bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying risk factors of anemia among women of reproductive age in Rwanda – a cross-sectional study using secondary data from the Rwanda demographic and health survey 2014/2015
Authors: Hakizimana Dieudonne , Nisingizwe Marie Paul , Logan Jenae , Wong Rex 
Published: December 2019

Abstract

Background
Anemia among Women of Reproductive Age (WRA) continues to be among the major public health problems in many developing countries, including Rwanda, where it increased in prevalence between the 2015 and 2010 Rwanda Demographic and Health Survey (RDHS) reports. A thorough understanding of its risk factors is necessary to design better interventions. However, to the best of our knowledge, no study has been conducted in Rwanda on a nationally representative sample to assess factors associated with anemia among WRA. Accordingly, this study was conducted to address such gap.

Methods
A quantitative, cross-sectional study was conducted using data from the RDHS 2014–2015. The study population consisted of 6680 WRA who were tested for anemia during the survey. Anemia was defined as having a hemoglobin level equal to or below 10.9 g/dl for a pregnant woman, and hemoglobin level equal to or below 11.9 g/dl for a non-pregnant woman. Pearson’s chi-squared test and multiple logistic regression were conducted for bivariate and multivariable analysis, respectively.

Results
The prevalence of anemia among WRA was 19.2% (95% CI: 18.0–20.5). Four factors were found to be associated with lower odds of anemia, including being obese (OR: 0.61, 95% CI: 0.40–0.91), being in the rich category (OR: 0.74, 95% CI: 0.63–0.87), sleeping under a mosquito net (OR: 0.85, 95% CI: 0.74–0.98), and using hormonal contraceptives (OR: 0.61, 95% CI: 0.50–0.73). Five factors were associated with higher odds of anemia, including being underweight (OR: 1.39, 95% CI: 1.09–1.78), using an intrauterine device (OR: 1.98, 95% CI: 1.05–3.75), being separated or widowed (OR: 1.35, 95% CI: 1.09–1.67), and living in the Southern province (OR: 1.45, 95% CI: 1.11–1.89) or in the Eastern province (OR: 1.41, 95% CI: 1.06–1.88).

Conclusion
Anemia continues to pose public health challenges; novel public health interventions should consider geographic variations in anemia risk, seek to improve women’s economic statuses, and strengthen iron supplementation especially for Intrauterine device users. Additionally, given the association between anemia and malaria, interventions to prevent malaria should be enhanced.
Take -home naloxone rescue kits following heroin overdose in the emergency department to prevent opioid overdose related repeat emergency department visits, hospitalization and death- a pilot study
Authors: Papp Joan , Vallabhaneni Mayur , Morales Ariel , Schrock Jon W. 
Published: December 2019

AbstractBackgroundOpioid overdoses are at an epidemic in the United States causing the deaths of thousands each year. Project DAWN (Deaths Avoided with Naloxone) is an opioid overdose education and naloxone distribution program in Ohio that distributes naloxone rescue kits at clinics and in the emergency departments of a single hospital system.MethodsWe performed a retrospective analytic cohort study comparing heroin overdose survivors who presented to the emergency department and were subsequently discharged. We compared those who received a naloxone rescue kit at discharge with those who did not. Our composite outcome was repeat opioid overdose related emergency department visit(s), hospitalization and death at 0–3 months and at 3–6 months following emergency department overdose. Heroin overdose encounters were identified by ICD- 9 or 10 codes and data was abstracted from the electronic medical record for emergency department patients who presented for heroin overdose and were discharged over a 31- month period between 2013 and 2016. Patients were excluded for previous naloxone access, incarceration, suicidal ideation, admission to the hospital or death from acute overdose on initial emergency department presentation. Data was analyzed with the Chi- square statistical test.ResultsWe identified 291emergency department heroin overdose encounters by ICD-9 or 10 codes and were analyzed. A total of 71% of heroin overdose survivors received a naloxone rescue kit at emergency department discharge. Between the patients who did not receive a naloxone rescue kit at discharge, no overdose deaths occurred and 10.8% reached the composite outcome. Of the patients who received a naloxone rescue kit, 14.4% reached the composite endpoint and 7 opioid overdose deaths occurred in this cohort. No difference in mortality at 3 or 6 months was detected,p = 0.15 and 0.36 respectively. No difference in the composite outcome was detected at 3 or 6 months either,p = 0.9 and 0.99 respectively.ConclusionsOf our emergency department patients receiving a naloxone rescue kit we did not find a benefit in the reduction of repeat emergency department visits hospitalizations, or deaths following a non-fatal heroin overdose.
Integrating health care in Australia: a qualitative evaluation
Authors: Trankle Steven A. , Usherwood Tim , Abbott Penny , Roberts Mary , Crampton Michael , Girgis Christian M. , Riskallah John , Chang Yashu , Saini Jaspreet , Reath Jennifer 
Published: December 2019

