bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical audit in the Pediatric primary care office and overweight prevention in toddlers.
Authors: Limauro Raffaele , Gallo Patrizia , Cioffi Luigi , Antignani Angelo , Cioffi Valentina , Calella Patrizia , Valerio Giuliana 
Published: April 2020

Abstract
Background: Clinical audit is a process by which physicians or other health care professionals perform a regular and systematic review of their clinical practice and amend it, when necessary. An internal audit allows to review the activities carried out by professionals, in order to assess the appropriateness, effectiveness, efficiency and safety of the services provided. Aim of this study was to apply the process of clinical audit to the obesity/overweight care in toddlers. After the correction of the nutritional errors that were considered potentially responsible for the excess weight gain, the effect of the changes of dietary advice s on the frequency of overweight/obesity was assessed in a cohort of children aged 24-36 months. Methods: Three Italian primary care pediatricians set up the audit strategy by recognizing the high prevalence of overweight and obesity in the entire cohort of toddlers born in 2005, 2006 and 2007 (Pre-Audit group, age 24-36 months old) under their care. By reviewing their clinical practice, they changed the protocol of weaning and feeding up to 36 months, mainly reducing protein and sugar excess. The change involved the cohorts of toddlers born in the years 2010, 2011 and 2012 (Post-Audit group). Results: Change in the approach of pediatricians to children’s diet yielded a reduction of the frequency of overweight/obesity in children between 24 and 36 months of life from 26.3% in the Pre-Audit group to 13.9% in the Post-Audit group (p<0.0001). Conclusion: Clinical audit revealed high rates of obesity/overweight among toddlers. The practice developed a new strategy for nutritional counseling, which was effective in reducing the frequency of overweight/obesity in young children.
The diagnostic yield of intellectual disability: Combined whole genome low-coverage sequencing and medical exome sequencing
Authors: Wang Jun , Wang Yan , Wang Liwen , Chen Wangyang , Sheng Min 
Published: April 2020

Abstract
Background: Intellectual disability (ID) is a heterogeneous neurodevelopmental disorder with a complex genetic underpinning in its etiology. Chromosome microarray (CMA) is recommended as the first-tier diagnostic test for ID due to high detection rate of copy number variation (CNV). Methods: To identify an appropriate clinical detection scheme for ID in Han Chinese patients, whole genome low-coverage sequencing was performed as the first-tier diagnostic test, and medical exome sequencing (MES) as the second-tier diagnostic test for patients with negative results of CNVs.Results: A total of 19 pathogenic CNVs in 16/95(16.84%) ID patients and 10 pathogenic single-nucleotide variations (SNVs), including 6 novel mutations in 8/95(8.42%) ID patients were identified on whom no pathogenic CNVs were discovered. The detection rate of CNVs in ID with multiple congenital anomalies (MCA) subgroup was significantly higher than ID with autism spectrum disorders and other IDs subgroups. And the single-nucleotide variations showed a higher occurrence rate in the other IDs subgroup.Conclusions: There were differences in the diagnostic yields of different variation types among the three ID subgroups. Our findings provided a new perspective on appropriate clinical detection scheme in different ID subgroups based on statistically significant differences among the three ID subgroups. The application of whole genome low-coverage sequencing as the first-tier diagnostic test for ID with MCA subgroup and MES as the first-tier diagnostic test for other ID subgroup was considered as an efficient clinical detection scheme.
Examining correlations between opioid dispensing and opioid-related hospitalizations in Canada, 2007 - 2016
Authors: Jones Wayne , Kurdyak Paul , Fischer Benedikt 
Published: April 2020

