bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Epidemiology of Infant Shaft Fractures of Femur or Humerus by Incidence, Birth, Accidents, and Other Causes
Authors: von Heideken Johan , Thiblin Ingemar , Högberg Ulf 
Published: September 2020

Abstract
Background: Knowledge of femur and humerus shaft fractures during infancy is scarce. The purpose of this population-based registry study was to analyze both birth-related femur and humerus shaft fractures and those diagnosed later in infancy, as regards incidence, perinatal characteristics, other diagnoses, and reported accidents.Methods: Children born in 1997–2014, diagnosed with a femur or humerus shaft fracture before age 1 year, were identified in the Swedish Health Registries. Rate of birth fractures were estimated by combining femur and humerus shaft fractures coded as birth-related with femur and humerus shaft fractures diagnosed during day 1-7 without registered trauma, abuse, or bone fragility disorders. Incidence was computed by comparing infants with femur or humerus shaft fractures to the total at-risk population. Results: The incidence for birth-related femur shaft fractures was 0.024‰ (n=45) and that for birth-related humerus shaft fractures was 0.101‰ (n=188). The incidence was 0.154‰ for later femur shaft fractures (n=287) and 0.073‰ for later humerus shaft fractures (n=142). Birth-related femur shaft fracture was associated with preterm, multiple birth, breech, cesarean, and small-for-gestational age, while humerus shaft fracture was associated with preterm, multiple birth, birth weight > 4,000 g, and shoulder dystocia. A bone fragility diagnosis was recorded in 5% of those with birth-related or later femur shaft fractures. Among infants with birth-related humerus shaft fractures, 1% had a bone fragility diagnosis; the figure for later fractures was 6%. Maltreatment diagnosis was associated with both fracture types, especially among those aged < 6 months, where approximately 20% and 14% of cases, respectively, were associated with abuse. Fall accidents were reported in 73% and 56% among those with later femur and humerus shaft fractures, respectively. Conclusion: This study provides data on epidemiology, birth, parental characteristics, and reported accidents in relation to femur and humerus shaft fractures during infancy. Few children had a bone fragility diagnosis. Fall accidents were the main contributor to femur or humerus shaft fracture during infancy; however, the proportion of fractures attributed to maltreatment was high in children under 6 months.
The Influence of Adding Traditional Chinese Medicine on COVID-19 Patients’ Liver Function: A Systematic Review and Meta-analysis
Authors: Song Danlei , Huang Taobi , Wei Yongjian , Chen Yuyue , Wang Yuping , Zhou Yongning 
Published: September 2020

Abstract
Background: Corona Virus Disease 2019 (COVID-19) is highly infectious and spreads rapidly across the world. Some patients occurred liver damage for unexplained reasons. Our study aims to explore whether Traditional Chinese Medicine (TCM) causes severe abnormal liver function compared to that of Western Medicine during the treatment process of COVID-19.Methods: We selected eligible studies with strict inclusion and exclusion criteria after systematically searching 7 databases up to May 30, 2020. Then, the study quality was assessed by the Cochrane risk of bias tool. Finally, we conducted a meta and subgroup analysis in the random-effects model to calculate risk ratio (RR) and 95% confidence intervals (95% CI) to evaluate the risk changes after adding TCM and the influence factor to RR. Results: A total of 2648 articles were searched, and 3 randomized controlled studies were included. Our results indicated that the occurrence of abnormal liver function had no statistical difference in the group added with TCM from Western Medicine groups. (RR=0.55[0.16,1,85], I2=58%, P=0.09>0.05). We also found that the high heterogeneity existed in two subgroups of common cases and all typecases, and it was statistically significant (I2=76.3%, P=0.04 <0.05）, which means the clinical type of COVID-19 may be the source of heterogeneity.Conclusion: Our research showed that adding TCM wouldn’ t damage the COVID-19 patients’ liver function. On the contrary, it may reduce the risk.
Biomechanical Effect of Plate-to-Disc Distance on Surgical and Adjacent Segment in C5/C6 Anterior Cervical Discectomy and Fusion - A Finite Element Analysis
Authors: Xue Yuan , Guo Xing , Zhou Jiaming , Tian Yueyang , Kang Liang 
Published: September 2020