Abstract
Background
With aging populations, a growing prevalence of chronic illnesses, higher expectations for quality care and rising costs within limited health budgets, integration of healthcare is seen as a solution to these challenges. Integrated healthcare aims to overcome barriers between primary and secondary care and other disconnected patient services to improve access, continuity and quality of care. Many people in Australia are admitted to hospital for chronic illnesses that could be prevented or managed in the community. Western Sydney has high rates of diabetes, heart and respiratory diseases and the NSW State Ministry of Health has implemented key strategies through the Western Sydney Integrated Care Program (WSICP) to enhance primary care and the outcomes and experiences of patients with these illnesses.

Methods
We aimed to investigate the WSICP’s effectiveness through a qualitative evaluation focused on the 10 WSICP strategies using a framework analysis. We administered 125 in-depth interviews in two rounds over 12 months with 83 participants including patients and their carers, care facilitators, hospital specialists and nurses, allied health professionals, general practitioners (GPs) and primary care nurses, and program managers. Most participants (71%) were interviewed twice. We analysed data within a framework describing how strategies were implemented and used, the experiences around these, their perceived value, facilitators and barriers, and participant-identified suggestions for improvement.

Results
Care facilitators helped patients access services within the hospital and in primary care and connected general practices with hospital specialists and services. Rapid access and stabilisation clinics with their patient hotlines assisted patients and carers to self-manage chronic illness while connecting GPs to specialists through the GP support-line. Action plans from the hospital informed GPs and their shared care plans which could be accessed by other community health professionals and patients. HealthPathways provided GPs with local, evidence-based guidelines for managing patients. Difficulties persisted in effective widespread access to shared records and electronic communication across sectors.

Conclusions
The combined WSICP strategies improved patient and carer experience of healthcare and capacity of GPs to provide care in the community. Information sharing required longer-term investment and support, though benefits were evident by the end of our research.
The effect of an organic rumen-protected fat supplement on performance, metabolic status, and health of dairy cows
Authors: Manriquez Diego , Chen Liang , Melendez Pedro , Pinedo Pablo 
Published: December 2019

Abstract
Background
Negative energy balance during the transition period is a concern for both conventional and certified organic dairy systems. During early lactation, supplemental strategies are used to cope with nutrient deficiencies that are associated with impaired health, production, and reproduction. As organic certified dairies in the United States face restricted access to dietary supplements, the evaluation of products especially formulated for organic production is needed. Our objective was to assess the effect of supplementing 0.45 kg/d of an organic rumen-protected fat (RPF) on health, metabolic status, and productive and reproductive performance of organic certified Holstein cows from 1 to 150 days in milk (DIM). Two-hundred and two cows were enrolled in a randomized blocked controlled trial conducted from January to July 2017 in a certified organic dairy located in Northern Colorado (USA). Two groups were randomly assigned to be individually supplemented with organic RPF (ORG; n = 100) or control pellets (CON; n = 102) once per day, in addition to the total mixed ration (TMR). Outcomes of interest included milk yield (kg/d) and milk components, serum concentration of glucose, and non-esterified fatty acids (NEFA), resumption of cyclicity, time-to-first artificial insemination (AI), conception at first AI, and conception within 150 DIM, disease occurrence, culling, mortality.

Results
A significant effect for the inclusion of RPF was found in daily milk yield; RPF supplemented cows had greater milk yield (1.6 kg/d) compared to CON cows up to 150 DIM (P = 0.03). During grazing, multiparous (MP) ORG cows had greater milk yield compared to MP CON cows, whereas no effect was found in primiparous (PP) cows. Health outcomes, serum metabolite concentrations, and reproductive performance were not affected by the inclusion of RPF. Body condition loss was smaller in the ORG group up to 80 DIM; however, there was no effect on body condition during the grazing season and in the overall study period.

