bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Abnormal Umbilical Arterial Flow on Doppler Ultrasound in Low-risk and Unselected Pregnant Women: A Systematic Review
Authors: Vogel Joshua Peter , Vannevel Valerie , Robbers Gianna , Gwako George , Lavin Tina , Adanikin Abiodun , Hlongwane Tsakane , Pattinson Robert C , Qureshi Zahida P. , Oladapo Olufemi T. 
Published: October 2020

Abstract
Background: While Doppler ultrasound screening is beneficial for women with high-risk pregnancies, there is insufficient evidence on its benefits and harms in low- and unselected-risk pregnancies. This may be related to fewer events of abnormal Doppler flow, however the prevalence of absent or reversed end diastolic flow (AEDF or REDF) in such women is unknown. In this systematic review, we aimed to synthesise available data on the prevalence of AEDF or REDF.Methods: We searched PubMed, Embase, CINAHL, CENTRAL and Global Index Medicus with no date, setting or language restrictions. All randomized or non-randomized studies reporting AEDF or REDF prevalence based on Doppler assessment of umbilical arterial flow >20 weeks’ gestation were eligible. Two authors assessed eligibility and extracted data on primary (AEDF and REDF) and secondary (fetal, perinatal, and neonatal mortality, caesarean section) outcomes, with results presented descriptively. Results: A total of 42 studies (18,282 women) were included. Thirty-six studies reported zero AEDF or REDF cases. However, 55 AEDF or REDF cases were identified from just six studies (prevalence 0.08% to 2.13%). Four of these studies were in unselected-risk women and five were conducted in high-income countries. There was limited evidence from low- and middle-income countries.Conclusions: Evidence from largely observational studies in higher-income countries suggests that AEDF and REDF are rare among low- and unselected-risk pregnant women. There are insufficient data from lower-income countries and further research is required.
Analysis on Bouguer Gravity Anomaly Characteristics and Boundary Identification in China and Surrounding Regions
Authors: Xue Zhixin , Guo Dongmei , Zhang Panpan 
Published: October 2020

Abstract
China is located in the southeast of the Eurasian Plate and is subject to the effects of subducting, squeezing and collision by the Pacific Plate to the east, Philippine Plate to the southeast and Indian Ocean Plate to the southwest. It has exceptional geotectonic structure. Based on the satellite gravity data with high precision, high resolution and ample geophysical information, combined with geological data, by using satellite gravity potential field and its full tensor gradient, this paper studies the distribution characteristics of gravity anomalies and the identification of tectonic boundaries in China and surrounding regions. Results suggest that the Bouguer gravity anomaly in eastern China reduces gradually from east to west, mostly in the direction of NNE; in the western, it reduces gradually in a wave mode from north to south, mainly in the directions of NW and NWW. In general, the stress field reduces gradually from west to east, and the tectonic of stress field in western China is complex. The maximum principal compressive stress in Xinjiang exists in SN direction and that in Qinghai-Tibet Plateau mostly changes gradually from NNE to SSE; the change in eastern China is relatively simple, and the maximum principal compressive stress direction gradually changes from NE to WE and then to SE. In addition to the above study results, by comprehensively referencing the previous studies by other people and by using the boundary identification methods based on the satellite gravity full-tensor gradient data and its combinations, we update the extension route of Red River fault zone and deduce the tectonic unit boundary between the North China and South China active tectonic block regions. This paper identifies in China and surrounding regions 6 primary active tectonic blocks, 22 secondary active tectonic blocks, 3 tertiary active tectonic blocks and the 20 active tectonic block boundary zones constituted of deformation belts and active tectonic belts with various geometric structures and width variations. The results of this study can improve the understanding of gravity anomalies and boundary structures in China and surrounding regions, and provide certain geophysical supports for geological structure analysis and crustal dynamic process.
Diabetes Distress, Depressive Symptoms and Type 2 Diabetes Management and Glycemic Control: The Mediating Role of Self-Efficacy
Authors: Gao Yuexia , Han Yarong , Zou Xin , Xu Judy , Mawen Dean Getrude , Zhong Yaqing , Lun qingyun , Chu Minjie , Ma Qiang , Zhuang Xun , Xiao Jing 
Published: October 2020