Abstract
Background: The PDD is an important factor affecting the degeneration of adjacent segments after ACDF. However, the most suitable PDD is controversial. This study examined the adjacent intervertebral disc stress, bone graft stress, titanium plate stress and screw stress to evaluate the biomechanical effect of different Plate-to-Disc Distance (PDD) on surgical segment and adjacent segment following C5/C6 anterior cervical discectomy and fusion (ACDF). Methods: We constructed 10 preoperative finite element models (FEM) of intact C4–C7 segments and validated them in the present study. We simulated ACDF surgery based on the 10 intact models in software. We designed three different distance of Plate-to-Disc titanium plates: L, long PDD (10 mm); S, short PDD (0 mm); and N, PDD (5 mm). The changes in C4/C5 and C6/C7 intervertebral disc stress, bone graft stress, titanium plate stress and screw stress were analyzed.Results: The von Mises stress of C4/C5 and C6/C7 intervertebral discs have no significant differences (P>0.05) in three different PDD groups. Titanium plate stress increased as the PDD decreased. The bone graft stress and screws stress decreased as the PDD decreased. The maximum stress of each part occurred was mostly in the conditions of rotation and lateral bending. Conclusions: The PDD has no effect on adjacent intervertebral disc stress, but it is an important factor that affecting the bone graft stress, titanium plate stress and screws stress after ACDF. Shorter PDD plate can provide better stability to reduce stress on screws and bone graft, that may be helpful to prevent cage subsidence, pseudarthrosis and instrument failure. This can serve as a reference for clinical choice of plate.
Knowledge, Attitudes and Practices Regarding Antimicrobial Use and Resistance Among Communities of Ilala, Kilosa and Kibaha Districts of Tanzania.&nbsp;
Authors: Sindato Calvin , Mboera Leonard EG , Katale Bugwesa Z , Frumence Gasto , Kimera Sharadhuli , Clark Taane G , Legido-Quigley Helena , Mshana Stephen E , Rweyemamu Mark M , Matee Mecky 
Published: September 2020

Abstract
Background: Antimicrobial resistance (AMR) represents one of the biggest threats to health globally. This cross-sectional study determined knowledge, attitudes and practices (KAP) regarding antimicrobial use (AMU) and AMR among communities of Ilala, Kilosa and Kibaha in Tanzania. Method: A semi-structured questionnaire was used to collect socio-demographic and KAP data through face-to-face interviews. Responses related to the triad of KAP were assigned scores that were aggregated for each participant. Linear regression analysis was conducted to determine predictors of KAP scores. Results: The study enrolled 828 participants from the three districts. A total of 816 (98.6%) were aware of antimicrobials, and 808 (99%, n=816) reported to have used them. Antimicrobials were mainly used to treat cough (68.0%), urinary tract infections (53.4%), diarrhoea (48.5%) and wounds (45.2%). The most frequent sources of antimicrobials were health facility (65.0%, n=820) and pharmacies/basic drug shops (53.7%). The median AMU knowledge score was 5 (IQR=4, 7) and that of AMR was 26 (IQR=23, 29). The median AMU attitudes score was 32 (IQR: 29, 35) and that of AMR was 19 (IQR=17, 22). The median AMU practice score was 3 (IQR: 3, 3). The KAP scores were significantly influenced by increased participant’s age (βadj=0.10; 95% CI: 0.05, 0.15) and level of education, being lower among those with primary education (βadj=5.32; 95% CI: 3.27, 7.37) and highest among those with college/university education (βadj=9.85; 95% CI: 6.04, 13.67). Conclusion: The study documented a moderate level of KAP regarding AMU and AMR in the study districts. The participant's age and level of education were significantly associated with participant's KAP scores. The observed inadequate knowledge, inappropriate attitude, and practices of AMU and AMR should be considered as alarming problems that require immediate actions including policy formulation and planning of community-based mitigation measures.
The Consequences of Declining Population Access to Insecticide Treated Nets (ITNs) on Net Use Patterns and Physical Degradation of Nets after 22 Months of Ownership
Authors: Mboma Zawadi Mageni , Festo Charles , Lorenz Lena M. , Massue Dennis J. , Kisinza William N. , Bradley John , Moore Jason D. , Mandike Renata , Akim Ikupa , Lines Jo , Overgaard Hans J. , Moore Sarah J. 
Published: September 2020

