bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systematic review and bibliometric analysis of African anesthesia and critical care medicine research Part I: Hierarchy of evidence and scholarly productivity
Authors: Kanmounye Ulrick Sidney , Tochie Joel Noutakdie , Mbonda Aimé Noula , Wafo Cynthia Solam , Daya Leonid , Atem Thompson Hope , Nyalundja Arsène Daniel , Eyaman Daniel Cheryl 
Published: September 2020

Abstract
Background: Research is an essential component of Anesthesia, and the contributions of researchers and institutions can be appreciated from the analysis of scholarly outputs. Such analyses help identify major contributors and trends in publication. Little is known about the state of Anesthesia and Critical Care Medicine (A.C.C.M.) research in Africa. We aimed to describe African A.C.C.M. research's current landscape by determining its productivity per country and point towards possible ideas for improvement. Methods: The authors searched PubMed, Embase, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception to May 4, 2020, for articles on or about A.C.C.M. in Africa. Studies were selected based on their titles and abstracts. Rayyan software was later on used for data management in the review selection process. Then, the full-text of eligible articles were screened. Data were extracted, and the number of articles per physician anesthesia providers and provider density were calculated. Kruskal Wallis test and Spearman's correlation were used, and a P-value <0.05 was considered statistically significant.Results: Of the 4690 articles, only 886 (18.9%) were included in the analysis. The articles were published between 1946 and 2020 in 278 target journals. 55 (6.2%) articles were published in the South African Journal of Surgery, 51 (5.8%) in Anesthesia and Analgesia, and 46 (5.2%) in Anaesthesia. 291 (32.8%) studies were cross-sectional. 195 (22.0%) first authors were from Nigeria, 118 (13.3%) from South Africa, and 88 (9.9%) from the U.S.A. Malawi (1.67), Togo (1.06), and Sierra Leone (1.00) had the highest number of articles per provider. Whereas Ethiopia (580.00), Nigeria (336.21), and Malawi (333.33) had the highest number of articles per provider density. Conclusion: We identified the most and least productive African countries in A.C.C.M. research and a low-quality hierarchy of evidence in these publications. Hence, the study's findings may aid in driving the A.C.C.M. research agenda and capacity building in Africa.
Midwives’ challenges and factors that motivate them to remain in their workplace in the Democratic Republic of Congo – An interview study
Authors: Bogren Malin , Grahn Malin , Kaboru Berthollet Bwira , Berg Marie 
Published: September 2020

Abstract
Background: The Democratic Republic of Congo (DRC) has high maternal mortality and a low number of midwives, which undermines the achievement of Goal 3 of the Sustainable Development Goals (SDGs) for 2030, specifically the health of mother and newborn. Scaling up the midwifery workforce in relation to number, quality of healthcare, and retention in service, are therefore critical. The aim of this study was to investigate midwives’ challenges and factors that motivate them to remain in their workplace in the DRC. Methods: Data were collected in two out of 26 provinces in the DRC through ten focus-group discussions with a total of 63 midwives working at ten different healthcare facilities. Transcribed discussions were inductively analysed using content analysis.Results: The midwives’ challenges and the factors motivating them to remain in their workplace in the DRC are summarised in one main category – Loving one’s work makes it worthwhile to remain in one’s workplace, despite a difficult work environment and low professional status – consisting of three generic categories: Midwifery is not just a profession; it’s a calling is described in the subcategories Saving lives through midwifery skills, Building relationships with the women and the community, and Professional pride; Unsupportive organisational system is expressed in the subcategories Insufficient work-related security and No equitable remuneration system, within Hierarchical management structures; and Inadequate pre-conditions in the work environment includes the subcategories Lack of resources and equipment and Insufficient competence for difficult working conditions. Conclusion: Midwives in the DRC are driven by a strong professional conscience to provide the best possible care for women during childbirth, despite a difficult work environment and low professional status. To attract and retain midwives and ensure that they are working to their full scope of practice, we suggest coordinated actions at the regional and national levels in the DRC and in other low-income countries with similar challenges, including: i) conducting midwifery education programmes following international standards; ii) prioritising and enforcing policies to include adequate remuneration for midwives; iii) involving midwives’ associations in policy and planning about the midwifery workforce; and iv) ensuring that midwives’ working environments are safe and well equipped.
Establishment of a Pediatric COVID-19 Biorepository: Unique Considerations and Opportunities for Studying the Impact of the COVID-19 Pandemic on Children
Authors: Lima Rosiane , Gootkind Elizabeth , Flor Denis De La , Yockey Laura , Bordt Evan , D'Avino Paolo , Ning Shen , Heath Katerina , Harding Katherine , Zois Jaclyn , Park Grace , Hardcastle Margot , Grinke Kathleen A. , Grimmel Sheila , Forde Pamela J. , Davidson Susan P. , Hall Kathryn E. , Neilan Anne , Matute Juan D. , Lerou Paul H. , Fasano Alessio , Shui Jessica E. , Edlow Andrea G. , Yonker Lael M. 
Published: September 2020

