bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post-Partum Hemorrhage is Still Killing Mothers in Bangladesh: An Observation from the 2016 Bangladesh Maternal Mortality Survey (BMMS)
Authors: Rahman Aminur , Austin Anne , Begum Tahmina , Anwar Iqbal 
Published: August 2020

Abstract
The main cause of maternal death in Bangladesh is postpartum hemorrhage (PPH). PPH accounts for 31%of maternal deaths. Proven interventions to prevent maternal mortality are active management of third stage of labour (AMTSL) and the availability of comprehensive emergency obstetric care (CEmOC). Both of these interventions mandate the administration of oxytocin. In Bangladesh there are nonfunctioning institutionalized guidelines from the Director General of Health Services on the storage of oxytocin, which may impact the potency of oxytocin used during labour. To reduce preventable PPH morbidity and mortality, Bangladesh needs to evaluate the potency of current stores of oxytocin used in both in public and private facilities, develop and enforce protocols to ensure the potency of oxytocin, and promote universal access to quality AMSTL and CEmOC services.
Orthodontic Treatment as a Protective Factor for Dental Caries Experience and Severity: A Population-Based Study
Authors: Alsulaiman Ahmed A. 
Published: August 2020

Abstract
Background: As the current evidence remains contradictory and inconclusive, there is an urgent need to determine the ability of orthodontic treatment to reduce the risk of dental caries development later in life. Thus, the objective of this study is to assess the effects of orthodontic treatment on the experience, prevalence, and severity of dental caries later in life in a representative sample of U.S. adults.Methods: Using a population-based study design, data from 9,486 participants in the third National Health and Nutrition Survey (NHANES), including self-reported information on previous history of orthodontic treatment and its timing, were obtained. Caries experience and prevalence was assessed using the decayed (DT) and filled (FT) teeth indices (i.e., DT>0, FT>0, and their aggregate DFT>0). Severe dental caries experience and prevalence was defined as DT>2, FT>11, and DFT>12. Unadjusted and adjusted logistic regression models that accounted for the complex sampling design were used to assess the association between orthodontic treatment and dental caries experience, prevalence, and severity. Statistical significance was set at a p-value of less than 0.05.Results: Previous history of orthodontic treatment was reported in 19.62% of the adults. Around 94% of participants had at least one decayed or filled tooth (DFT>0), and 21.09% met the aggregate DFT criterion for severe caries (DFT>12). After controlling for confounding variables, a reported history of orthodontic treatment was found to significantly decrease the odds of DT>0, DT>2, FT>11, and DFT>12 (odds ratios [OR] = 0.41, 0.36, 0.74, and 0.60 respectively).Conclusion: A history of orthodontic treatment was a protective factor for untreated dental caries, in assessments of the severity and prevalence of dental caries experience.
Comparison of Oral Hygiene Status and Relative Abundance of Periodontal Pathogens Between Individuals With and Without Intellectual Disabilities: a Cross-Sectional Study
Authors: Oda Yuki , Furutani Chiaki , Kawano Reo , Murakami Jumpei , Mizota Yuika , Okada Yoshiyuki , Nikawa Hiroki 
Published: August 2020

