bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changing trends of birth weight with maternal age: a cross-sectional study in Xi'an city of Northwestern China
Authors: Wang Shanshan , Yang Liren , Shang Li , Yang Wenfang , Qi Cuifang , Huang Liyan , Xie Guilan , Wang Ruiqi , Chung Mei Chun 
Published: August 2020

Abstract
Background: Most studies have shown that maternal age is associated with birth weight. However, the specific relationship between each additional year of maternal age and birth weight remains unclear. The study aimed to analyze the specific association between maternal age and birth weight. Methods: Raw data for all live births from 2015 to 2018 were obtained from the Medical Birth Registry of Xi’an, China. A total of 490143 mother-child pairs with full-term singleton live births and the maternal age ranging from 20 to 40 years old were included in our study. Birth weight, gestational age, birth date of the newborns, maternal birth date, residence and ethnicity were collected. Generalized additive model and two-piece wise linear regression model were used to analyze the specific relationships between maternal age and birth weight, risk of low birth weight, and risk of macrosomia. Results: The relationships between maternal age and birth weight, risk of low birth weight, and risk of macrosomia were nonlinear. Birth weight increased 16.204 g per year when maternal age is less than 24 years old (95%CI: 14.323, 18.086), and increased 12.051g per year when maternal age ranged from 24 to 34 years old (95%CI: 11.609, 12.493), then decreased 0.824g per year (95% CI: -3.112, 1.464). The risk of low birth weight decreased with the increase of maternal age until 36 years old (OR= 0.917, 95%CI: 0.903, 0.932 when maternal age younger than 27 years old; OR= 0.965, 95%CI: 0.955, 0.976 when maternal age ranging from 27 to 36 years old), then increased when maternal age older than 36 years old (OR=1.133, 95%CI: 1.026, 1.250). The risk of macrosomia increased with the increase of maternal age (OR=1.102, 95%CI: 1.075, 1.129 when maternal age younger than 24 years old; OR=1.065, 95%CI: 1.060, 1.071 when maternal age ranged from 24 to 33 years old; OR=1.029, 95%CI: 1.012, 1.046 when maternal age older than 33 years old). Conclusions: For women of childbearing age (20-40 years old), the threshold of maternal age on low birth weight was 36 years old, and the risk of macrosomia increased with the increase of maternal age.
Characterizing sensitivity and coverage of clinical WGS as a diagnostic test for genetic disorders
Authors: Sun Yan , Liu Fengxia , Fan Chunna , Wang Yaoshen , Song Lijie , Fang Zhonghai , Han Rui , Wang Zhonghua , Wang Xiaodan , Yang Ziying , Xu Zhenpeng , Peng Jiguang , Shi Chaonan , Zhang Hongyun , Dong Wei , Huang Hui , Li Yun , Le Yanqun , Sun Jun , Peng Zhiyu 
Published: August 2020

Abstract
Background: Due to its reduced cost and incomparable advantages, WGS is likely to lead to changes in clinical diagnosis of rare and undiagnosed diseases. However, the sensitivity and breadth of coverage of clinical WGS as a diagnostic test for genetic disorders has not been fully evaluated. Here, the performance of WGS in NA12878, the YH cell line, and the Chinese trios were measured by assessing their sensitivity, PPV, depth and breadth of coverage using MGISEQ-2000. We also compared the performance of WES and WGS using NA12878. The sensitivity and PPV were tested using the family-based trio design for the Chinese trios. We further developed a systematic WGS pipeline for the analysis of 8 clinical cases. Results: In general, the sensitivity and PPV for SNV/indel detection increased with mean depth and reached a plateau at an ~40X mean depth using down-sampling samples of NA12878. With a mean depth of 40X, the sensitivity of homozygous and heterozygous SNPs of NA12878 was >99.25% and >99.50%, respectively, and the PPV was 99.97% and 98.96%. Homozygous and heterozygous indels showed lower sensitivity and PPV. The sensitivity and PPV were still not 100% even with a mean depth of ~150X. We also observed a substantial variation in the sensitivity of CNV detection across different tools, especially in CNVs with a size less than 1 kb. In general, the breadth of coverage for disease-associated genes and CNVs increased with mean depth. The sensitivity and coverage of WGS (~40X) was better than WES (~120X). Among the Chinese trios with an ~40X mean depth, the sensitivity among offspring was >99.48% and >96.36% for SNP and indel detection, and the PPVs were 99.86% and 97.93%. All 12 previously validated variants in the 8 clinical cases were successfully detected using our WGS pipeline.Conclusions: The current standard of a mean depth of 40X may be sufficient for SNV/indel detection and identification of most CNVs. It would be advisable for clinical scientists to determine the range of sensitivity and PPV for different classes of variants for a particular WGS pipeline, which would be useful when interpreting and delivering clinical reports.
Incidence and predictors of surgical site infection after distal femur fractures treated by open reduction and internal fixation: a prospective single-center study
Authors: Zhang Junzhe , Li Junyong , Zhao Kuo , Meng Hongyu , Zhu Yanbin , Zhang Yingze 
Published: August 2020

