cultures were associated with ischemic–hypoxic encephalopathy requiring therapeutic hypothermia. Conclusions Combined enrichment/PCR and the Xpert GBS rapid test found a high prevalence of GBS colonization. The Xpert GBS technique gives faster results and could be useful for evaluating mothers who present without antenatal GBS screening results and are at risk of preterm labor, thus allowing institution of prophylactic antibiotic therapy. Trial Registration: The study was approved by the institutional Research Ethics Committee (CAAE: 59688316.0.0000.5327)
The phylogenetic significance of the morphology of the syrinx, hyoid and larynx, of the Southern Cassowary, Casuarius casuarius (Aves, Palaeognathae)
Authors: McInerney Phoebe Louise , Lee Michael S. Y. , Clement Alice M. , Worthy Trevor H. 
Published: November 2019

Abstract
Background: The Palaeognathae are a basal clade within Aves and include the large and flightless ratites and the smaller, volant tinamous. Although much research has been conducted on various aspects of palaeognath morphology, ecology, and evolutionary history, there are still areas which require investigation. This study aimed to fill gaps in our knowledge of the Southern Cassowary, Casuarius casuarius, for which information on the skeletal systems of the syrinx, hyoid and larynx is lacking - despite these structures having been recognised as performing key functional roles associated with vocalisation, respiration and feeding. Previous research into the syrinx and hyoid have also indicated these structures to be valuable for determining evolutionary relationships among neognath taxa, and thus suggest they would also be informative for palaeognath phylogenetic analyses, which still exhibits strong conflict between morphological and molecular trees.
Results: The morphology of the syrinx, hyoid and larynx of C. casuarius is described from CT scans. The syrinx is of the simple tracheo-bronchial syrinx type, lacking specialised elements such as the pessulus; the hyoid is relatively short with longer ceratobranchials compared to epibranchials; and the larynx is comprised of entirely cartilaginous, standard avian anatomical elements including a concave, basin-like cricoid and fused cricoid wings. As in the larynx, both the syrinx and hyoid lack ossification and all three structures were most similar to Dromaius. We documented substantial variation across palaeognaths in the skeletal character states of the syrinx, hyoid, and larynx, using both the literature and novel observations (e.g. of C. casuarius). Notably, new synapomorphies linking Dinornithiformes and Tinamidae are identified, consistent with the molecular evidence for this clade. These shared morphological character traits include the ossification of the cricoid and arytenoid cartilages, and an additional cranial character, the articulation between the maxillary process of the nasal and the maxilla.
Conclusion: Syrinx, hyoid and larynx characters of palaeognaths display greater concordance with molecular trees than do other morphological traits. These structures might therefore be less prone to homoplasy related to flightlessness and gigantism, compared to typical morphological traits emphasised in previous phylogenetic studies.
Key Words: Palaeognathae, Cassowary, Syrinx, Hyoid, Larynx, Morphology, Phylogenetics, Optimisation
Tooth Extraction as a Risk Factor for Maxillary Sinus Pneumatization: A Case-control Study
Authors: Ocak Hakan , Çolpak Halis Ali , Demetoğlu Umut , Soydan Damla , Kılıç Erdem , Canger Murat E , Alkan Alper 
Published: November 2019

Abstract
Purpose Maxillary sinus pneumatization following teeth extraction may require various treatment plans such as sinus lifting and alveolar grafting procedures to obtain sufficient alveolar bone height for implant surgery. The aim of this study was to identify sinus pneumatization and to help in determining the proper time for preprosthetic surgery following extraction of maxillary sinus related teeth. Methods We evaluated 75 teeth extraction related to maxillary sinus floor. The panoramic radiographs were evaluated before and after extraction of the posterior maxillary teeth. The radiographs were divided into 5 groups according to duration after extraction. Two reference points (the first point corresponds to the nasal spine while the second point corresponds to the most inferior point of the floor of the maxillary sinus wall) were determined on digital panoramic radiographs before and after teeth extraction and the distance between both aforementioned points was measured. Results The amount of pneumatization was found to be increased with time. The pneumatization within the first 6 months was limited. However, a sudden increase of pneumatization after 6th month, especially the highest between 18th and 24th months, was observed. The mean pneumatization amount was found to be highest in the 1st molar group. Conclusion According to the results of the present study, surgeons should not be waited any more than 6 months after tooth extraction for preprosthetic surgery in the posterior maxillary region as long as physiological healing of extraction socket is allowed.
Understanding factors influencing care seeking for sick children in Ebonyi and Kogi states, Nigeria
Authors: Dougherty Leanne , Gilroy Kate , Olayemi Abimbola , Ogesanmola Omitayo , Ogaga Felix , Nweze Chinwe , Banerjee Joya , Oduenyi Chioma , Pacqué Michel 
Published: November 2019

