bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential Diagnostic Value of Bilateral Inferior Petrosal Sinus Sampling (BIPSS) in ACTH-Dependent Cushing Syndrome: a Systematic Review and Meta-Analysis
Authors: Wang Hao , Ba Ying , Xing Qian , Cai Run-Ce 
Published: January 2020

Abstract
Background: Previous studies have shown inconsistent results in the differential diagnosis obtained from bilateral inferior petrosal sinus sampling (BIPSS) in adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome. This meta-analysis evaluated the diagnostic value of BIPSS via the published literature. Methods: This study searched PubMed, Embase, Web of Science, the Cochrane library, and the Wanfang database for published data on the differential diagnosis obtained using BIPSS in Cushing syndrome as of October 2019. Sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and receiver operating characteristic (ROC) curves were calculated based on the relevant data. Results: This meta-analysis included a total of 23 studies with 1,617 patients. The calculated sensitivity, specificity, PLR, and NLR were 0.94 (95% confidence interval, CI: 0.91–0.96), 0.89 (95% CI: 0.79–0.95), 8.8 (95% CI: 4.3–17.9), and 0.07 (95% CI: 0.04–0.11), respectively. The pooled DOR and area under the ROC curve were 129 (95% CI: 48–345) and 0.97 (95% CI: 0.95–0.98), respectively. Conclusion: This meta-analysis indicated that BIPSS had a highly diagnostic value for ACTH originally in patients with ACTH-dependent Cushing syndrome, and BIPSS should be used as a routine method to identify ACTH sources. Keywords: Bilateral inferior petrosal sinus sampling, ACTH-dependent Cushing syndrome, Differential diagnosis , Diagnostic meta-analysis
Evaluation of Role of Hyperbilirubinemia as a New Diagnostic Marker of Complicated Appendicitis.
Authors: Bakshi Sabyasachi , Mandal Nilay 
Published: January 2020

Abstract
BACKGROUND: Hyperbilirubinemia has also been found in infective diseases involving organs other than liver. The bacteremia/endotoxemia resulting in impaired hepatocyte function and bile secretion along with increased acute phase reactants contribute to the pathogenesis. In appendicitis, elevated intra-luminal pressure and ischemic necrosis of mucosa causes tissue gangrene/perforation. This is accompanied by bacterial cytotoxin facilitated progressive bacterial invasion. This elevated load of bacteria causes direct invasion or translocation into the portal system. Direct invasion of bacteria into the hepatic parenchyma interferes with the bilirubin excretion into the bile canaliculi biochemically rather than by any obstructive pathway. In the present study, establishment of a possible role of hyperbilirubinemia as a marker of gangrenous/perforated appendicitis has been studied. METHODS: After matching the inclusion and exclusion criteria, all cases of clinically diagnosed acute appendicitis were taken for this prospective, single center, observational study. Per-operative diagnosis was confirmed by histopathological examination. RESULTS: Out of 110 patients of acute appendicitis 41 patients (37.27%) had hyperbilirubinemia. Out of 35 patients diagnosed as complicated appendicitis 32 patients (91.42%) had raised total bilirubin levels, while the remaining 03(8.58%) had normal levels .Among 75 patients diagnosed as acute simple appendicitis 09 patients (12%) had raised total bilirubin level, while the remaining 66 patients (88%) had normal levels .It was MIXED TYPE OF HYPERBILIRUBINEMIA in gangrenous/perforated appendicitis. The SENSITIVITY of Total serum bilirubin in predicting complicated appendicitis was found 91.43% (76.942% to 98.196%), where as the SPECIFICITY of this test was 88.00% (78.439% to 94.363%). POSITIVE PREDICTIVE VALUE and NEGATIVE PREDICTIVE VALUE were 78.03% and 95.65% respectively. POSITIVE LIKELIHOOD RATIO and NEGATIVE LIKELIHOOD RATIO were found to be 7.619 and 0.097 respectively taking PREVALENCE of Complicated appendicitis be 31.80%. ROC (Receiver Operating Characteristic) curve was obtained which shows OPTIMAL CRITERION at Total Bilirubin Level 1.06 mg/dl where sensitivity was 91.43% and specificity was 97.33% at 95% confidence interval with 31.8% disease prevalence. CONCLUSIONS: Serum Bilirubin level estimation, which is a simple, cheap and easily available laboratory test, can be added to the routine investigations in clinically suspected cases of acute appendicitis for early diagnosis of complications. Trial Registration:Trial URL: http://ctri.nic.in/Clinicaltrials/rmaindet.php?trialid=33113&EncHid=2976.35990&modid=1&compid=19
The effects of Enhanced Primary Healthcare interventions on primary care providers job satisfaction
Authors: Wong Wen Jun , Norzi Aisyah Mohd , Ang Swee Hung , Chan Chee Lee , Jaafar Faeiz Syezri Adzmin , Sivasampu Sheamini 
Published: January 2020