Conclusions
These results indicate that supplementation of RPF increased daily milk yield and prevented body condition loss during at 90 DIM. However, RPF supplementation did not affect health, serum metabolite concentration, milk components, and reproductive outcomes.
Threshold of the upper airway cross-section for hypopnea onset during sleep and its identification under waking condition
Authors: Lin Hongyi , Wang Cunting , Zhang Han , Xiong Huahui , Li Zheng , Huang Xiaoqing , Ji Changjin , Xian Junfang , Huang Yaqi 
Published: December 2019

Abstract
Background
There is currently no method that can predict whether or under what condition hypopnea, even obstructive sleep apnea (OSA), will occur during sleep for individuals based on credible parameters measured under waking condition. We propose a threshold concept based on the narrowest cross-sectional area of the upper airway (CSA-UA) and aim to prove our hypothesis on the threshold of the area for hypopnea onset (TAHO), which can be used as an indicator of hypopnea onset during sleep and measured while awake.

Methods
We performed magnetic resonance imaging for 20 OSA patients to observe CSA-UA changes during fluid accumulation in the neck caused by elevating their legs, and identified TAHO by capturing the sudden enlargement in CSA-UA. Correlation analyses between TAHO and the body mass index (BMI), and between the reduction in CSA-UA and the increase in the neck circumference (NC) with fluid accumulation were performed. Logistic regression analysis was performed for identifying OSA patients based on the behaviors of their CSA-UA changes during leg raising. Shape changes of airway cross-section were also investigated.

Results
Four CSA-UA change patterns after fluid redistribution were identified. Six patients had similar CSA-UA variation behaviors observed in healthy subjects. From the other three change patterns involving 14 patients, a threshold value of CSA-UA 0.63 ± 0.21 cm2 was identified for normal breathing. Data showed a positive correlation between TAHO and BMI (r = 0.681, p = 0.0007), and a negative correlation between the reduction in CSA-UA and the increase in NC (r = − 0.513, p = 0.051) with fluid accumulation. A sigmoid function for the probability of being a OSA patient p = 1/[1 + exp. (4.836 + 3.850 t-8.4 h)] was obtained to effectively separate OSA patients from normal subjects. The upper airway narrowing occurred in anteroposterior, lateral, or both directions, suggesting different tendencies of upper airway collapse in patients. Three types of shape changes in the cross-section of the upper airway, which had different effects on airway resistance, were measured.

Conclusions
Our findings prove TAHO hypothesis. The threshold measured while awake for normal breathing can be used clinically as the indicator of hypopnea onset during sleep, and therefore to identify OSA patients under waking condition and design effective personalized treatments for OSA patients. Both shape and size changes in the cross-section of the upper airway affect airway resistance significantly. Shape change in the cross-section of the upper airway can provide key clinical information on the collapse patterns of the upper airway for individuals.
Prognostic value of HbA1c for in-hospital and short-term mortality in patients with acute coronary syndrome: a systematic review and meta-analysis
Authors: Pan Wenjun , Lu Haining , Lian Baotao , Liao Pengda , Guo Liheng , Zhang Minzhou 
Published: December 2019

Abstract
Background
HbA1c, the most commonly used indicator of chronic glucose metabolism, is closely associated with cardiovascular disease. However, the relationship between HbA1c and the mortality of acute coronary syndrome (ACS) patients has not been elucidated yet. Here, we aim to conduct a systematic review assessing the effect of HbA1c on in-hospital and short-term mortality in ACS patients.

Methods
Relevant studies reported before July 2019 were retrieved from databases including PubMed, Embase, and Central. Pooled relative risks (RRs) and the corresponding 95% confidence interval (CI) were calculated to evaluate the predictive value of HbA1c for the in-hospital mortality and short-term mortality.