Abstract
BackgroundDiabetes distress has been distinguished from depressive symptoms in the linkages to type 2 diabetes management and glycemic control. There are few evidences in rural China untangled the underlying pathways among them. The aim of our study was to examine whether self-efficacy reduced the detrimental effects of psychological variables on diabetes outcomes such as self-care behaviors, glycemic control and health-related quality of life (HRQoL).Methods1574 adults diagnosed with type 2 diabetes from 31 rural clinics in China were assessed for psychological variables, self-management and HRQoL. Hemoglobin A1c (HbA1c) data at 6 months after the survey were extracted from electronic medical records. Hierarchical regression model examined independent effects of psychological variables, self-efficacy on diabetes outcomes. KHB method and bootstrapping confidence intervals were employed to test the mediating effect of self-efficacy.ResultsHierarchical regression analysis showed both diabetes distress and depressive symptoms were significantly related to diet and HRQoL, but not related to glycemic control and medication adherence. Depressive symptoms, but not diabetes distress, was directly associated with physical activity. Mediation analysis demonstrated self-efficacy mediated the relationships of both diabetes distress and depressive symptoms on self-care behaviors, glycemic control and HRQoL.ConclusionsSelf-efficacy may contribute to better diabetes outcome by ameliorating the effects of diabetes distress and depressive symptoms. Patients with psychological conditions may need tailored intervention that enhance self-efficacy to improve diabetes management.
A Transparent Dialogue Between Iconography and Chemical Characterisation: A Set of Foreign Stained Glasses in Portugal
Authors: Rodrigues Alexandra J. , Coutinho Mathilda Larsson , Machado Andreia , Martinho Bruno A. , Alves Luís Cerqueira , Macedo Maria Filomena , Vilarigues Márcia 
Published: October 2020

Abstract
This work presents the first results of the iconographic study and analytical characterisation of a set of four stained-glass panels that are part of the collection of National Palace of Pena (Sintra, Portugal). These panels were collected by the King Ferdinand II in the mid-19th century, for his main residence the Palace of Necessidades (Lisbon, Portugal), and only first presented to the general public in 2011. This study contributes with the knowledge of Technichal Art History and Heritage Science to a better and deeper understanding of their history, materials and techniques used in the production, where an art-historical and a scientific approach are applied to attribute their origins. Based on the analysis of the formal and stylistic characteristic of the panels, it is proposed that the drawings used for the production of three of these panels may be based on the design and painting being carried out in the same workshop, and that the four panels have the same provenance (Germany). The composition of the glass and grisaille was determined and colourising elements were identified. Through this approach, conclusive correlation among the analysed glasses was possible: all are calcium rich or calcium-potassium rich types, and the results also suggest that the same source of silica was used for their production. A typical mixture of glass and lead oxide was found on the grisaille applied on the painted panels. However, less usual was the use of a copper oxide pigment for the black grisaille. All these findings support the proposals made regarding provenance and production period (15th century).
How is Organisational Fit Addressed in Australian Entry Level Midwifery Job Advertisements
Authors: Bloxsome Dianne , Glass Courtney , Bayes Sara 
Published: October 2020