Abstract
Background:In response to address the rising burden of cardiovascular risk factors, Malaysian government has implemented Enhanced Primary Healthcare (EnPHC) interventions in July 2017 at public clinics level. Healthcare providers (HCPs) play crucial roles in healthcare service delivery and health system reform can influence HCPs’ job satisfaction. However, studies evaluating HCPs’ job satisfaction following primary care transformation remain scarce in low- and middle-income countries. This study aims to evaluate the effects of EnPHC interventions on HCPs. Methods:This is a quasi-experimental study conducted in 20 intervention and 20 matched control clinics. We surveyed all healthcare providers who were directly involved in patient management. A self-administered questionnaire which included six questions on job satisfaction were distributed at baseline (April and May 2017) and post-intervention (March and April 2019). Difference-in-differences analysis was used in the multivariable linear regression model in which we adjusted for providers and clinics characteristics to detect the changes in job satisfaction following EnPHC interventions. Results:A total of 1042 and 1215 HCPs responded at baseline and post-intervention respectively. At post-intervention, the intervention group reported higher level of stress and change in score between two groups was -0.14 (β= -0.139; 95% CI -0.266,-0.012; p=0.032). In subgroup analysis, nurses from intervention group experienced increase in work stress following EnPHC interventions (β= -0.223; 95% CI -0.419,-0.026; p=0.026). Additionally, the same group also responded that they were less likely to perceive their profession as well-respected at post-intervention (β= -0.175; 95% CI -0.331,-0.019; p=0.027). Conversely, allied health professionals from intervention group were more likely to report a good balance between work and effort (β= 0.386; 95% CI 0.033,0.738; p=0.032) after implementing EnPHC interventions. Conclusions:Our findings suggest that EnPHC interventions had resulted in some untoward effect on HCPs’ job satisfaction. Job dissatisfaction can have detrimental effects on the organisation and healthcare system. Therefore, provider experience and well-being should be considered before introducing healthcare delivery reforms to avoid overburdening of HCPs.
Root resorption in patients treated with self-ligating or conventional brackets: A systematic review
Authors: Xie Jiye , Yin Kang , Wen Xin , He Wei , Xu Yanhua 
Published: January 2020

Abstract
Background: To compare the degree of external apical root resorption (EARR) in patients using self-ligating brackets with conventional brackets in a long run. Methods: Electronic search was made in databases including PubMed, OVID, the Cochrane Library, EMBASE, FMRS, CBM, CNKI, VIP and WanFang Data until November 2019 to retrievalled randomized controlled trials and clinical controlled trials that compared the EARR between patients using self-ligating or conventional brackets. What’s more, manual search was made in NLM, SIGLE, Campbell library, WHOLIS, Chinese Journal of Evidence-based Medicine and the Journal of Orthodontics. Literature filtering, data extraction and methodological quality evaluation were finished independently by two researchers and disagreements were solved by a third reviewer. Original outcome data, if possible, were subjected to statistical pooling by Review Manager 5.3 for Meta analysis.Results: Through a predefined search strategy, ten studies were included in the systematic review and nine eligible studies were pooled in meta-analysis. There was a significant difference between self-ligating and conventional brackets in terms of the value of EARR in maxillary central incisors (P=0.01; SMD: -0.42mm; 95%CI: -0.76, -0.09) in a long run. No significant difference in maxillary lateral incisors (P=0.07; SMD: -0.17; 95%CI: −0.35, 0.01), mandibular central incisors (P=0.69; SMD: 0.04; 95%CI: −0.17, 0.26) and mandibular lateral incisors (P=0.38; SMD: −0.10; 95%CI: −0.32, 0.12).Conclusions: Self-ligating brackets have a long-term effect in protecting maxillary central incisors from the EARR compared to conventional brackets. However, self-ligating brackets were not superior to conventional brackets in reducing the EARR of maxillary lateral incisors, mandible central incisors and mandible lateral incisors.
Discovery of a naturally-occurring allele of eIF4E1.S in Nicotiana tabacum and development of a co-dominant marker
Authors: Lin Shifeng , Dewey Ralph E. , Wang Rengang , Yu Jing , Long Mingjin , Zhang Jie , Yu Shizhou , Zhang Jishun , Wang Zili , Ren Xueliang 
Published: January 2020