Abstract
Background Nigeria has one of the highest child mortality rates in the world, with an estimated 750,000 deaths annually among children under age five. The majority of these deaths are due to pneumonia, malaria, or diarrhea. Many parents do not seek sick-child care from trained, biomedical providers, contributing to this high rate of mortality. Methods This qualitative study explores factors enabling or preventing parents from seeking care for sick under-five children in Nigeria’s Kogi and Ebonyi states, including gender-related roles and social norms. Interviews were conducted with parents of sick under-five children and service providers, and focus group discussions were held with community leaders to assess how care-seeking behavior was influenced by four modes from the Colvin et al conceptual framework for household decision-making and pathways to care. These include (1) caregivers’ recognition and response to illness, (2) seeking advice and negotiating access within the family, (3) making use of community-based treatment options, and (4) accessing biomedical services. Results Parents were found to have a general understanding of illness symptoms but did not always attribute illness to biomedical causes. Intra-household decision-making processes were shaped by gender dynamics between men and women, and were found to have great effects on decisions to seek care. Use of traditional medicine and self-treatment were found to be common first steps in treatment before turning to the biomedical care system. Once the decision to seek biomedical care was taken, the route of seeking care varied between seeking care at chemists and then continuing to health facilities or starting with a health facility and then accessing prescriptions from a chemist. Conclusion We conclude that care-seeking decisions do not follow a linear process; that intra-household decision-making processes particularly among parents should not be underestimated in addressing sick-child care seeking; and that, given the role of mothers as primary caregivers, their knowledge in illness recognition and agency in care-seeking decision-making, and seeking biomedical care, is deserving of future study.
Dietary practices and associated factors among pregnant women in West Gojjam Zone, Northwest Ethiopia
Authors: Mulugeta Yeshalem , Alem Getu Degu , Belachew Tefera 
Published: November 2019

Abstract
Background: The optimal dietary practice is critical requisite for maternal nutrition. However, the majority of Ethiopian pregnant women have inadequate nutrient intakes. This may be due to their poor dietary habit. Identifying factors affecting dietary practices of pregnant women is crucial to design appropriate interventions. In this country, the dietary practices of pregnant women and determinants are not well studied. Therefore, the purpose of this study was to assess the dietary practices and associated factors among pregnant women in West Gojjam Zone, Northwest Ethiopia. Methods: A community-based cross-sectional study was carried out among 712 pregnant women from May to August 2018. Quantitative data complemented with qualitative method. Pregnant women were selected using a cluster sampling technique. Structured questionnaires were utilized for data collection. Data were entered into Epi-Info version 7.2.2 and exported to SPSS version 23 software for analysis. Data were described using frequencies and mean. Logistic regression analysis was done. For qualitative data, three focus group discussions and 17 key-informant interviews were conducted. . Focus group discussion participants were mother-in-lows, husbands and health professionals. Typical case and homogeneous sampling techniques were used for the key-informant interviews and focus group discussions, respectively. The tape-recorded interviews and FGDs were transcribed verbatim into Amharic language and then translated from Amharic to English. Thematic analysis was used for the qualitative data. Results: Only 19.9% of respondents had appropriate dietary practices. On the multivariable logistic regression analyses, being food secure [AOR=2.25, 95% CI: (1.1, 4.5)], having high edible crop production [AOR=2.00, 95% CI: (1.2, 3.2)] and favorable attitude [AOR=1.69, 95% CI: (1.1, 2.6)] were significantly associated with the appropriate dietary practices of pregnant women. In the qualitative study lack of knowledge on maternal diet, cultural prohibition and knowledge gap of professionals were barriers that interfere with dietary practices during pregnancy. Conclusion: Pregnant women in the study area are found to have suboptimal dietary practices. Therefore, health professionals should give regular nutrition counseling using cards and role models for promoting diversified food production and consumption to meet the nutrient requirements during pregnancy. Keywords: pregnant women, dietary practice, dietary diversity, food variety score
Association of Cleft Lip and Palate on Mother-to-Infant Bonding: a Cross-Sectional Study in the Japan Environment and Children's Study (JECS).
Authors: Tsuchiya Shinobu , Tsuchiya Masahiro , Momma Haruki , Koseki Takeyoshi , Igarashi Kaoru , Nagatomi Ryoichi , Arima Takahiro , Yaegashi Nobuo 
Published: November 2019