Abstract
Background Midwifery job retention is an ongoing global issue. Prior research has recognised that considering an individual’s attributes in relation to their work environment may assist in improving job satisfaction among midwives, leading to improved long-term job retention in the midwifery profession. The aim of this study was to evaluate whether, and how organisational fit is addressed in current entry level midwifery job advertisements within Australia. Methods Midwifery jobs were searched for within 12 search engines, using the search term ‘midwife’, including Seek.com, Indeed.com, government employment websites for all Australian states and territories, and private health organisation websites. Data were extracted from eligible job advertisements by three independent researchers. Extracted data encompassed elements addressing person-job fit and person-organisation fit. Content analysis involving chi-square and Fischer exact tests were completed on extracted data. Results Key findings demonstrate private health care organisations (29.2%) are more likely than public health care organisations (8.8%) to ask potential candidates to have additional qualifications, however, public health care organisations (34.1% vs. 16.7%) are more likely to ask for dual registration as a midwife and nurse. This is further supported by private health care organisations being more likely to refer to the candidate as a midwife (72.9% vs. 48.4%) than as a nurse. Private health care organisations more often noted access to support for employees and were more likely to mention access to employee assistance programs (41.7% vs. 13.2%), orientations (16.7% vs. 0%) and included benefits (72.9% vs. 42.9%). Clinical skills and personality traits were more frequently addressed in public health organisation advertisements; these included a requirement of employees to be accountable (49.5% vs. 6.3%), innovative (28.6% vs. 0%), have teamwork (69.2% vs. 52.1%) and conflict resolution skills (36.3% vs. 8.3%), and have knowledge of legislation (44.0% vs. 25.0%) and contemporary midwifery issues (28.6% vs. 4.2%). Conclusion This study highlights that organisations employing midwives may be unwittingly contributing to the problem of midwife attrition through inattention to factors that endear midwives to workplaces in job advertisements. Further work developing employee selection and recruitment processes that are informed by the concept of person-job-organisation fit, is necessary.
Co-location of Out of Hours Primary Care and Emergency Department in Belgium: Patients’ and Physicians’ View
Authors: Schoenmakers Birgitte , Criekinge Jasper Van , Boeve Timon , Wilms Jonas , Mullen Chris Van Der , Sabbe Marc 
Published: October 2020

Abstract
Background In Belgium, General Practitioner Cooperatives (GPC) aim to improve working conditions for unplanned care and to reduce the number of inappropriate emergency visits. Although this system is well organised, the number of inappropriate visits does not decrease. Methods We explored the position of patients and physicians on the co-location of a GPC and an emergency service for unplanned care. The study was carried out in a cross section design in primary and emergency care services, including patients and physicians. Main outcome measures were the position of patients and physician on co-location a GPC and an emergency service. Results 404 patients and 488 physicians participated. 334 (82.7%) of all patients favored a co-location. The most important advantages were fast service (104, 25.7) and adequate referral (54, 13.4%). 237 (74%) of the GP’s and 38 (95%) of the emergency physicians were in favor of a co-location. The major advantage of this system was a more adequate referral of patients. 254 (79%) of the GP’s and 23 (83%) of the emergency physicians believed that a co-location would lower the workload, decrease waiting time and increase care quality (resp. 251 (78%), 224 (70%) and 37 (93%), 34 (85%). Conclusions To meet all concerns and to reach for high care quality information campaigns and development of workflows are necessary for a successful implementation of a co-location of primary and emergency care.
A Meta-Analysis of HDL Cholesterol Efflux Capacity and Concentration in Patients With Rheumatoid Arthritis
Authors: Xie Binbin , He Jiang , Liu Yong , Liu Ting , Liu Chaoqun 
Published: October 2020

Abstract
Background: Poor cholesterol efflux capacity (CEC) has been proposed to be an independent risk factor for cardiovascular diseases. However, the current evidences in the literature are inconsistent. This meta-analysis aimed to identify whether CEC is impaired or altered by drug therapy in individuals with rheumatoid arthritis (RA).Methods: The PubMed, Embase, and Cochrane library databases were searched to identify studies on CEC in RA patients. The searches were focused on studies in human subjects that were published before 10 Sep 2020, without language restrictions. The primary outcomes were CEC and the high-density lipoprotein cholesterol (HDL-C) and C-reactive protein levels (CRP).Results: A total of 11 eligible articles, including 6 observational and 5 intervention studies, were retrieved. The pooled results showed that CEC is not significantly lower in RA patients than in healthy controls (SMD: -0.34, 95% CI: -0.83 to 0.14), whereas the plasma HDL-C level is not significantly lower HDL-C levels (WMD: -3.91, 95% CI: -7.15 to -0.68). Furthermore, in the before-after studies, the CEC of RA patients (SMD: 0.20, 95% CI: 0.02 to 0.37) increased, but the plasma HDL-C level (WMD: 3.63, 95% CI: -0.13 to 7.39) remained at a similar level after anti-rheumatic treatment compared to the baseline. In addition, the funnel plot was relatively symmetric and did not suggest the presence of publication bias.Conclusion: The current meta-analysis demonstrated that HDL-mediated CEC can be improved by the early control of inflammation and anti-rheumatic treatment in RA patients, which is independent of HDL-C levels. Future research is needed to determine whether therapeutic strategies to enhance CEC in RA patients have beneficial effects for preventing CVD.
Cumulative Risk Exposure and Emotional Symptoms among Early Adolescent Girls
Authors: Demkowicz Ola , Panayiotou Margarita , Humphrey Neil 
Published: October 2020