Results
Data from 25 studies involving 304,253 ACS patients was included in systematic review. The pooled RR of in-hospital mortality was 1.246 (95% CI 1.113–1.396, p: 0.000, I2 = 48.6%, n = 14) after sensitivity analysis in studies reporting HbA1c as categorial valuable. The pooled RR was 1.042 (95% CI 0.904–1.202, p: 0.57, I2 = 82.7%, n = 4) in random-effects model for studies reporting it as continuous valuable. Subgroup analysis by diabetic status showed that elevated HbA1c is associated increased short-term mortality in ACS patients without diabetes mellitus (DM) history and without DM (RR: 2.31, 95% CI (1.81–2.94), p = 0.000, I2 = 0.0%, n = 5; RR: 2.56, 95% CI 1.38–4.74, p = 0.003, I2 = 0.0%, n = 2, respectively), which was not the case for patients with DM and patients from studies incorporating DM and non-DM individuals (RR: 1.16, 95% CI 0.79–1.69, p = 0.451, I2 = 31.9%, n = 3; RR: 1.10, 95% CI 0.51–2.38), p = 0.809, I2 = 47.4%, n = 4, respectively).

Conclusions
Higher HbA1c is a potential indicator for in-hospital death in ACS patients as well as a predictor for short-term mortality in ACS patients without known DM and without DM.
Effect of strontium-containing on the properties of Mg-doped wollastonite bioceramic scaffolds
Authors: Wang Su , Liu Linlin , Zhou Xin , Yang Danfeng , Shi Zhang’ao , Hao Yongqiang 
Published: December 2019

Abstract
Background
Bone scaffold is one of the most effective methods to treat bone defect. The ideal scaffold of bone tissue should not only provide space for bone tissue growth, but also have sufficient mechanical strength to support the bone defect area. Moreover, the scaffold should provide a customized size or shape for the patient’s bone defect.

Methods
In this study, strontium-containing Mg-doped wollastonite (Sr-CSM) bioceramic scaffolds with controllable pore size and pore structure were manufactured by direct ink writing 3D printing. Biological properties of Sr-CSM scaffolds were evaluated by apatite formation ability, in vitro proliferation ability of rabbit bone-marrow stem cells (rBMSCs), and alkaline phosphatase (ALP) activity using β-TCP and Mg-doped wollastonite (CSM) scaffolds as control. The compression strength of three scaffold specimens was probed after completely drying them while been submerged in Tris–HCl solution for 0, 2,4 and 6 weeks.

Results
The mechanical test results showed that strontium-containing Mg-doped wollastonite (Sr-CSM) scaffolds had acceptable initial compression strength (56 MPa) and maintained good mechanical stability during degradation in vitro. Biological experiments showed that Sr-CSM scaffolds had a better apatite formation ability. Cell experiments showed that Sr-CSM scaffold had a higher cell proliferation ability compared with β-TCP and CSM scaffold. The higher ALP activity of Sr-CSM scaffold indicates that it can better stimulate osteoblastic differentiation and bone mineralization.

Conclusions
Therefore, Sr-CSM scaffolds not only have acceptable compression strength, but also have higher osteogenesis bioactivity, which can be used in bone tissue engineering scaffolds.
Complement C3 gene polymorphisms are associated with lipid levels, but not the risk of coronary artery disease: a case-control study
Authors: Cai Gaojun , Li Li , Chen Yifei , Huang Haomin , Yu Lei , Xu Lianhong 
Published: December 2019

Abstract
Background
Coronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide. Previous studies have shown that complement component 3 (C3) is associated with atherosclerosis and cardiovascular risk factors.

Methods
We conducted this study to evaluate the associations between tagSNPs in the C3 gene locus and the CAD susceptibility and lipid levels in the Chinese population. A hospital-based case-control study, including 1017 subjects (580 CAD patients and 437 non-CAD controls), was conducted. TagSNPs in the C3 gene were searched and genotyped by using the polymerase chain reaction-ligase detection reaction method.

Results
The C3 levels were positively associated with the low-density lipoprotein cholesterol (LDL-C) levels (r = 0.269, P = 0.001). Compared with those in controls, the serum C3 levels in CAD patients were significantly higher (Control: 0.94 + 0.14 g/l; CAD: 1.10 + 0.19 g/l, P < 0.001). No significant differences in genotype or allele frequencies were observed between CAD patients and controls. The minor T allele of rs2287848 was associated with low apolipoprotein A1 (ApoA1) levels in controls (Bonferroni corrected P, Pc = 0.032). Linkage disequilibrium and haplotype analysis established two haplotype blocks (Block1: rs344555-rs2277984, Block 2: rs2287848-rs11672613) and six haplotypes. No significant associations between haplotypes and the risk of CAD were observed (all Pc > 0.05).