Abstract
Background: Studies have reported a high prevalence of periodontal disease in individuals with intellectual disability (ID). The aim of this study was to compare the relative abundance of periodontal pathogens (red, orange, yellow, purple, and green complexes) between individuals with ID and healthy controls.Methods: Of the 31 subjects enrolled in this study, 16 with severe ID were selected from the outpatient clinic of the Special Care Dentistry of Hiroshima University Hospital, and 14 healthy subjects were selected from the outpatient clinic of another department at the same hospital. Dental plaque was sampled after oral examination. Decayed, missing, and filled permanent teeth (DMFT) counts were obtained and periodontal measurements were taken using the papillary-marginal-attached (PMA) index, plaque index (PI), gingival index (GI), and probing depth (PD). Gene sequencing (16S rRNA) was performed for each sample using next-generation high-throughput sequencing methods. The relative abundance of the periodontal pathogens and the clinical parameters were compared. An unpaired t-test was used to compare the oral health status in both groups and analysis of covariance was performed to compare the relative abundance of each pathogen.Results: No statistically significant difference in DMFT was observed between the two groups. However, significant differences in the median PMA index, PI, and GI were noted between the groups (P < 0.0001). In addition, the mean PD in the ID group was significantly higher than that in the control group (P < 0.0001). The relative abundances of Tannerella spp. and Treponema spp. were significantly higher in the ID group when compared to the control group at the genus level (P = 0.0383 and 0.0432, respectively); alternatively, the relative abundance of Porphyromonas spp. was significantly lower in the ID group (P < 0.0001).Conclusions: The PMA index, PI, GI, and PD were significantly lower in the ID group than in the control group. On the other hand, no significant difference in DMFT was observed between the two groups. Furthermore, our findings indicate that Tannerella forsythia might be more closely associated with periodontal disease than Porphyromonas gingivalis in individuals with ID.
Rhamnolipid Coating Reduces Microbial Biofilm Formation on Titanium Implants: an in-vitro Study
Authors: Tambone Erica , Bonomi Emiliana , Ghensi Paolo , Maniglio Devid , Ceresa Chiara , Agostinacchio Francesca , Caciagli Patrizio , Nollo Giandomenico , Piccoli Federico , Caola Iole , Fracchia Letizia , Tessarolo Francesco 
Published: August 2020

Abstract
Background: Peri-implant mucositis and peri-implantitis are biofilm-related diseases causing major concern in oral implantology, requiring complex anti-infective procedures or implant removal. Microbial biosurfactants emerged as new of anti-biofilm agents for coating implantable devices preserving biocompatibility. This study aimed to assess the efficacy of rhamnolipid biosurfactant R89 (R89BS) to reduce Staphylococcus aureus and Staphylococcus epidermidis biofilm formation on titanium. Methods: R89BS was physically adsorbed on titanium discs (TDs) and the ability of coated TDs to inhibit biofilm formation was evaluated by quantifying biofilm biomass and cell metabolic activity, at different time-points, with respect to uncoated controls. A qualitative analysis of sessile cells was also performed by scanning electron microscopy. Results: R89BS-coated discs showed no cytotoxic effects on normal lung fibroblasts (MRC5). TDs coated with 4 mg/mL R89BS inhibited the biofilm biomass of S. aureus by 98%, 49% and 10% and of S. epidermidis by 53%, 29%, and 10% at 24, 48 and 72 h respectively. A significant reduction of the biofilm metabolic activity was also documented. The same coating applied on three commercial implant surfaces resulted in a biomass inhibition higher than 90% for S. aureus, and up to 75% for S. epidermidis at 24 h. Conclusions: R89BS-coating was effective in reducing Staphylococcus biofilm formation at the titanium implant surface. The anti-biofilm action can be obtained on several different commercially available implant surfaces, independently of their surface morphology.
Broncho-alveolar inflammation in COVID-19 patients: a correlation with clinical outcome
Authors: pandolfi laura , Tommaso Fossali , Vanessa Frangipane , Sara Bozzini , Monica Morosini , Maura D’Amato , Sara Lettieri , Mario Urtis , Alessandro Di Toro , Laura Saracino , Elena Percivalle , Stefano Tomaselli , Lorenzo Cavagna , Emanuela Cova , Francesco Mojoli , Paola Bergomi , Davide Ottolina , Daniele Lilleri , Guido Corsico Angelo , Eloisa Arbustini , Riccardo Colombo , Federica Meloni 
Published: August 2020