Abstract
BackgroundFrom early adolescence, girls and women report the highest rates of emotional symptoms, and there is evidence of increased prevalence in recent years. We investigate risk factors and cumulative risk exposure (CRE) in relation to emotional symptoms among early adolescent girls.MethodsUsing structural equation modelling, risk factors were identified in relation to symptoms and collated into a CRE index to investigate associations among 8,327 girls aged 11–12 years.ResultsFour risk factors were identified: Low academic attainment, special educational needs, low family income, and caregiving responsibilities. CRE was positively associated with symptoms.ConclusionsFindings offer insight into the epidemiology of emotional symptoms among adolescent girls during a vulnerable period, offering a timely contribution given current evidence of increased prevalence. Results suggest that several factors in day-to-day life are associated with emotional symptoms among early adolescent girls. Furthermore, early adolescent girls experiencing higher CRE are likely to experience greater emotional distress, highlighting the need for identification and intervention for of those facing greater adversity in daily life.
The Time-varying Networks of the Wrist Extension in Post-stroke Hemiplegic Patients
Authors: Li Fali , Jiang Lin , Li Yuqin , Huang Dongfeng , Jiang Yuanling , Peng Yueheng , Zhang Xiabing , Yao Dezhong , Xu Peng , Li Hai 
Published: October 2020

Abstract
Background: Hemiplegia is a common dysfunction caused by a stroke and leads to movement disability. Although the movement-related oscillation, the lateralization of the movement-related potential, and the event-related desynchronization have been investigated, the dynamic network modalities related to the movements in post-stroke hemiplegic patients are still left unveiled. Methods: In our present study, we designed the motor execution task of the wrist extension, collected the movement-related electroencephalograms, and adopted the adaptive directed transfer function to investigate the dynamic motor networks in post-stroke hemiplegic patients. The corresponding time-varying networks of the wrist extension in post-stroke hemiplegic patients were constructed and then statistically explored. Results: The results demonstrated that the effective connectivity between the stroked motor area and other areas decreased. In contrast, connectivity between non-stroked motor area and other areas was enhanced, especially the frontal and parietal-occipital lobes, to compensate for the dysfunction of the motor behaviors of the stroked patients.Conclusions: These findings help us better understand the time-varying networks underlying the implementation of the motor behaviors of the patients with post-stroke hemiplegia and might provide a reliable biomarker to predict their future rehabilitation.
A Structured Program for Teaching Pancreatojejunostomy Outside the Operating Room
Authors: Oshiro Kenichi , Endo Kazuhiro , Morishima Kazue , Kaneda Yuji , Koizumi Masaru , Sasanuma Hideki , Sakuma Yasunari , Lefor Alan Kawarai , Sata Naohiro 
Published: October 2020

Abstract
Background: Pancreatojejunostomy (PJ) is one of the most difficult and challenging abdominal surgical procedures. Most trainees learn this procedure in the operating room (OR) because there are no appropriate training systems available outside the OR. This extends the learning curve and may affect patient safety. We developed a structured program for teaching PJ to increase training opportunities outside the OR. Methods: We have created this structured program to help trainees acquire both didactic knowledge and technical skills to perform PJ. A manual was created to provide general knowledge about PJ and the specific PJ procedure used in our institution. Based on questionnaires completed by trainers and trainees, the procedure for PJ was divided into twelve steps and described in detail. After creating the manual, we developed organ models, needles and a frame box for simulation training.Results: Trainees learn about PJ by reading the procedure manual, acquiring both general and specific knowledge. We conducted simulation training outside the OR using the training materials created for this system. Training was performed with participants referring to the procedure manual while performing the simulation training. They simulate the procedure with surgical instruments as both primary and assistant surgeon. After finishing the anastomosis, trainees inspect the resulting structures from all angles including the posterior side and intraluminally, which cannot be observed during the actual operation. Conclusion: We developed a structured program for teaching PJ. By implementing this program, it is expected that a trainee’s learning curve will be shortened while ensuring patient safety.
Three-dimensional Camera Systems Assistant the Sheath of Prostate Preservation Laparoscopic Radical Prostatectomy: Technique and Initial Experience
Authors: Song Lingmin , Wang Gang , Gao Wenbo , Yang Yusheng , Weng Guobin 
Published: October 2020