Abstract
BackgroundAs the number of insecticide-treated nets (ITNs) in households (access) declines when nets wear out some household-members are prioritised to use the remaining ITNs. This study assessed how nets are allocated within households to individuals of different age categories as ITNs are lost or damaged and as new ITNs are obtained. The study also explored how ITN allocation affects ITN durability. MethodsA cross-sectional household survey and ITN durability study was conducted among 2,875 households across Tanzania to determine the proportion of nets that remain protective (serviceable) twenty-two months after net distribution aiming for universal coverage. Allocation of study nets within houses and re-allocation of ITNs when new Universal Replacement Campaign (URC) nets arrived in study households in Musoma District was also assessed.ResultsOnly 57.0% [95% CI: 53.9-60.1%] of households had enough ITNs for every household member (assuming one net covers every 2 members). In households with enough nets, 77.5% of members slept under ITNs. In households without enough nets, pregnant women (54.6%), children<5 (45.8%) and adults (42.1%) were prioritised, with fewer school-age children 5-14 (35.9%), youths 15-24 (28.1%) and seniors>65 (32.6%) sleeping under ITNs. Crowding ( 3 people slept under nets) was twice as common among people residing in houses without enough nets for all age groups apart from children<5. Nets were less likely to be serviceable if 3 people slept under them (OR=0.50 [95%CI 0.40-0.63]); if nets were used by school-age children (OR=0.72 [95%CI 0.56-0.93]) and if the net product was Olyset®. One month after the URC, only 23.6% [95%CI 16.7-30.6%] had access to an URC ITN in Musoma district. Householders in Musoma district continued the use of old ITNs even with the arrival of new URC nets.ConclusionUsers determined the useful life of ITNs and prioritized pregnant women and children<5 to serviceable ITNs. When household net access declines, users adjust by crowding under remaining nets, which further reduces ITN lifespan. School-age children that commonly harbour gametocytes that mediate malaria transmission are compelled to sleep under unserviceable nets, crowd under nets or remain uncovered. However, they were accommodated by the arrival of new nets. More frequent ITN delivery through the school-net program in combination with mass distribution campaigns is essential to maximise ITN effectiveness.
Sero-prevalence of Hepatitis B virus infection and associated factors among pregnant women attending antenatal care service in health institutions in Gedeo Zone, Southern Ethiopia
Authors: Tadiwos Mhiret Belay , Kanno Girum Gebremeskel , Areba Abereham Shiferaw , Kabtyemer Robel Hussen , Abate Zeleke Girma , Aregu Mekonnen Birhanie 
Published: September 2020

Abstract
Background: Hepatitis B virus infection is a major public health problem worldwide and is a major cause of morbidity and mortality. This study aimed to assess the prevalence of hepatitis B virus infection and associated factors among pregnant mothers in the Gedeo Zone, southern Ethiopia.Methods: An institution-based cross-sectional study was conducted in governmental and private health facilities in the Gedeo zone from January to April 2019. The study participants were selected using systematic random sampling techniques. The Eugene strip test was used to determine hepatitis B virus infection among pregnant mothers. The status of HIV was collected from the records. Other variables were collected from the mothers using interviewer-administered questionnaires. Binary logistic regression was used for the analysis. Adjusted odds ratios and their 95% confidence intervals (CIs) were calculated to determine the association between HBsAg seropositivity and various factors. A p-value of less than 0.05 was considered significant.Results: The prevalence of hepatitis B virus infection among pregnant mothers was 9.2% in the Gedeo Zone. Previous history of blood transfusion [AOR=5.2, 95% CI: 2.1, 12.5], previous history of hospital admission [AOR=3, 95% CI: 1.4, 6.6], history of having an abortion [AOR=4.1, 95% CI: 1.5, 11.7], age of the pregnant women [AOR=5.1, 95% CI: 1.5, 18.0], and HIV status of the mother [AOR=8.1, 95% CI: 1.9, 36.0] had a statistically significant association with HBsAg seropositivity.Conclusions: Hepatitis B virus infection was found to have higher endemicity (9.2%) in the Gedeo Zone which is higher than the national pooled prevalence which was 4.75%. Early initiation of antenatal care services which incorporate the prevention and control of HBV must be implemented by the health facilities in the Gedeo Zone.
Sareomycetes: More Diversity than Meets the Eye
Authors: Mitchell James Kameron , Garrido-Benavent Isaac , Quijada Luis , Pfister Donald H. 
Published: September 2020