Abstract
Background
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapidly reached pandemic proportions. We conducted a prospective study to assess deep lung inflammatory status in patients with moderate to severe COVID-19.
Methods
Diagnostic bronchoalveolar lavage (BAL) was performed in 33 adult patients with SARS-CoV-2 infection by real-time PCR on nasopharyngeal swab admitted to the Intensive care unit (ICU) (n = 28) and to the Intermediate Medicine Ward (IMW) (n = 5). We analyze the differential cell count, ultrastructure of cells and Interleukin(IL)6, 8 and 10 levels.
Results
ICU patients showed a marked increase in neutrophils (72%, 60–81), lower lymphocyte (8%, 4–12) and macrophages fractions (17%, 11–27) compared to IMW patients (3%, 2–17, 15%, 6–26 and 74%, 58–90, respectively) (p < 0.01). Ultrastructural study from ICU patients showed viral-like particles in cytopathic mononuclear cells however extensive cytopathic damage in all cell lineages. Immunostaining with anti-viral capsid and spike antibodies specifically immunoreacted with BAL cells, mostly cytopathic ones. IL6 and IL8 were significantly higher in ICU patients than in IMW (IL6 p < 0.01, IL8 p < 0.0001), and also in patients who did not survive (IL6 p < 0.05, IL8 p = 0.05 vs. survivors). IL10 did not show a significant variation between groups. Dividing patients by treatment received, lower BAL concentrations of IL6 were found in patients treated with steroids as compared to those treated with tocilizumab (p < 0.1) or antivirals (p < 0.05).
Conclusions
Alveolitis, associated with COVID-19, is mainly sustained by innate effectors which showed features of extensive activation. The burden of pro-inflammatory cytokines IL6 and IL8 in the broncho-alveolar environment is associated with clinical outcome.
Multinomial Propensity Score for Ternary Exposure for Genetic Study
Authors: Fann Cathy S. J. , Dinh Thai Son , Chang Yu-Hsien , Sie Jia Jyun , Lian Ie-Bin 
Published: August 2020

Abstract
Background: Propensity score (PS) is a popular method for reducing multiple confounding effects in observational studies. It is applicable mainly for situations wherein the exposure/treatment of interest is dichotomous and the PS can be estimated through logistic regression. However, multinomial exposures with 3 or more levels are not rare, e.g., when considering genetic variants, such as single nucleotide polymorphisms (SNPs), which have 3 levels (aa/aA/AA), as an exposure. Conventional PS is inapplicable for this situation unless the 3 levels are collapsed into 2 classes first. Methods: A simulation study was conducted to compare the performance of the proposed multinomial propensity score (MPS) method under various contrast codings and approaches, including regression adjustment and matching.Results: MPS methods had more reasonable type I error rate than the non-MPS methods, of which the latter could be as high as 30~50%. Compared with MPS-direct adjusted methods, MPS-matched cohort methods have better power but larger type I error rate. Performance of contrast codings depend on the selection of MPS models. Conclusions: In general, two combinations had relatively better performance in our simulation of ternary exposure: MPS-matched cohort method with Helmert contrast and MPS-direct adjusted regression with treatment contrasts. Compared with the latter, the former had better power but larger type I error rate as a trade-off.
A Global Perspective on the Management of Bacterial Infections in Pregnancy: A Systematic Review of International Guidelines
Authors: Koucky Michal , Kamel Rasha , Vistejnova Lucie , Kalis Vladimir , Ismail Khaled M.K. 
Published: August 2020

Abstract
Introduction: Maternal sepsis is a leading cause of maternal and neonatal mortality. Despite the availability of management protocols, there is disparity in case fatality rates for pregnancy-related sepsis compared to other maternity-related complications. The main aim of this systematic review was to assess concordance between international evidence-based guidelines for the prevention and management of childbirth-related bacterial infections. Material and methods: The PRISMA statement was followed during the conduct and reporting of this review. PubMed and G-I-N were searched electronically from 2009 to November 2019 for clinical guidelines covering the topic of childbirth-related infections and specific searches for relevant guidelines on the websites of the top 5 international professional bodies most commonly identified by our searches. We did not apply any language restrictions. Guidelines were included if they provided any information about the prevention or management of childbirth-related bacterial infections irrespective of whether the guideline stated a recommendation or not. Two independent reviewers undertook study selection, decisions about inclusion of selected guidelines and data extraction. Extracted information was synthesized under the following topics: Asymptomatic bacteriuria; group B streptococcal infection (GBS); preterm premature rupture of membranes (P-PROM); Intrauterine infection; Interventions and procedures; maternal sepsis; miscellaneous. Concordance was defined as absence of contradictory information between the different guidelines with regards to a specific topic, subtopic or recommendation. Quality of included guidelines was assessed against the AGREE II guideline reporting domains.Results: A total of 43 guidelines were selected of which 11 were excluded leaving 32 guidelines that fulfilled our inclusion criteria. None of the guidelines fulfilled all the quality assessment domains and 11 (34%) of the guidelines satisfied 1 - 2 of domains only. Two guidelines covered the topic of asymptomatic bacteriuria, nine for GBS, five for P-PROM and three covered each of intra-amniotic infections maternal sepsis, obstetric procedures and interventions topics. The remaining guidelines covered miscellaneous topics.Conclusions: There was concordance between guidelines with regards to several aspects in the prophylaxis and treatment of bacteriological infections in pregnancy. Nevertheless, there were several areas of discordance, some of which reached the extent of contradictory information as in the case of antenatal screening for GBS.
The Knowledge of Danger Signs of Obstetric Complications Among Women in Rural India: Evaluating an Integrated Microfinance and Health Literacy Program
Authors: Ahmad Danish , Mohanty Itismita , Hazra Avishek , Niyonsenga Theo 
Published: August 2020