Abstract
Background: The Potato Virus Y (PVY) resistance tobacco mutant VAM, which was produced by X-ray irradiation, and its derived mutant va were previously shown to contain large chromosomal deletions. Among the genes deleted in lines containing these loci is a specific eukaryotic translation initiation factor 4E (eIF4E) gene, designated eIF4E1.S, whose protein product has been shown to facilitate infection by certain potyviruses, the most important of which from an agronomic perspective is PVY. Because the extent of the deletions and the exact nature of their specific breakpoints have not been precisely established for VAM or va, it has not been possible to develop co-dominant markers for these loci. Results: Here, we identified a PVY-resistant tobacco landrace Fuquanliuye with a deletion in the 3' region of the eIF4E1.S gene. The approximate position of the 5' deletion breakpoint was defined by segmented amplification, cloning and sequencing. Using information from this analysis, a chromosome walk was initiated and the nucleotide sequence of the deletion junction was obtained. Through comparison with the tobacco reference genome, it was found that an approximately 27 kb sequence including the 3' region of the eIF4E1.S gene was deleted from the Fuquanliuye genome and nine extra nucleotides of unknown origin were inserted at the breakpoint. Based on the information above, a PCR-based co-dominant molecular marker for the identification of the eIF4E1.S mutant allele was developed. Using this co-dominant marker, we genotyped F2 plants segregating for the eIF4E1.S mutant allele and confirmed good consistency between the genotype and the phenotype to PVY virus. Conclusions: We report a novel naturally-occurring mutant allele of eIF4E1.S from the PVY-resistant tobacco landrace Fuquanliuye, designated eIF4E1.Fu, and a PCR-based co-dominant marker specific for eIF4E1.Fu. This may provide a valuable genetic resource and a basis for marker-assisted selection to improve the PVY resistance of breeding cultivars/lines.
Overexpression of a type 2 diacylglycerol acyltransferase in the marine diatom Phaeodactylum tricornutum enhances lipid production and omega-3 Long Chain Polyunsaturated Fatty Acid content
Authors: Haslam Richard P. , Hamilton Mary L. , Economou Chloe K. , Smith Richard , Hassall Kirsty L. , Napier Johnathan A. , Sayanova Olga 
Published: January 2020

Abstract
Background: Oleaginous microalgae represent a valuable resource for the production of high value molecules. Considering the importance of omega-3 long chain polyunsaturated fatty acids (LC-PUFAs) for human health and nutrition the yields of high value eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) require significant improvement to meet demand, however, the current cost of production remains high. A promising approach is to metabolically engineer strains with enhanced levels of triacylglycerols (TAGs) enriched in EPA and DHA. Results: Recently we have engineered the marine diatom Phaeodactylum tricornutum to accumulate enhanced levels of DHA in TAG. To further improve the incorporation of omega-3 LC-PUFAs in TAG we focused our effort on the identification of a type 2 acyl-CoA:diacylglycerol acyltransferase (DGAT) capable of improving lipid production and the incorporation of DHA in TAG. DGAT is a key enzyme in lipid synthesis. Following a diatom based in vivo screen of candidate DGATs, a native P. tricornutum DGAT2B was taken forward for detailed characterisation. Expression of DGAT2B in P. tricornutum was confirmed by qRT-PCR and the transgenic strain grew successfully in comparison to wildtype. PtDGAT2B has broad substrate specificity with preferences for C16 and LC-PUFAs acyl groups. Moreover, the expression of DGAT2B resulted in higher lipid yields and enhanced levels of DHA in TAG. Furthermore, co-expression with a Δ5-elongase showed how iterative metabolic engineering can be used to increase DHA and TAG content, irrespective of nitrogen treatment.Conclusion: This study provides further insight into lipid metabolism in P. tricornutum and suggests a metabolic engineering approach for the efficient production of EPA and DHA in microalgae.
Identification and characterization of circRNA during muscle development in different breeds of cattle
Authors: Liu Ruili , Liu Xianxun , Bai Xuejin , Xiao Chaozhu , Dong Yajuan 
Published: January 2020