Abstract
Background: There remain limited data on the epidemiological characteristics and related predictors of surgical site infection (SSI) after open reduction and internal fixation (ORIF) for distal femur fractures. We designed this single-centre prospective study to explore and resolve these clinical problems. Methods ： From October 2014 to December 2018, 364 patients with distal femur fractures were treated with ORIF and followed for complete data within one year. Receiver operating characteristic (ROC) analyses, univariate Chi-square analyses, and multiple logistic regression analyses were used to screen the adjusted predictors of SSI. Results : The incidence of SSI was 6% (22/364): 2.4% for superficial SSIs and 3.6% for deep SSIs. Staphylococcus aureus (methicillin-resistant S. aureus in 2 cases) was the most common pathogenic bacteria (7, 36.8%). In multivariate analysis, parameters independently associated with SSI were: Open fracture (OR: 7.27, p = 0.003), drain use (OR: 4.11, p = 0.037), and incision cleanliness (OR: 3.53, p = 0.002). An albumin/globulin (A/G) level ≥ 1.35 (OR: 0.23, p = 0.042) was an adjusted protective factor for SSI. Conclusions : The SSI after ORIF affected approximately one in 15 patients with distal femur fractures. We recommend that maintaining A/G levels higher than 1.35 is introduced during hospitalization and elaborative evaluation of drain use is conducted for reducing the risk of post-operative SSI. Trial registration: NO 2014-015-1, October 15, 2014. We registered our trial prospectively in October 15, 2014 before the first participant was enrolled. This study protocol was conducted according to the Declaration of Helsinki and approved by the Institutional Review Board. The ethics committee approved the Surgical Site Infection in Orthopaedic Surgery (NO 2014-015-1). Data used in this study were obtained from the patients who underwent orthopaedic surgeries between October 2014 to December 2018.
Comparative study of preoperative prediction scores for lymph node metastasis in gastric and colon cancer patients
Authors: Zheng Xiangjian , Chen Xiaodong , Li Min , Li Chunmeng , Shen Xian 
Published: August 2020

Abstract
Background: Surgery combined with chemo-radiotherapy is a recognized model for the treatment of gastric and colon cancers. Lymph node metastasis determines the patient's surgical or comprehensive treatment plan. This analytical study aims to compare preoperative prediction scores to better predict lymph node metastasis in gastric and colon cancer patients.Methods: This study comprised 768 patients, which included 312 patients with gastric cancer and 462 with colon cancer. Preoperative clinical tumor characteristics, serum markers, and immune indices were evaluated using single-factor analysis. Logistic analysis was designed to recognize independent predictors of lymph node metastasis in these patients. The independent risk factors were integrated into preoperative prediction scores, which were accurately assessed using receiver operating characteristic (ROC) curves.Results: Results showed that serum markers (CA125, hemoglobin, albumin), immune indices (S100, CD31, d2–40), and tumor characteristics (pathological type, size) were independent risk factors for lymph node metastasis in patients with gastric and colon cancer. The preoperative prediction scores reliably predicted lymph node metastasis in gastric and colon cancer patients with a higher area under the ROC curve (0.901). The area was 0.923 and 0.870 in gastric cancer and colon cancer, respectively. Based on the ROC curve, the ideal cutoff value of preoperative prediction scores to predict lymph node metastasis was established to be 287. Conclusion: The preoperative prediction scores is a useful indicator that can be applied to predict lymph node metastasis in gastric and colon cancer patients.
A clinical prediction model for complicated appendicitis in children younger than five years of age
Authors: Feng Wei , Zhao Xu-Feng , Li Miao-Miao , Cui Hua-Lei 
Published: August 2020