Abstract
Background: COVID-19, the disease caused by the highly infectious and transmissible coronavirus SARS-CoV-2, has quickly become a morbid global pandemic. Although the impact of SARS-CoV-2 infection in children is less clinically apparent, collecting high-quality biospecimens from infants, children, and adolescents in a standardized manner during the COVID-19 pandemic is essential to establish a biologic understanding of the disease in the pediatric population. This biorepository enables pediatric centers world-wide to collect samples uniformly to drive forward our understanding of COVID-19 by addressing specific pediatric and neonatal COVID-19-related questions. Methods: A COVID-19 biospecimen collection study was implemented with strategic enrollment guidelines to include patients seen in urgent care clinics and hospital settings, neonates born to SARS-CoV-2 infected mothers, and asymptomatic children. The methodology described here, details the importance of establishing collaborations between the clinical and research teams to harmonize protocols for patient recruitment and sample collection, processing and storage. It also details modifications required for biobanking during a surge of the COVID-19 pandemic.Results: Considerations and challenges facing enrollment of neonatal and pediatric cohorts are described. A roadmap is laid out for successful collection, processing, storage and database management of multiple pediatric samples such as blood, nasopharyngeal and oropharyngeal swabs, sputum, saliva, tracheal aspirates, stool, and urine. Using this methodology, we enrolled 327 participants, who provided a total of 972 biospecimens.Conclusions: Pediatric biospecimens will be key in answering questions relating to viral transmission by children, differences between pediatric and adult viral susceptibility and immune responses, the impact of maternal SARS-CoV-2 infection on fetal development, and factors driving the Multisystem Inflammatory Syndrome in Children. The specimens in this biorepository will allow necessary comparative studies between children and adults, help determine the accuracy of current pediatric viral testing techniques, in addition to, understanding neonatal exposure to SARS-CoV-2 infection and disease abnormalities. The successful establishment of a pediatric biorepository is critical to provide insight into disease pathogenesis, and subsequently, develop future treatment and vaccination strategies.
Factors Influencing the Result of Superior Oblique Weakening Procedures in Patients with Superior Oblique Overaction in Horizontal Strabismus
Authors: Chun Junwoo , Kim Seong-Joon 
Published: September 2020

Abstract
Background

Few studies have evaluated the surgical outcome of superior oblique weakening procedures in patients with superior oblique overaction associated with exotropia or esotropia. This study aimed to evaluate the outcome of superior oblique muscle weakening and the influencing factors in patients with superior oblique overaction.

Methods

The medical charts of 37 patients (55 eyes) with superior oblique overaction associated with esotropia or exotropia who were treated with a superior oblique weakening procedure at the Seoul National University Hospital from January 2010 to June 2017 were retrospectively reviewed. Superior oblique overaction was graded using, a 6-point scale ranging from +0.5 to +3, and pre- and postoperative grades were recorded for all patients.