Abstract
Background: Cleft lip and/or palate is among the most prevalent congenital birth defects, and negatively affects maternal psychological status and may consequently result in higher prevalence of child maltreatment. However, the association of childbirths of infant with cleft lip and/or palate with maternal emotional involvement still remains unclear. We examined the association between childbirths of infant with cleft lip and/or palate and mother-to-infant bonding, using data from the Japan Environment and Children's Study, a nationwide birth cohort study.
Methods: A cross-sectional study using the jecs-an-20180131 dataset was performed. A total 104,065 foetuses in 15 regional centres in Japan were enrolled after obtaining informed written consent. The Mother-to-Infant Bonding Scale, a self-report scale consisting of 10 items, was used to evaluate maternal bonding at one year after childbirth. Finally, the participants consisted of 79,140 mother-infant pairs, of which 211 mothers of infants with cleft lip and/or palate were included in our analyses. Multivariable logistic regression analysis using multiple imputation for missing data was performed to calculate the odds ratio and 95% confidence interval in the estimation of the association between bonding disorders and childbirths with cleft lip and/or palate.
Results: No increased risk of bonding disorders was observed among all the mothers of infants with cleft lip and/or palate (odds ratio [95% confidence interval]; 0.97 [0.63-1.48], p = 0.880), however, advanced maternal age or multiple parity may adversely affect the associations between bonding disorders and cleft lip and/or palate, respectively. After stratification with a combination of maternal age and parity, a significant association of cleft lip and/or palate with bonding disorders was found only among advanced-age multiparae (odds ratio [95% confidence interval] = 2.51 [1.17-5.37], p = 0.018), but it was weakened after additional adjustment for maternal depression.
Conclusions: Childbirths of infant with cleft lip and/or palate may increase the risk of bonding disorders among advanced-age multiparae, possibly through maternal depression. This finding provides valuable information for the provision of multidisciplinary cleft care.
Genome-wide characterization of the rose (Rosa chinensis) WRKY family and role of RcWRKY41 in gray mold resistance
Authors: Liu Xintong , Li Dandan , Zhang Shiya , Xu Yaling , Zhang Zhao 
Published: November 2019

Abstract
Background The WRKYs are a major family of plant transcription factors that play roles in the responses to biotic and abiotic stresses; however, a comprehensive study of the WRKY family in roses ( Rosa sp.) has not previously been performed.Results In the present study, we performed a genome-wide analysis of the WRKY genes in the rose ( Rosa chinensis ), including their phylogenetic relationships, gene structure, chromosomal locations, and collinearity. Using a phylogenetic analysis, we divided the 56 RcWRKY genes into three subgroups. The RcWRKY s were unevenly distributed across all seven rose chromosomes, and a study of their collinearity suggested that genome duplication may have played a major role in RcWRKY gene duplication. A Ka/Ks analysis indicated that they mainly underwent purifying selection. Botrytis cinerea infection induced the expression of 19 RcWRKY s, most of which had undergone gene duplication during evolution. These RcWRKY s may regulate rose resistance against B. cinerea . Based on our phylogenetic and expression analyses, RcWRKY41 was identified as a candidate regulatory gene in the response to B. cinerea infection, which was confirmed using virus-induced gene silencing.Conclusions This study provides useful information to facilitate the further study of the function of the rose WRKY gene family.
Endoscopic treatment of early leaks and strictures after laparoscopic one anastomosis gastric bypass
Authors: Younis Fadi , Shnell Mati , Gluck Nathan , Abu-Abeid Subhi , Eldar Shai , Fishman Sigal 
Published: November 2019