Abstract
Background: No reliably specific method for complicated appendicitis has been identified in children younger than five years of age. This study aimed to analyze the independent factors for complicated appendicitis in children younger than five years of age, develop and validate a prediction model for the differentiation of simple and complicated appendicitis. Methods: A retrospective study of 382 children younger than five years of age with acute appendicitis from January 2007 to December 2016 was conducted with assessments of demographic data, clinical symptoms and signs, and pre-operative laboratory results. According to intraoperative findings and postoperative pathological results, acute appendicitis were divided into simple and complicated appendicitis. Univariate and multivariate analyses were used to screen out the independent factors of complicated appendicitis, and develop a prediction model for complicated appendicitis. Then 156 such patients from January 2017 to December 2019 were collected as validation sample to validate the prediction model. Test performance of the prediction model was compared with the ALVARADO score and Pediatric Appendicitis Score (PAS). Results: Of the 382 patients, 244 (63.9 %) had complicated appendicitis. Age, white blood cell count, and duration of symptoms were the independent factors for complicated appendicitis in children younger than five years of age. The final predication model for complicated appendicitis included factors above. In validation sample, the prediction model exhibited a high degree of discrimination (area under the curve [AUC]: 0.830; 95% confidence interval [CI]: 0.762 - 0.885) corresponding to a optimal cutoff value of 0.62, and outperformed the PAS (AUC: 0.735; 95% CI: 0.658 - 0.802), ALVARADO score (AUC: 0.733; 95% CI: 0.657 - 0.801). Conclusion : Age, white blood cell count, and duration of symptoms could be used to predict complicated appendicitis in children younger than five years of age with acute appendicitis. The prediction model is a novel but promising method that aids in the differentiation of acute simple and complicated appendicitis.
LncRNA MCM3AP-AS1 sponges miR-148a to cell invasion and migration in small cell lung cancer
Authors: Luo Hua , Zhang Yu Kun , Qin Guang Mei , Jiang Bing , Miao Li li 
Published: August 2020

Abstract
Background: MCM3AP-AS1 is a recently characterized lncRNA in hepatocellular carcinoma (HCC) and (GBM). We found that miR-148a may be able to bind MCM3AP-AS1. We explored the functions of lncRNA MCM3AP-AS1 in small cell lung cancer (SCLC). Methods: Gene expression in SCLC patients was analyzed by qPCR. Transient transfections were performed to analyze gene interactions. Cell invasion and migration were analyzed by Transwell assays.Results: We found that MCM3AP-AS1 was upregulated in SCLC and high expression levels were accompanied by low survival rate. Bioinfromatics analysis showed that MCM3AP-AS1 may bind miR-148a, which can target ROCK1. In SCLC tissues, MCM3AP-AS1 was positively correlated with ROCK1. In SCLC cells, MCM3AP-AS1 overexpression mediated the upregulated ROCK1 expression and increased cell invasion and migration rates. However, MCM3AP-AS1 and miR-148a could not regulate each other. However, miR-148a overexpressed led to downregulated ROCK1 expression, decreased cell invasion and migration rates, and reduced effects of MCM3AP-AS1 overexpression. Conclusions: Therefore, MCM3AP-AS1 may sponge miR-148a to cell invasion and migration in SCLC through the upregulation of ROCK1.
The gaps in health-adjusted life years (HALE) by income and region in Korea: a national representative bigdata analysis
Authors: Kim Young-Eun , Ock Minsu , Park Hyesook , Kim Ki-beom , Go Dun-Sol , Jung Yoon-Sun , Yoon Seok-Jun 
Published: August 2020

Abstract

Background

This study aims to calculate the health-adjusted life years (HALE) by using years lived with disability from the national claims data and aims to identify the differences and inequalities in income level and region.