Conclusions
The results revealed that C3 gene polymorphisms were associated with the lipid levels, but not CAD susceptibility in the Chinese population.
Study on measurement method for apple root morphological parameters based on Labview
Authors: Liu Yu , Qian Ji , Yang Xin , Di Bao , Zhou Juan 
Published: December 2019

Abstract
Background
Traditional measurements of apple seedling roots often rely on manual measurements and existing root scanners on the market. Manual measurement requires a lot of labor and time, and subjective reasons may cause the uncertainty of data; root scanners have limited scanning size and expensive. In case of fruit roots, coverage and occlusion issues will occur, resulting in inaccurate results, but our research solved this problem.

Results
The background plate was selected according to the color of the seedling roots; the image of the roots of the collected apple seedlings was preprocessed with Vision Development Module by combining image and Labview. The root surface area, average root diameter, root length and root volume of apple seedlings were measured by combining root characteristic parameters algorithm. In order to verify the effectiveness of the proposed method, a set of measurement system for root morphology of apple seedlings was designed, and the measurement result was compared with the Canadian root system WinRHIZO 2016 (Canada). With application of SPSS v22.0 analysis, the significance P > 0.01 indicated that the difference was not significant. The relative error of surface area was less than 0.5%. The relative error of the average diameter and length of the root system was less than 0.1%, and the relative error of the root volume was less than 0.2%.

Conclusions
It not only proved that the root surface area, average root diameter, root length and root volume of apple seedlings could be accurately measured by the method described herein, which was handy in operation, but also reduced the cost by 80–90% compared with the conventional scanner.
TasselNetv2: in-field counting of wheat spikes with context-augmented local regression networks
Authors: Xiong Haipeng , Cao Zhiguo , Lu Hao , Madec Simon , Liu Liang , Shen Chunhua 
Published: December 2019

Abstract
Background
Grain yield of wheat is greatly associated with the population of wheat spikes, i.e., $$spike~number~\text {m}^{-2}$$spikenumberm-2. To obtain this index in a reliable and efficient way, it is necessary to count wheat spikes accurately and automatically. Currently computer vision technologies have shown great potential to automate this task effectively in a low-end manner. In particular, counting wheat spikes is a typical visual counting problem, which is substantially studied under the name of object counting in Computer Vision. TasselNet, which represents one of the state-of-the-art counting approaches, is a convolutional neural network-based local regression model, and currently benchmarks the best record on counting maize tassels. However, when applying TasselNet to wheat spikes, it cannot predict accurate counts when spikes partially present.

Results
In this paper, we make an important observation that the counting performance of local regression networks can be significantly improved via adding visual context to the local patches. Meanwhile, such context can be treated as part of the receptive field without increasing the model capacity. We thus propose a simple yet effective contextual extension of TasselNet—TasselNetv2. If implementing TasselNetv2 in a fully convolutional form, both training and inference can be greatly sped up by reducing redundant computations. In particular, we collected and labeled a large-scale wheat spikes counting (WSC) dataset, with 1764 high-resolution images and 675,322 manually-annotated instances. Extensive experiments show that, TasselNetv2 not only achieves state-of-the-art performance on the WSC dataset ($$91.01\%$$91.01% counting accuracy) but also is more than an order of magnitude faster than TasselNet (13.82 fps on $$912\times 1216$$912×1216 images). The generality of TasselNetv2 is further demonstrated by advancing the state of the art on both the Maize Tassels Counting and ShanghaiTech Crowd Counting datasets.

Conclusions
This paper describes TasselNetv2 for counting wheat spikes, which simultaneously addresses two important use cases in plant counting: improving the counting accuracy without increasing model capacity, and improving efficiency without sacrificing accuracy. It is promising to be deployed in a real-time system with high-throughput demand. In particular, TasselNetv2 can achieve sufficiently accurate results when training from scratch with small networks, and adopting larger pre-trained networks can further boost accuracy. In practice, one can trade off the performance and efficiency according to certain application scenarios. Code and models are made available at: https://tinyurl.com/TasselNetv2.