Abstract
Background: Laparoscopic one anastomosis gastric bypass has become a prominent bariatric procedure. Yet, early and late complications, primarily leaks and strictures, are not uncommon. This study summarizes our experience with endoscopic treatment of laparoscopic one anastomosis gastric bypass complications. Methods: This is a retrospective study of consecutive patients referred to our hospital from 2015 to 2017 with post laparoscopic one anastomosis gastric bypass complications. Therapy was tailored to each case, including fully covered self-expandable metal stents, fibrin glue, septotomy, internal drainage with pigtail stents, through-the-scope and pneumatic dilation. Success was defined as resuming oral nutrition without enteral or parenteral support or further surgical intervention. Results : Nine patients presented with acute or early leaks: 5 (56%) had staple-line leaks, 3 (33%) had anastomotic leaks and 1 (11%) had both. All were treated with stents. Adjunctive endoscopic drainage was applied in 4 patients (44%). Overall 5 patients (56%) with acute/ early leaks recovered completely, including all 3 patients with anastomotic leak and the patient with both leaks but only 1/5 with staple line leak (20%). Complication rate in the leak group reached 22%. Eight patients presented with strictures, 7 at the anastomosis and one due to remnant stomach misalignment. All anastomotic strictures were dilated successfully. However, the patient with the pouch stricture required conversion to Roux-en-Y gastric bypass after 3 failed attempts of dilatation. Conclusion: Endoscopic treatments of laparoscopic one anastomosis gastric bypass complications are relatively effective and safe. Anastomosis-related complications are more amenable to endoscopic treatment compared to staple line leaks.
The effect of Liv-52 on liver ischemia reperfusion damage in rats
Authors: Cimen Orhan , Eken Huseyin , Cİmen Ferda Keskin , Cekic Arif Burak , Kurt Nezahat , Bilgin Asli Ozbek , Suleyman Bahadir , Suleyman Halis , Mammadov Renad , Pehlivanoglu Kamil , Kurnaz Eray 
Published: November 2019

Abstract
Background: Liver ischemia reperfusion (I/R) damage is frequently seen in clinical hepatobiliary surgeries and there is no effective treatment for it. Liv-52, known to have hepatoprotective effects, is a natural antioxidant drug licensed by Ministry of Health of India. Therefore, the aim of our study is to investigate the effect of Liv-52 on liver damage induced by I/R in rats.
Methods: Albino Wistar male rats were divided into three groups; liver I/R (IR), 20 mg/kg Liv-52 + liver ischemia reperfusion (LIR) and sham operation applied to control group (HG). Liv-52 was administered to the LIR group (n-6) one hour prior to I/R application and distilled water was given orally to IR (n-6) and HG (n-6) groups as a solvent. In animals, ischemia was determined as one hour, and reperfusion was identified as six hours.
Results: Increased levels of alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase, malondialdehyde, myeloperoxidase, and decreased levels of superoxide dismutase, and glutathione related enzymes caused by I/R application have been converged to healthy group level with Liv-52 treatment and the damage occurred in liver tissue has been improved histopathologically.
Conclusions: Liv-52 may be beneficial for preventing liver I/R damage in pre-surgery application.
Three Easily-Implementable Changes Reduce Median Door-To-Needle Time for Intravenous Thrombolysis by 23 Minutes
Authors: Tran Demi , Zhu Zhu , Shafie Mohammad , Abcede Hermelinda , Stradling Dana , Yu Wengui 
Published: November 2019

Abstract
Background: The benefit of intravenous thrombolysis (IVT) for acute ischemic stroke is time dependent. Despite great effort, the median door-to-needle time (DNT) was 60 minutes at the United States stroke centers. We investigated the effect of a simple quality improvement initiative on DNT for IVT.
Methods: This is a single-center study of patients treated with IVT between 2013 and 2017. A simple quality improvement initiative was implemented in January 2015 to allow the Stroke team to manage hypertension in the emergency room, to make decision for IVT before getting blood test results unless patients were taking oral anticoagulants, and to give IVT in the CT suite. Baseline characteristics, DNT and outcomes at hospital discharge were compared between pre- and post-intervention groups.
Results: Ninety and 136 patients were treated with IVT in pre- and post-intervention groups, respectively. The rate of IVT was significantly higher in the post-intervention group (20% vs. 14.4%, p=0.007). The median DNT with interquartile range (IQR) was reduced significantly by 23 minutes (63[53-81] vs. 40[29-53], p<0.001) with more patients in the post-intervention group receiving IVT within 60 minutes (81.6% vs. 46.7%) and 45 minutes (64.0% vs.17.8%). There was no significant difference in symptomatic intracerebral hemorrhage rate (1.5% vs. 1.1%), modified Rankin Scale 0-1 (29.4% vs. 23.3%), and hospital mortality (7.4% vs. 6.7%) between the 2 groups.
Conclusions: Three easily-implementable quality improvement initiative increases IVT rate and reduces DNT significantly without increasing the rate of IVT-related complications in our comprehensive stroke center.