Methods

The study was carried out on total population receiving health insurance and medical benefits. We calculated incidence-based years lived with disability (YLD) for 260 disease groups, and this was used as the number of healthy years lost to calculate HALE. We adopted the insurance premium to calculate the income as a proxy indicator. For the region classification, we chose 250 administrative districts to cover the whole country.

Results

The primary outcome was HALE in the Korean population. The second outcome was the HALE’s gap in terms of income and region. HALE increased from 2008 to 2016. Results by gender suggest that HALE in males increases faster than in females. Results by income level show that HALE is higher in higher income level. In 2016, the gap in HALE between Q1 and Q2, the lower income group, was about 5.10 years. The gap in females by income level was smaller than that in males, which can be because males have greater inequality in terms of HALE by income level. Moreover, the gap in HALE by region was found to increase.

Conclusions

Results suggest that there is an inequality in years of living with disability in terms of income level in Korea. Therefore, we need intensive management for the low-income group to promote HALE at the national level.
Iranian senior dental students as future role models of good health behaviour – a ten year study
Authors: Khami Mohamad Reza , Mohebbi Simin Zahra , Dorostkar Zahra , Keshavarz Hooman , Bonabi Maedeh , Murtomaa Heikki , Virtanen Jorma I 
Published: August 2020

Abstract
Background: Dentists according to professional knowledge of the prevention, have a key role in providing a positive model for oral health-promoting behaviours. We aimed to investigate health behaviour of Iranian senior dental students in terms of oral self-care and tobacco use during a ten-year period to assess their preparedness to act as role models for health-promoting behaviours.Method: The study was performed in six dental schools selected through stratified cluster random sampling to have a representative sample of established (old) and new dental schools in Iran. Data were collected in four occasions in 2005, 2008, 2011, and 2015. Senior dental students (n=1185) were invited to voluntarily complete a self-administered anonymous questionnaire about their oral self-care and tobacco use. Recommended tooth-brushing habit (RTH) was defined as at least twice a day brushing with fluoridated toothpaste. Three separate questions about cigarette, pipe, and water-pipe use were applied to indicate the students’ tobacco use. Results: In 2005, 2008, 2011, and 2015, 22.5% (n=60), 26% (n=52), 28.5% (n=81), and 24.6% (n=51) of the students reported smoking, respectively. Women reported a better status in both tooth brushing twice daily and frequent use of fluoridate toothpaste than men did (p<0.001). Among male students, 42.2% (n=159) and among female students 14.9% (n=83) of the students reported current smoking. The trend of reported smoking had the least variation among female students. This was true also for male students regarding RTH.Conclusion: The status and trend of oral self-care and tobacco use among Iranian dental students calls for more emphasis on adopting health-promoting behaviours during dental education.
Similarities between Inferior-Center and Center-Center Lag Screw Positions in Femoral Intertrochanteric Fracture Surgeries
Authors: Yeh Yu-Cheng , Liu Chang-Heng , Chou Ying-Chao , Hsu Yung-Heng , Yu Yi-Hsun 
Published: August 2020

Abstract
Background: The center-center lag screw position has been widely accepted as the optimal lag screw/helical blade position in femoral intertrochanteric fracture surgery to achieve a tip-apex distance (TAD) less than 25 mm. Despite the inferior-center lag screw/helical blade position having some biomechanical advantages, and the emergence of calcar-referenced tip-apex distance (CalTAD), the clinical differences between the two commonly placed lag screw/helical blade positions remain unclear. This study aimed to (1) report radiological outcomes in managing geriatric femoral intertrochanteric fractures, (2) identify the influences of positions of lag screw/helical blade, and (3) identify the relationship between implants and the values of TAD and CalTAD.Methods: We retrospectively assessed the clinical and radiographic findings of geriatric patients (age ≥ 55 years) who underwent surgery for acute closed femoral intertrochanteric fractures during 1-year period and were followed up a minimum of 6 months. The radiographic parameters and incidences of fixation failure were compared between the different lag screw and helical blade positions (center-center vs. inferior-center). Subgroup analyses of different implant types (extramedullary and intramedullary) were also performed for comparisons for different lag screw positions, and TAD and CalTAD beyond the normal standard value of 25 mm.Results: A total of 206 patients were included during the study period, with a 7.8% fixation failure. There were no differences in incidences of fixation failure between the commonly inserted lag screw/helical blade positions (center-center vs. inferior-center), regardless of the implant types. Those with a TAD > 25 mm had significantly higher incidence of fixation failure than those with a TAD ≤ 25 mm in the extramedullary plate (17.0% vs. 1.2%, p = 0.001), but not in the intramedullary nails (16.1% vs. 4.4%, p = 0.08). There were no significant differences in incidences of fixation failure between CalTAD ≤ 25 mm and CalTAD > 25 mm in either extramedullary or intramedullary implants. Conclusion: Although TAD > 25 mm might increase the fixation failure rate in extramedullary plates, an inferior-center lag screw/helical blade position could achieve comparable radiographic results as a center-center position after osteosynthesis for geriatric femoral intertrochanteric fractures.
Linkage of sustainability to environmental impact assessment using ecosystem services concept; lessons from Thailand
Authors: Swangjang Kanokporn 
Published: August 2020