Abstract
Background: High levels of opioid-related mortality, as well as morbidity, contribute to the excessive opioid-related disease burden in North America, induced by high availability of opioids. While correlations between opioid dispensing levels and mortality outcomes are well-established, fewer evidence exists on correlations with morbidity (e.g., hospitalizations).Methods: We examined possible overtime correlations between medical opioid dispensing and opioid-related hospitalizations in Canada, by province, 2007 – 2016. For dispensing, we examined annual volumes of medical opioid dispensing from a representative, stratified sample of retail pharmacies across Canada. Raw dispensing information for ‘strong opioids’ was converted into Defined Daily Doses per 1,000 population per day (DDD/1,000/day). Opioid-related hospitalization rates referred to opioid poisoning-related admissions by province, for fiscal years 2007-08 to 2016-17, drawn from the national Hospital Morbidity Database. We assessed possible correlations between opioid dispensing and hospitalizations by province using the Pearson product moment correlation; correlation values (r) and confidence intervals were reported.Results: Significant correlations for overtime correlations between population-levels of opioid dispensing and opioid-related hospitalizations were observed for three provinces: Quebec (r=0.87, CI: 0.49–0.97; p=0.002); New Brunswick (r=0.85;CI: 0.43–0.97; p=0.004) and Nova Scotia (r=0.78; CI:0.25–0.95; p=0.012), with Saskatchewan (r=0.073; CI:-0.07–0.91;p=0.073) featuring borderline significance.Conclusions: The correlations observed further contribute to evidence on opioid dispensing levels as a systemic driver of population-level harms. Notably, correlations were not identified principally in provinces with reported high contribution levels (>50%) of illicit opioids to mortality, which are not captured by dispensing data and so may have distorted potential effects due to contamination.
Association Between Cytomegalovirus End-organ Diseases andModerate-to-Severe Dementia: A Population-Based Cohort Study
Authors: Lee Kyoung Hwa , Kwon Da Eun , Han Kyung Do , La Yeonju , Han Sang Hoon 
Published: April 2020

Abstract
Background: The association between cytomegalovirus (CMV) and dementia remains controversial. Previous studies have suggested that CMV serostatus, as assessed by serum immunoglobulin G, plays a role in neurodegeneration with cognitive impairment. We aimed to evaluate the association between CMV tissue-invasive end-organ diseases and moderate-to-severe dementia.Methods: The ICD 10th revision codes from the National Health Insurance Database covering the entire population of the Republic of Korea were used to classify patients into exposed (n = 687, age ≥40 years, with CMV disease) and unexposed (n = 3,435, without CMV disease) groups, matched by age and sex at a 1:5 ratio of exposed: unexposed. All non-HIV-1-infected subjects selected during 2010–2014 with a washout period of the previous 4 years were followed up until December 2016 to identify newly diagnosed cases of moderate-to-severe dementia. Results: Multivariate regression model (M3) adjusted for age, sex, low income, body mass index, transplantation status, malignant neoplasms, end-stage renal disease on dialysis, type 2 diabetes mellitus, hypertension, and dyslipidaemia showed a significantly higher incidence of dementia (odds ratio: 1.9; 95% confidence interval: 1.2–2.8) in the exposed group than that in the unexposed group. The risk of vascular dementia (2.9, 1.1–7.5) was higher than that of Alzheimer’s disease (1.6, 1.0–2.6) in the exposed group in M3. In M3, patients aged 40–59 years with CMV diseases had a significantly higher risk of all kinds of dementia than those aged 60-79 and ≥80 years (11.7, 2.5–49.4 vs. 1.8, 1.1–3.2 vs. 1.3, 0.5–2.8; P=0.025). Conclusions: CMV diseases may be associated with the risk of moderate-to-severe dementia.
Ethnomedicinal knowledge of a marginal hill community of Central Himalaya: Diversity, usage pattern and conservation concerns
Authors: Ojha S. N. , Tiwari Deepti , Anand Aryan , Sundriyal R.C. 
Published: April 2020