Results

The mean age of the patients was 91.81 ± 59.37 months. Superior oblique muscle suture spacer and superior oblique posterior tenectomy were performed for 17 (23 eyes) and 20 (32 eyes) patients, respectively. Surgical success was achieved in 15 (65.2%) eyes in the suture spacer group and 23 (71.9%) eyes in the posterior tenectomy group. Surgical success was achieved for 69.1% (38/55 eyes) of patients. Dissociated vertical deviation exhibited a significant negative association with the surgical success rate (p<0.001).

Conclusion

There was no significant difference in surgical success rate between the superior oblique posterior tenectomy and superior oblique suture spacer groups in superior oblique overaction associated with horizontal strabismus. Associated dissociated vertical deviation can affect the surgical success of the superior oblique weakening procedure.
Identification of potential specific biomarkers and key signaling pathways between osteogenic and adipogenic differentiation of hBMSCs for osteoporosis therapy
Authors: wu jianjun , Cai Peian , Lu Zhenhui , Zhang Zhi , He Xixi , Zhu Bikang , Zheng Li , Zhao Jinmin 
Published: September 2020

Abstract
Background: The differentiation of bone mesenchymal stem cells (BMSCs) into adipogenesis (AD) rather than osteogenesis (OS) is an important pathological feature of osteoporosis. Illuminating the detailed mechanisms of the differentiation of BMSCs into OS and AD would contribute to the interpretation of osteoporosis pathology. Methods: To identify the regulated mechanism in lineage commitment of the BMSCs into OS and AD in the early-stages, the gene expression profiles with temporal series were downloaded to reveal the distinct fates when BMSCs adopt a committed lineage. For both OS and AD lineages, the profiles of day 2-4 were compared with day 0 to screen the differentially expressed genes (DEGs), respectively. Next, the functional enrichment analysis was utilized to find out the biological function, and Protein-Protein Interaction network to predict the central genes. Finally, experiments were performed to verify our finding. Results: FoxO signaling pathway with central genes like FoxO3, IL6 and CAT, is the crucial mechanism of OS, while Rap1 signaling pathway of VEGFA and FGF2 enrichment is more significant for AD. Besides, PI3K-Akt signaling pathway might serves as the latent mechanism about the initiation of differentiation of BMSCs into multiple lineages. Conclusion: Above hub genes and early-responder signaling pathways control osteogenic and adipogenic fates of BMSCs, which maybe mechanistic models clarifying the changes of bone metabolism in the clinical progress of osteoporosis. The findings provide a crucial reference for the prevention and therapy of osteoporosis.
Enriched Environment Ameliorates Adult Hippocampal Neurogenesis Deficits in Tcf4 Haploinsufficient Mice
Authors: Braun Katharina , Häberle Benjamin M. , Wittmann Marie-Theres , Lie Dieter Chichung 
Published: September 2020

Abstract
Background: Transcription factor 4 (TCF4) has been linked to human neurodevelopmental disorders such as intellectual disability, Pitt-Hopkins Syndrome (PTHS), autism, and schizophrenia. Recent work demonstrated that TCF4 participates in the control of a wide range of neurodevelopmental processes in mammalian nervous system development including neural precursor proliferation, timing of differentiation, migration, dendritogenesis and synapse formation. TCF4 is highly expressed in the adult hippocampal dentate gyrus – one of the few brain regions where neural stem / progenitor cells generate new functional neurons throughout life.Results: We here investigated whether TCF4 haploinsufficiency, which in humans causes non-syndromic forms of intellectual disability and PTHS, affects adult hippocampal neurogenesis, a process that is essential for hippocampal plasticity in rodents and potentially in humans. Young adult Tcf4 heterozygote knockout mice showed a major reduction in the level of adult hippocampal neurogenesis, which was at least in part caused by lower stem/progenitor cell numbers and impaired maturation and survival of adult-generated neurons. Interestingly, housing in an enriched environment was sufficient to enhance maturation and survival of new neurons and to substantially augment neurogenesis levels in Tcf4 heterozygote knockout mice.Conclusion: Haploinsufficiency for the transcription factor TCF4 has been linked to non-syndromic intellectual disability and PTHS. The present findings raise the possibility that TCF4 haploinsufficiency may have a continuous negative impact on hippocampal function by impeding hippocampal neurogenesis and suggest that behavioural stimulation may be harnessed to ameliorate a subset of TCF4 haploinsufficiency associated neural deficits during adulthood.
Live birth rate and neonatal outcomes of different quantities and qualities of frozen transferred blastocyst in patients requiring whole embryo freezing stratified by age
Authors: Chen Shiping , Du Hongzi , Liu Jianqiao , Liu Haiying , Li Lei , He Yuxia 
Published: September 2020