Abstract
Background Black cattle are a new breed of cattle that are developed by applying modern biotechnology, such as somatic cloning, and conventional breeding methods to Luxi cattle. It is very important to study the function and regulatory mechanism of circRNAs in muscle differentiation among different breeds to improve meat quality and meat production performance and to provide new ideas for beef cattle meat quality improvements and new breed development. Therefore, the goal of this study was to sequence and identify circRNAs in muscle tissues of different breeds of cattle. We used RNA-seq to identify circRNAs in the muscles of two breeds of black cattle (Black and Luxi). Results We identified 14640 circRNAs and found 655 differentially expressed circRNAs. We also analysed the classification and characteristics of circRNAs in muscle tissue. GO and KEGG analyses were used on the parental genes of circRNAs. They were mainly involved in a variety of biological processes, such as muscle fibre development, smooth muscle cell proliferation, bone system morphogenesis, tight junctions and the MAPK, AMPK and mTOR signalling pathways. In addition, we used miRanda to predict the interactions between 15 circRNAs and 12 miRNAs. Based on the above assays, we identified circRNAs (circ0001048, circ0001103, circ0001159, circ0003719, circ0003794, circ0003721, circ0003720, circ0001519, circ0001530, circ0005060, circ0006589, circ0000181, circ0000190, circ0010558, circ0010577) that may play an important role in the regulation of muscle growth and development. Conclusion Our results provide more information about circRNAs regulating muscle development in different breeds of cattle and lay a solid foundation for future experiments.
Nursing and midwifery students’ experiences and perception of their clinical learning environment in Malawi: A mixed method study
Authors: Mbakaya Balwani Chingatichifwe , Kalembo Fatch Welcome , Zgambo Maggie , Konyani Alice , Lungu Florence , Tveit Bodil , Kaasen Anne , Simango Modesta , Bvumbwe Thokozani 
Published: January 2020

Abstract
BackgroundThe clinical learning environment is an important part of the nursing and midwifery training as it helps students to integrate theory into clinical practice. However, not all clinical learning environments foster positive learning. The aim of this study was to assess the experiences and perception of nursing and midwifery students of their clinical learning environment in Malawi.Methods A mixed-methods approach was used to collect data from nursing and midwifery students. Data were collected using a questionnaire and focus group discussions. Questionnaire data were collected using the Clinical Learning Environment Inventory (CLEI). Data from focus group discussions were collected using an interview guide which had questions about clinical learning, supervision, assessment, communication and resources. Quantitative data were analysed by independent t-test and multivariate linear regression while qualitative data were analysed by thematic analysisResults A total of 126 participants completed the questionnaire data while 30 students participated in the focus group discussions. Satisfaction subscale had the highest mean score (M = 26.93, SD = 4.82) while Individualisation had the lowest mean score (M = 18.01, SD =3.50). Multiple linear regression analysis showed statistically significant association between Satisfaction with clinical learning environment and Personalization (β = 0.50, p = < 0.001), and Task orientation (β =0.16 p= < 0.05). Teaching and learning resources, hostile environment, poor relationship with a qualified staff, absence of clinical supervisors, and lack of resources were some of the challenges faced by students in their clinical learning environment.Conclusion The findings of this study show that although satisfaction with clinical learning environment had the highest scores, students encountered multifaceted challenges in their clinical learning environment. A collaborative effort from training institutions and hospitals is needed to better support students with their clinical learning.
The Impact of Patient Safety Culture and the Leader Coaching Behavior of Nurses on the Intention to Report Errors: A Cross-Sectional Survey
Authors: Chegini Zahra , JAFARABADI Mohammad ASGHARI , KAKEMAM Edris , JANATI Ali 
Published: January 2020