Abstract
Background Indigenous communities use wild plants to cure human ailments since ancient times, such knowledge has significant potential for formulating new drugs and administering future health care. Considering this the present study was undertaken to assess use value, diversity, and conservation concerns of medicinal plants used in traditional herbal care system of a marginal hill community in Bageshwar district of Uttarakhand in the Central Himalayan region of India. Methodology Extensive surveys were made in 73 villages to gather information on ethnomedicinal use of plant species used in traditional herbal healing system. A total of 100 respondents were identified (30 herbal healers called ‘ Vaidyas’ and 70 non-healers/natives) and interviewed using semi-structured questionnaires, target interviews and group discussion. Some important indices such as the use value index (UV), relative frequency citation (RFC), cultural importance index (CI), and informant consensus factor (F ic ) were calculated for the medicinal plants included in the present study. Result It was recorded that the community use a total of 70 species with 64 genera and 35 families for curing various ailments. Family Lamiaceae recorded maximum number of medicinal plants. 21 species used most extensively in traditional health care system. The major parts of the identified plants used for treatment of various ailments were root/rhizome and leaf. The most common methods used for preparation of these plants were decoction and infusion. Ocimum basilicum L., Cannabis sativa L., Citrus aurantifolia (Christm) Sw., Curcuma longa L.and Setaria italic L. had the highest rate of use report. RFC value ranged between 0.03 to 0.91 with highest values for Setaria italica, Zingiber officinale, Ocimum basilicum, and Rephanus sativus . The traditional knowledge is passed verbally to generations and needs to be preserved for the future bio-prospecting of plants that could be a potential cure to any future disease. Conclusion In recent years the community has access to modern hospitals and medicinal facilities, although a considerable number still prefer medicinal plants for curing select ailments. It is suggested that these ethnomedicial species need to be screened and evaluated further for their effectiveness for pharmacological activity. Also, significant efforts are required to conserve traditional knowledge and natural habitats of wild medicinal plants.
Malaria knowledge and experiences with community health workers among recently pregnant women in Malawi
Authors: Malpass Ashley , Chinkhumba Jobiba , Davlantes Elizabeth , Munthali John , Wright Katherine , Ramsey Kathryn , Troell Peter , Kayange Michael , Kachale Fannie , Mathanga Don P. , Chatata Dziko , Gutman Julie R 
Published: April 2020

Abstract
Background The World Health Organization recommends three or more doses of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) to mitigate the negative effects of malaria in pregnancy (MIP). Many pregnant women in Malawi are not receiving the recommended number of doses. Community delivery of IPTp (cIPTp) is being piloted as a new approach to increase coverage. This survey assessed recently pregnant women’s knowledge of MIP and their experiences with community health workers (CHWs) prior to implementing cIPTp. Methods Data were collected via a household survey in Ntcheu and Nkhata Bay Districts, Malawi, from women aged 16-49 years who had a pregnancy resulting in a live birth in the previous 12 months. Survey questions were primarily open response and utilized review of the woman’s health passport whenever possible. Analyses accounted for selection weighting and clustering at the health facility level and explored heterogeneity between districts.Results A total of 370 women were interviewed. Women in both districts found their CHWs to be helpful (77.9%), but only 35.7% spoke with a CHW about antenatal care and 25.8% received assistance for malaria during their most recent pregnancy. A greater proportion of women in Nkhata Bay than Ntcheu reported receiving assistance with malaria from a CHW (42.7% vs 21.9%, p=0.01); women in Nkhata Bay were more likely to cite IPTp-SP as a way to prevent MIP (41.0% vs 24.8%, p=0.02) and were more likely to cite mosquito bites as the only way to spread malaria (70.6% vs 62.0% p=.03). Women in Nkhata Bay were more likely to receive 3+ doses of IPTp-SP (IPTp3) (59.2% vs 41.8%, p=0.0002). Adequate knowledge was associated with increased odds of receiving IPTp3, although not statistically significantly so (adjusted odds ratio = 1.50, 95% confidence interval 0.97- 2.32, p-value 0.066). Conclusions Women reported positive experiences with CHWs, but there was not a focus on MIP. Women in Nkhata Bay were more likely to be assisted by a CHW, had better knowledge, and were more likely to receive IPTp3+. Increasing CHW focus on the dangers of MIP and implementing cIPTp has the potential to increase IPTp coverage.
Does zero-profile anchored cage accompanied by a higher postoperative subsidence compared with cage-plate construct? A meta-analysis
Authors: Lu Yingjie , Fang Yuepeng , Shen Xu , Lu Dongdong , Zhou Liyu , Gan Minfeng , Zhu Xuesong 
Published: April 2020