Abstract
Since its resurrection, the resinicolous discomycete genus Sarea has been accepted as containing two species, one with black apothecia and pycnidia, and one with orange. We investigate this hypothesis using three ribosomal (nuITS, nuLSU, mtSSU) regions from and morphological examination of 70 specimens collected primarily in Europe and North America. The results of our analyses support separation of the traditional Sarea difformis s.l. and Sarea resinae s.l. into two distinct genera, Sarea and Zythia. Sarea as circumscribed is shown to comprise three phylospecies, with one corresponding to Sarea difformis s.s. and two, morphologically indistinguishable, corresponding to the newly combined Sarea coeloplata. Zythia is maintained as monotypic, containing only a genetically and morphologically variable Z. resinae. The new genus Atrozythia is erected for the new species A. klamathica. Arthrographis lignicola is placed in this genus on molecular grounds, expanding the concept of Sareomycetes by inclusion of a previously unknown type of anamorph. Dating analyses using additional marker regions indicate the emergence of the Sareomycetes was roughly concurrent with the diversification of the genus Pinus, suggesting that this group of fungi emerged to exploit the newly-available resinous ecological niche supplied by Pinus or another, extinct group of conifers. Our phylogeographic studies also permitted us to study the introductions of these fungi to areas where they are not native, including Antarctica, Cape Verde, and New Zealand and are consistent with historical hypotheses of introduction.
Super-rotating protostellar jets
Authors: Matsushita Yuko , Takahashi Satoko , Ishii Shun , Tomisaka Kohji , Ho Paul , Carpenter John , Machida Masahiro 
Published: September 2020

Abstract
Protostellar jets are most striking phenomena in star-forming regions and considered to be an essential ingredient in the star formation process. Stars form in gravitationally collapsing clouds. The mass of protostar at its birth is equivalent to Jovian mass or 0.1 percent of the solar mass. After the birth, the protostar acquires its mass by accreting material from a surrounding rotation disk embedded in an infalling envelope that is a remnant of the natal cloud of the star. Protostellar jets are believed to expel the excess angular momentum from the circumstellar region that allows accretion on to the star. Here, we report the detection of super-rotating jets driven from a protostar FIR 6b (HOPS 60) in Orion Molecular Cloud-2. The jet rotation velocity exceeds 20kms-1 and the specific angular momentum of the jet is as large as ∼ 1022cm2s-1, which hitherto are the largest that have been observed in protostellar jets. The extraordinary large rotation velocity and specific angular momentum can be explained by a magnetohydrodynamic disk wind. This is clear evidence that magnetic fields play a crucial role for protostellar evolution and that angular momentum is removed by protostellar jets.
A probabilistic model to evaluate the effectiveness of main solutions to COVID-19 spreading in university buildings according to proximity and time-based consolidated criteria
Authors: D'Orazio Marco , Bernardini Gabriele , Quagliarini Enrico 
Published: September 2020

Abstract
Crowds in buildings open to the public can alter the occupants’ safety in different emergency conditions, including those related to a pandemic. In this sense, university buildings are one of the most relevant scenarios in which the COVID-19 event clearly pointed out the stakeholders’ needs toward safety issues, especially because of the possibility of day-to-day presences of the same users (i.e. students, teachers) and overcrowding causing long-lasting contacts with possible “infectors” in such closed environments. While waiting for the vaccine, as for other public buildings, policy-makers’ measures to limit (second) virus outbreaks combine individual’s strategies (facial masks), occupants’ capacity and access control to avoid lockdowns and ensure adequate conditions for occupants. Simulators could support effectiveness evaluations of such measures. To fill this gap, this work proposes a quick and probabilistic simulation model based on consolidated proximity and exposure-time-based rules for virus transmission (confirmed by international health organizations). The building occupancy is defined according to university schedule, identifying the main “attraction areas” in the building (classrooms, break-areas). Scenarios are defined in terms of occupants’ densities, mitigation strategies, virus-related aspects. The model is calibrated on experimental data and applied to a relevant university building. Results demonstrate the model capabilities. In the case study, occupants’ capacity limitation could support the adoption of surgical masks by users instead of FFPk masks (thus improving users’ comfort issues). Preliminary correlations to combine acceptable mask filters-occupants’ density are proposed to support stakeholders in organizing users’ presences in the building during the pandemic.
Interrupted time series analysis of the implementation of social distancing policy, its lifting and the mandate of wearing face masks in Iran to mitigate against COVID-19
Authors: Saki Mandana , Behzadifar Masoud , Behzadifar Meysam , Ghanbari Mahboubeh Khaton , Bakhtiari Ahad , Azari Samad , Gorji Hasan Abolghasem , Wu Jianhong , Bragazzi Nicola Luigi 
Published: September 2020