Abstract
Background: Maternal mortality can be prevented in low-income settings through early health care seeking during maternity complications. While health system reforms prioritised institutional deliveries, inadequate antenatal and postnatal services limit the knowledge of danger signs of obstetric complications to women, which delays the recognition of complications and seeking appropriate health care. Recently, a novel rapidly scalable community-based program combining maternal health literacy delivery through microfinance-based women-only self-help groups (SHG) was implemented in rural India. This study evaluates the impact of the integrated microfinance and health literacy (IHLMF) program on the knowledge of maternal danger signs in marginalised women from one of India’s most populated and poorer states - Uttar Pradesh. Additionally, the study evaluates the presence of a diffusion effect of the knowledge of maternal danger signs from SHG members receiving health literacy to non-members in program villages.Methods: Secondary data from the IHLMF program comprising 17,232 women from SHG and non-member households in rural Uttar Pradesh was included. Multivariate logistic regression models were used to identify the program’s effects on the knowledge of maternal danger signs adjusting for a comprehensive range of confounders at the individual, household, and community level.Results: SHG member women receiving health literacy were 27 per cent more likely to know all danger signs as compared with SHG members only. Moreover, the results showed that the SHG network facilitates diffusion of knowledge of maternal danger signs from SHG members receiving health literacy to non-members in program villages. The study found that the magnitude of the program impact on outcome remained stable even after controlling for other confounding effects suggesting that the health message delivered through the program reaches all women uniformly irrespective of their socioeconomic and health system characteristics.Conclusions: The findings can guide community health programs and policy that seek to impact maternal health outcomes in low resource settings by demonstrating the differential impact of SHG alone and SHG plus health literacy on maternal danger sign knowledge.
Which Texture Property of Semi-Solid Food Affects the Effort of Pharyngeal Swallow in the Elderly?
Authors: Park Jin-Woo , Lee Seul , Yoo Byoungseung , Nam Kiyeon 
Published: August 2020

Abstract
Background: Increasing viscosity can reduce the risk of aspiration into the airway, but conversely, very thick solid food may require greater strength and effort. We assumed that semi-solid foods with similar viscosities will behave differently in the oropharynx and there might exist the possibility that properties other than viscosity may have clinical relevance. This study aimed to find out the texture of semi-solid foods that affects the effort of pharyngeal swallow in the elderly. Methods: Nine kinds of semi-solid foods not requiring mastication were selected for texture profile analysis (TPA), and included whipped cream, mayonnaise, soft tofu, mango pudding, boiled mashed pumpkin, boiled mashed potatoes, boiled mashed sweet potatoes, red bean paste, and peanut butter. Hardness, adhesiveness and cohesiveness of each food were measured three times by using the rheometer. A blinded sensory test using a 9-point hedonic scale was also conducted in eighteen elderly people to investigate how much effort was required to swallow food, and how much of the food remained in the pharynx after swallowing. The correlation between texture and sensory outcome was statistically analyzed.Results: Foods that belonged to the same viscosity category showed different texture values, and the participants also rated different scores respectively. Only adhesiveness among three properties was significantly correlated with the sensory test. (r= 0.882, p=0.002 for difficult to swallow, r=0.879, p=0.002 for sense of residue).Conclusions: Adhesiveness was the most important property of the semi-solid foods, requiring most efforts in pharyngeal swallow in the elderly. If we select and provide food having low adhesiveness value in the same viscosity category, there might be the possibility to make it easier to swallow in older adults.
Hypertension Before Pregnancy and Infant Outcomes: Secondary Analysis of North Carolina Pregnancy Risks Assessment Monitoring System (PRAMS) Data
Authors: Avorgbedor Forgive , Silva Susan , Blumenthal James A , Yeo Seonae , Merwin Elizabeth , Holditch-Davis Diane 
Published: August 2020