Abstract
Background: The zero-profile anchored cage (ZP) has been widely used for its lower occurrence of dysphagia. However, it is still controversial whether it has the same stability as the cage-plate construct (CP) and increases the incidence of postoperative subsidence. We compared the rate of subsidence after anterior cervical discectomy and fusion (ACDF) with ZP and CP to determine whether the zero-profile device had a higher subsidence rate.Methods: We performed a meta-analysis of studies that compared the subsidence rates of ZP and CP. An extensive and systematic search covered the Medline, Embase and Web of Science databases according to the PRISMA guidelines and identified ten articles that satisfied our inclusion criteria. Relevant clinical and radiological data were extracted and analyzed by RevMan 5.3 software.Results: Ten trials involving 626 patients were included in this meta-analysis. The incidence of postoperative subsidence in the ZP group was significantly higher than that in the CP group [15.1% (89/588) vs. 8.8% (51/581), OR = 1.97 (1.34, 2.89), P = 0.0005]. In the subgroup analysis, we found that the definition of subsidence did not affect the higher subsidence rate in the ZP group. Considering the quantity of operative segments, there was no significant difference in the incidence of subsidence between the two groups after single-level fusion (OR 1.43, 95% CI 0.61-3.37, P = 0.41). However, the subsidence rate of the ZP group was significantly higher than that of the CP group (OR 2.61, 95% CI 1.55-4.40, P = 0.0003) after multilevel (≥ 2-level) procedures. There were no significant differences in intraoperative blood loss, JOA score, NDI score, fusion rate or cervical alignment in the final follow-up between the two groups. In addition, the CP group had a longer operation time and a higher incidence of dysphagia than the ZP group at each follow-up time. Conclusion: Based on the limited evidence, we suggest that ZP has a higher risk of postoperative subsidence than CP, although with elevated swallowing discomfort. A high-quality, multi-center randomized controlled trial is required to validate our results in the future.
iTRAQ-based quantitative proteomics analysis of cantaloupe (Cucumis melo var. saccharinus) after cold storage
Authors: Song Wen , Tang Fengxian , Cai Wenchao , Zhang Qin , Zhou Fake , Ning Ming , Tian Huan , Shan Chunhui 
Published: April 2020

Abstract
Background: Cantaloupe is susceptible to cold stress when it is stored at low temperatures, resulting in the loss of edible and commercial quality. To ascertain the molecular mechanisms of low temperatures resistance in cantaloupe, a cold-sensitive cultivar, Golden Empress-308 (GE) and a cold-tolerant cultivar, Jia Shi-310 (JS), were selected in parallel for iTRAQ quantitative proteomic analysis. Results: The two kinds of commercial cultivars were exposed to a temperature of 0.5℃ for 0, 12 and 24 days. We found that the cold-sensitive cultivar (GE) suffered more severe damage as the length of the cold treatment increased. Proteomic analysis of both cultivars indicated that the number of differentially expressed proteins (DEPs) changed remarkably during the chilly treatment. JS expressed cold-responsive proteins more rapidly and mobilized more groups of proteins than GE. Furthermore, metabolic analysis revealed that more amino acids were up-regulated in JS during the early phases of low temperatures stress. The DEPs we found were mainly related to carbohydrate and energy metabolism, structural proteins, reactive oxygen species scavenging, amino acids metabolism and signal transduction. The consequences of phenotype assays, metabolic analysis and q-PCR validation confirm the findings of the iTRAQ analysis. Conclusion: We found that the prompt response and mobilization of proteins in JS allowed it to maintain a higher level of cold tolerance than GE, and that the slower cold responses in GE may be a vital reason for the severe chilling injury commonly found in this cultivar. The candidate proteins we identified will form the basis of future studies and may improve our understanding of the mechanisms of cold tolerance in cantaloupe.
Modeling Observations with a Detection Limit using a Truncated Normal Distribution with Censoring
Authors: Williams Justin R. , Kim Hyung-Woo , Crespi Catherine M. 
Published: April 2020