Abstract
BackgroundCOVID-19 was first reported in Wuhan, China, and has spread rapidly around the world. The purpose of this study was to investigate the effects of implementing social distancing policy, and the impact of its lifting, with the resumption of social contacts and activities, as well as the effects of mandating face masks on the temporal trend of new COVID-19 cases in Iran. Methods We employed the interrupted time series analysis (ITSA), which is a very valuable method that can be used to evaluate the impact of the implementation of various policies in the health sector to help health policy-makers make effective decisions. Daily data were collected from the Ministry of Health and Medical Education and the World Health Organization from 954 public hospitals and health center settings. Data were extracted 14 days before and after the implementation of each policy. Results were computed with their 95% confidence interval (CI) and p-values equal to or less than 0.05 were considered as statistically significant. All data were analyzed using the open-source software R Version 3.6.1 using the “nlme” and “car” packages.ResultsThe slope of changes in new confirmed cases following the implementation of the social distancing policy decreased by 118.79 (P <0.001). With the resumption of social and economic activities in all provinces except for Tehran, initially the number of new daily confirmed cases was 3300, which was statistically significant (P <0.001). The slope of changes due to the implementation of this policy was 47.89 (P <0.001). A similar trend was detected with the resumption of social and economic activities in Tehran. With the implementation of the policy of mandatory use of masks, the slope of changes showed a decrease of 25.84 (P <0.001). Conclusion Given the absence of effective drugs and vaccines against COVID-19, policy-makers have implemented non-pharmacological interventions to reduce the transmission of the disease and prevent more deaths. Social distancing may be unsustainable in the long-term, while wearing masks is both a cost-effective and efficacious measure to curb disease transmission.
An Inducible Expression System for Recombinant Sca Proteins with an Autotransporter Domain from Orientia Tsutsugamushi in Escherichia coli
Authors: Cho Hyejin , Kim Kwang-Sun 
Published: September 2020

Background:
Orientia tsutsugamushi (Ot) is an obligate, intracellular, gram-negative
bacterium causing scrub typhus. Some of its encoded proteins play key roles in the adhesion and internalization
of the Ot strain into host cells and are suitable resources for vaccine development and
tools for scrub typhus diagnosis. Surface cell antigen (Sca) proteins, classified as autotransporter
(AT) proteins, are one of the largest protein families involved in bacterial pathogenesis and can be
promising candidates for vaccine development. These proteins are typically large and contain inhibitory
domains; therefore, recombinant proteins without such domains have been evaluated for
this purpose. However, the expression for recombinant Sca proteins containing the AT domain,
which might largely affect their protective role against scrub typhus, has not been analyzed and optimized.

Objective:
In this study, we optimized expression and purification conditions for individual Ot Sca
protein fragments [ScaA (27–1461), ScaC (257–526), ScaD (26–998), and ScaE (35–760)] harboring
the AT domain.

Methods:
To this end, we subcloned sequences of codon-optimized DNA encoding Sca protein
fragments into the Escherichia coli expression vector. In addition, the expression condition for individual
Sca fragments was optimized, and the proteins were purified using one-step Ni-NTA column
method. The purified fractions were re-folded by serial dilution method, followed by BCA
quantification and densitometric analysis to estimate the yield and purity of proteins.

Results:
We prepared platforms for expression of recombinant Sca protein fragments [ScaA
(27–1461), ScaC (257–526), ScaD (26–998), and ScaE (35–760)] containing an AT domain without
the signal peptide and transmembrane (TM) domain. The protein yield per liter of culture with
>70% of purity was ScaC (257–576), ScaE (35–760), ScaD (26-998), and ScaA (27-1461) in order.

Conclusion:
Our results could be used to develop Sca AT-domain based vaccines and tools for
scrub typhus diagnosis with rapid and cost-effective ways.