Abstract
Background: To report our refinement of laparoscopic radical prostatectomy by preservation of the sheath of prostate (SPP-LRP) and 1-year follow-up results.Methods: SPP-LRP was performed in 39 consecutive patients diagnosed as clinically localized prostate cancer from January 2016 to December 2018. The inclusion criteria consisted of Gleason score ≤7, tPSA＜10 ng/ml, positive in no more than 3 in 12 needles by systematical puncture biopsy, less than 50% tumor core involvement, clinical stage T1-2, good potency. The oncological results were identified by postoperative pathology test. Functional outcomes, including continence and potency, were followed postoperatively.Results: The mean operation time was 108.3±35.2 min and the mean estimated blood loss was 129.3±46.4 ml with no transfusion. The catheter was removed 7 days after the surgery. There were no relevant postoperative complications requiring intervention. The histopathological results showed 2 cases (6.1%) in pT2 and 1 case (16.7%) in pT3 presented positive resection margins for tumor (R1). Only 1 case (pT3a,Gleason score 8) suffered pelvic lymph node metastasis. No biochemical relapse was observed after 1-year follow-up. The continence rates were 71.8% and 87.2% after 1 and 3 months, and no patients suffered G2 incontinence after 6 months , and 97.4% recovered continence after 12 months. The potency rates were 61.5% and 82.1% after 1 and 3 months, and that was 92.3% after 12 months. Conclusion:SPP-LRP is a practical and worth-promoting technique for RP. The initial results are preferable and promising in technical, oncological and functional aspects.
Validation of a newly developed competency assessment tool for the Posterior Sagittal Anorectoplasty
Authors: Joosten Maja , Bökkerink Guus MJ , Sutcliffe Jonathan , Levitt Marc A , Diefenbach Karen A , Reck Carlos A , Krois Wilfried , Blaauw Ivo de , Botden Sanne MBI 
Published: October 2020

Abstract
Background: The correction of an anorectal malformation (ARM) is highly complex and relatively infrequent. Simulation training and subsequent assessment of its effectiveness may result in better clinical outcomes. Assessment can be done using a CAT to assess surgical skills of a specific procedure. This study aims to develop and validate a competency assessment tool (CAT) for the posterior sagittal anorectoplasty (PSARP) for the repair of anorectal malformation. Methods: The CAT-PSARP was developed after consultation with experts in the field. The PSARP was divided into five steps, while general skills (tissue and instrument handling) were scored separately. During several pediatric colorectal hands-on courses in 2019 and 2020 participants were asked to voluntarily participate. They performed one PSARP procedure on an ARM simulation model, while being assessed by two objective observers using the CAT-PSARP.Results: A total of 82 participants were enrolled. Intra-class correlation coefficient analysis demonstrated a fair inter-observer agreement for ‘total score of general skills’ (ICC =0.524, p<0.001), a good agreement for ‘total score of specific skills’ (ICC=0.646 , p<0.001) and ‘total score overall’ (ICC=0.669, p<0.001). When comparing the experienced with the inexperienced group a significantly higher score for the experienced group was found for all steps (p=0.013 to p<0.001), except for step 5 ‘anoplasty’ (p=0.440). Conclusion: Good inter-observer agreement was found for the total scores of the CAT-PSARP. It is a suitable objective assessment tool for the overall performance of the included steps of the PSARP for repair of an ARM.