Abstract
Background: Chronic hypertension complicates birth outcomes. This secondary analysis of data from the North Carolina 2009-2011 Pregnancy Risks Assessment Monitoring System (PRAMS) examined factors associated with infant outcomes (preterm birth and small for gestational age) among women with hypertension before pregnancy to determine if the maternal age and race/ethnicity moderated the effect of preexisting hypertension on preterm birth and small for gestational age infants.Methods: We performed logistic regression to determine whether hypertension before pregnancy (HTN, n=292; non-HTN controls, n=2625), maternal age and race/ethnicity (Black vs Non-Black) and their interactions with hypertension before pregnancy predicted preterm birth and small for gestational age infants compared to normotensive women. Results: Results indicated that women with hypertension before pregnancy had significantly higher rates of preterm birth (29.8% vs. 21.3%) and small for gestational infants (23.0% vs. 17.9%) compared to non-HTN controls without adjusting for covariates. HTN had an effect on preterm birth that was independent of other maternal risk factors (aOR= 1.31) after adjusting for covariates . Being Black was associated with a greater likelihood of preterm birth (aOR=1.55). Conclusion: Hypertension before pregnancy is more likely to be associated Black race and with adverse birth outcomes. Black women are especially likely to experience poor birth outcomes. Continuous education to encourage all women and especially women of color and women with chronic illness to access preconception care is needed
Incidence and Time-Varying Predictors of HIV and Sexually Transmitted Infections Among Male Sex Workers in Mexico City
Authors: Ganley Karla , Wilson-Barthes Marta , Zullo Andrew R. , Sosa-Rubí Sandra G. , Conde-Glez Carlos J. , García-Cisneros Santa , Lurie Mark N. , Marshall Brandon D.L. , Operario Don , Mayer Kenneth H. , Galarraga Omar 
Published: August 2020

Abstract
Introduction: Male sex workers (MSWs) are at high-risk for HIV/STI acquisition. We quantified HIV/STI incidence rates and identified their time-varying predictors among MSWs in Mexico City. Methods: MSWs recruited from the largest HIV clinic and community sites in Mexico City were tested for chlamydia, gonorrhea, syphilis, hepatitis, and HIV at baseline, 6-months, and 12-months. Incidence rates with 95% bootstrapped confidence limits were calculated. We examined potential time-varying predictors using generalized estimating equations for a population averaged model. Results and Discussion: Among 227 MSWs, median age was 24 and baseline HIV prevalence was 32%. Incidence rates (per 100 person-years) were as follows: HIV (5.28; 95%CIs 2.52, 11.07), chlamydia (4.63; 95% 2.41, 8.90), gonorrhea (3.92; 95% 1.96, 7.84), syphilis (12.44; 95% 8.11, 19.08), hepatitis B (2.09; 95% 0.79, 5.58), hepatitis C (0.96; 95% 0.24, 3.85), any STI except HIV (17.61; 95% 12.51, 22.72), and any STI including HIV (19.93; 95%CI 14.78, 26.89). In the multivariable-adjusted model, incident STIs (excluding HIV) were lower among those who reported consistently using condoms during anal and vaginal intercourse (odds ratio (OR) = 0.03, 95% 0.00, 0.68) compared to those who reported inconsistently using condoms during anal and vaginal intercourse. Conclusions: HIV/STI incidence is high among MSWs in Mexico City. Consistent condom use is an important protective factor for HIV/STIs, and should be an important component of interventions to prevent incident infections.