Abstract

Ecosystem Services (ES) could support Environmental Assessments (EAs) purpose towards sustainable approaches. This study systematically analyzed the ES contents of Environmental Impact Statements (EISs) to ascertain whether they addressed appropriate data that could be used as a tool for sustainable project implementation. Three levels of EISs including Environmental Health Impact Assessments (EHIA), Environmental Impact Assessments (EIA), and Initial Environmental Examinations (IEE) were analyzed. The results indicated that the quality of EISs which reflect the ES depended primarily on the project type. Relationships among ecological, social and economic components, based on land use consideration were crucial to consider the supply of resources and the demands made by the project. However, indirect effects, especially residual and cumulative impacts and alternative evaluations were lacking. Mitigation and monitoring specifications were satisfied, but could not guarantee the efficiency of project control due to lacking of mitigation hierarchy. The weakness of ecological impact analysis directly concerned biodiversity compensation, which links to net loss and net gain in ecosystem.The possibility of ES integration in EAs was reflected by the limitations and opportunities detailed in the content which was finally developed.
Improving case detection of tuberculosis in hospitalised Kenyan children– employing the Behaviour Change Wheel to aid intervention design and implementation
Authors: Oliwa Jacquie Narotso , Nzinga Jacinta , Masini Enos , Hensbroek Michaël Boele van , Jones Caroline , English Mike , Hoog Anja van't 
Published: August 2020

Abstract
Background The true burden of tuberculosis in children remains unknown, but approximately 65% go undetected each year. Guidelines for tuberculosis clinical decision-making are in place in Kenya and the National Tuberculosis programme conducts several trainings on them yearly. By 2018, there were 183 Xpert® machines in Kenyan public hospitals. Despite these efforts, diagnostic tests are underused and there is observed under detection of tuberculosis in children. We describe the process of designing a contextually appropriate, theory-informed intervention to improve case detection of TB in children and implementation guided by the Behaviour Change Wheel.Methods We used an iterative process, going back and forth from quantitative and qualitative empiric data to reviewing literature, and applying the Behaviour Change Wheel guide. The key questions reflected on included: i) what is the problem we are trying to solve; ii) what behaviours are we trying to change and in what way; iii) what will it take to bring about desired change; iv) what types of interventions are likely to bring about desired change; v) what should be the specific intervention content and how should this be implemented?Results The following behaviour change intervention functions were identified: i) training: imparting practical skills; ii) modelling: providing an example for people to aspire/imitate; iii) persuasion: using communication to induce positive or negative feelings or stimulate action; iv) environmental restructuring: changing the physical or social context; and v) education: increasing knowledge or understanding. The process resulted in a multi-faceted intervention package composed of redesigning of child tuberculosis training; careful selection of champions; use of audit and feedback linked to group problem solving; and work flow restructuring with role specification.Conclusion The intervention components were selected for their effectiveness (from literature), affordability, acceptability and practicability and designed so that TB programme officers and hospital managers can be supported to implement them with relative ease, alongside their daily duties. This work contributes to the field of implementation science by utilising clear definitions and descriptions of underlying mechanisms of interventions that will guide others to do likewise in their settings for similar problems.