Abstract
Background: When data are collected subject to a detection limit, observations below the detection limit may be considered censored. In addition, the domain of such observations may be restricted; for example, values may be required to be non-negative. Methods: We propose a method for estimating population mean and variance from censored observations that accounts for known domain restriction. The method finds maximum likelihood estimates assuming an underlying truncated normal distribution. Results: We show that our method, tcensReg, has lower bias, Type I error rates, and mean squared error than other methods commonly used for data with detection limits such as Tobit regression and single imputation under a range of simulation settings from mild to heavy censoring and truncation. We further demonstrate the consistency of the maximum likelihood estimators. We apply our method to analyze vision quality data collected from ophthalmology clinical trials comparing different types of intraocular lenses implanted during cataract surgery. All of the methods yield similar conclusions regarding non-inferiority, but estimates from the tcensReg method suggest that there may be greater mean differences and overall variability. Conclusions: In the presence of detection limits, our new method tcensReg provides a way to incorporate known domain restrictions in dependent variables that substantially improves inferences.
A Comparison of Efece Systems With Tension Band Wiring for Patella Fracture Fixation in Cadavers
Authors: Karadeniz emre , keskinöz elif nedret 
Published: April 2020

Abstract
Background: EFECE Systems are newly-defined internal fixation systems, which are suitable for patella fracture fixation. The aim of this study was to compare the fixation strength of EFECE Systems with tension band wiring for transverse patellar fracture simulation on fresh frozen cadaver models. Methods: Quadriceps tendon-patella-patellar tendon (QT-P-PT) complex was prepared from human cadavers. After simulation of a transverse patella fracture, in Group 1, 5 patella were fixed with a pair of 1.2 mm EFECE wires and 4 EFECE devices. In Group 2, 5 patella were fixed with a pair of 1.2 mm Kirschner wires (K-wire) and a cerclage wire according to the tension band technique.Using a testing device with custom-made jaws, increasing distraction force was applied to these QT-P-PT complexes. Extension of these complexes with the distraction forces was observed. The maximum distraction force and the elongation during maximum force were evaluated. Results: After 5 experiments with the EFECE Systems, there was no EFECE wire breakage or EFECE wire-EFECE device catching failure. The median maximum force was 740 N (720-810N). During maximum distraction force the median extension was 2.5 mm (1.6-2.5 mm).After 5 experiments with the tension band technique, there was no K-wire breakage. The median maximum force was 330 N (240-510N). During this maximum distraction force the median extension was 3.4 mm (2.2-3.8 mm).Conclusions: Based on the biomechanical advantages, patella fracture treatment with EFECE systems may constitute a reasonable alternative in the treatment of patella fractures.
Magnitude of Home Delivery and Associated Factors Among Child Bearing Age Mothers in Sherkole District, Benishangul Gumuz Regional State-Western-Ethiopia
Authors: Gebremariam Resom Berhe , Nigusie Adane 
Published: April 2020

Abstract
Background: The World Health Organization estimates that globally only 43 percent of women have access to skilled care during deliveries and the rest are exposed to unskilled delivery service. A recent Ethiopian Demographic and Health Survey report stated that maternal death was 412 per 100,000 in 2016.This still indicate that maternal health remains a major public health problem in Ethiopia irrespective of the government’s measure to institutional delivery.Methods: - A community based cross sectional study was conducted among women aged 15-49 years in Sherkole district, Benishangul Gumuz region from January to June 2018. A total of 451 randomly selected women were included in the study. Stratified sampling followed by simple random sampling technique was used to select the study participants. Data were collected using pretested and structured questionnaires. Bivariate and multivariate logistic regression models were fitted to identify factors associated with home delivery among women in the child bearing age. An adjusted odds ratio with 95% confidence interval was computed to determine the level of significance. Results: The magnitude of home delivery was 353 (80%) and were assisted by non-skilled birth attendants. Mothers whose husband choose the place of delivery [AOR: 5.6, 95% CI (2.1-15.2), Mothers’ occupation ([AOR: 0.21 95% C I (0.08-0.57), ANC visit [AOR: 95 CI: 5.1(1.6-15.8), decision making [AOR: 95 CI: 0.3(0.01-0.7)] and traditional remedies [AOR: 95%CI: 0.03(0.01-0.09)] were significantly associated with home delivery.Conclusions: Based on the findings of the survey, it was concluded that the overall magnitude of home delivery was found to be high. Therefore, it is recommended that promotion of antenatal care follow-up with maternal and child health information particularly on delivery complications or danger signs needs due attention and remedial actions.