Abstract
Background There is growing interest in examining the factors affecting the reporting of errors by nurses. However, little research has been conducted into the effects of perceived patient safety culture and leader coaching behavior of nurses on the intention to report errors.Methods This cross-sectional study was conducted amongst 256 nurses in the emergency departments of 18 public and private hospitals in Tabriz, northwest Iran. Participants completed the self- administered questionnaires and the data was analyzed using linear regression analysis.Results Overall, 43% of nurses had an intention to report errors; 50% of respondents reported that their nursing managers demonstrated high levels of coaching. With regard to patient safety culture, areas of strength and weakness were “Teamwork within Units” (PRR = 66.80%) and “Non-punitive response errors” (PRR = 19.66%). Regression findings highlighted a significant association between an intention to report errors and patient safety culture (B=0.123, CI 95%: 0.005 to 0.328, P = 0.026), leader coaching behavior (B=0.172, CI 95%: 0.066 to 0.347, P = 0.004) and nurses’ educational status (B=0. 787, 95% CI: -.064 to 1.638, P = 0.048). Conclusions Further research is needed to assess how interventions addressing patient safety culture and leader coaching behaviors might increase the intention to report errors.
Clinical learning environment of nursing and midwifery students in Ghana
Authors: Ziba Florence Assibi , Yakong Vida Nyagre , Ali Zakari 
Published: January 2020

Abstract
Background Data on student experience of the clinical learning environment in Ghana are scarce. We therefore aimed to assess students’ evaluation of the clinical learning environment and the factors that influence their learning experience.Methods This was a cross-sectional survey of 225 undergraduate nursing and midwifery students. We used the Clinical Learning Environment and Supervision + Nurse Teacher (CLES +T) evaluation scale to assess students’ experience of their clinical placement. The association between student demographic characteristics and clinical placement experience was determined using t-test or ANOVA.Results Most of the sampled students were Nurses (67%) and in the third year of training (81%). More students received supervision from a nurse (57%) during clinical placement and team supervision (67%) was the most common during clinical placement. Nursing students were more likely to rate their clinical experience better than midwifery students (p=0.002). Students who had increased contact with private supervisors were also more likely to rate their experience higher (p=0.002). Clinical experience was also rated higher by students who received successful supervision compared to those who had unsuccessful or team supervision (p=0.001).Conclusion Team supervision is high in health facilities where students undertake clinical placement in Ghana. Frequent contact with private supervisor and successful supervision are associated with better rating of clinical experience among Ghanaian undergraduate nursing and midwifery students.
Utilization of Denture Adhesives and the Factors Associated with its Use: A Cross-Sectional Survey
Authors: BO TUN MIN , Hama Yohei , AKIBA NORIHISA , MINAKUCHI SHUNSUKE 
Published: January 2020

Abstract
Background An increase in the number of elderly edentulous patients likely leads to a greater demand for complete or partial dentures. However, there are some related problems such as retention and stability in both complete and partial dentures. In order to solve these problems, denture adhesives are widely utilized by denture wearers. Since denture adhesives have positive and negative features, dentists need to know the kinds of denture adhesive users for the purpose of giving instruction to denture wearers on how to use denture adhesives properly and effectively. The aim of this study was to examine the utilization of denture adhesives and to determine the factors associated with such use through a web-based survey system. Methods Seven closed-ended questionnaires were developed for the web-based survey system. A table on the utilization of denture adhesives by denture wearers was first presented. Thereafter, Fisher’s exact tests were performed to determine the difference in the denture adhesive usage rate by gender, type of denture, last dental visit, and smoking. Moreover, multivariate-adjusted logistic regression analysis was performed with denture adhesive use or non-use as the dependent variable and the other items as independent variables. Statistical analyses were performed for all denture wearers, complete denture wearers, and partial denture wearers respectively. Results A total of 1470 denture wearers in Japan participated in this study. Of these, 318 used denture adhesives, while 212(66.7%) used cream; 74(23.3%) used home liner; 25(7.9%) used powder; 4(1.3%) used sheet; 3(0.9%) used several types. Fisher’s exact test revealed that the ratios of using denture adhesives were significantly higher for complete denture wearers (p<0.001), last dental visit within one year (p=0.005) and smokers (p=0.005). For partial denture wearers, the ratio was significantly higher in smokers (p=0.262). Multivariate adjusted logistic regression revealed that denture adhesive use or non-use were significantly associated with the type of denture and smoking in all denture wearers, and just smoking in partial denture wearers. Conclusions In all denture wearers, complete denture wearers and smokers significantly use denture adhesives. On the other hand, smokers significantly use denture adhesives for partial denture wearers.