Abstract
Background: Multiple pregnancies are associated with significant complications and health risks for both mothers and infants. Single blastocyst transfer (SBT) is a logical and effective measure to reduce the incidence of multiple pregnancy with assisted reproductive technology (ART). Whether it is suitable for everyone undergoing SBT was inconclusive, in view of the consideration of embryo quality and patients’ age. Therefore, this study aimed to explore live birth rate (LBR) and neonatal outcomes of different quantities and qualities of blastocysts in patients stratified by age, using a cutoff of 35 years, who required whole embryo freezing and underwent a subsequent frozen thawed transfer (FET) cycle.Methods: A total of 3,362 patients were divided into five groups: group A (n=1569) received a single good-quality blastocyst, group B (n=1113) received two good-quality blastocysts, group C (n=313) received one good- and one average-quality blastocyst, group D (n=222) received two average-quality blastocysts, and group E (n=145) received one average-quality blastocyst.Results: For patients who received good-quality blastocysts, irrespective of age, the LBR of double blastocyst transfer (DBT) was about 50–65% and the multiple pregnancy rate (MPR) was 40–60%; however, the LBR of SBT was 40–55%, and the MPR was 3.5–6.3%. For patients who only had average-quality blastocysts, the MPR of double average-quality blastocyst transfer was as high as 30–50%. Moreover, about 70–90% of preterm births resulted from multiple pregnancies, and about 85–95% of low birth weight babies come from multiple pregnancies. The neonatal outcomes (gestational age, birth weight, and birth height) of DBT were significantly lower than those of SBT regardless of age, and this statistical difference disappeared if the patients were subgrouped by singleton or twin. There is no significant difference in neonatal outcomes between single good-quality blastocyst and single average-quality blastocyst transfer.Conclusions: SBT is a preferable option for patients regardless of age when good-quality blastocysts are available. For patients who only had average-quality blastocysts, they should be informed that DBT was associated with higher multiple pregnancy and adverse neonatal outcomes when compared with SBT regardless of age, suggesting that the practice of SBT is also feasible for these patients.
Post-status Epilepticus Treatment With the Fyn Inhibitor, Saracatinib, Improves Cognitive Function in Mice
Authors: Luo Xinming , Zhao Jing , Wu Wenyue , Fu Jie , Li Zhengyu , Zhang Ming , Lu Jie 
Published: September 2020

Abstract
BackgroundStatus epilepticus (SE) is a life-threatening neurological disorder. The hippocampus, as an important area of the brain that regulates cognitive function, is usually damaged after SE, and cognitive deficits often result from hippocampal neurons lost after SE. Fyn, a non-receptor Src family of tyrosine kinases, is closely related to SE occurrence. Saracatinib, a Fyn inhibitor, suppresses epileptogenesis and reduces epileptiform spikes. However, whether saracatinib inhibits cognitive deficits after SE is still unknown. MethodsIn the present study, a pilocarpine-induced SE mouse model was used to answer this question by using the Morris water maze and normal object recognition behavioral tests. ResultsWe found that saracatinib inhibited the loss in cognitive function following SE. Furthermore, we found that the number of hippocampal neurons in the saracatinib treatment group was increased, when compared to the SE group. ConclusionsThese results showed that saracatinib can inhibit cognitive deficits resulting from SE by reducing the loss of hippocampal neurons, suggesting that Fyn is involved in the loss of cognitive function after SE, and that the inhibition of Fyn is a possible treatment to improve cognitive function in SE patients.
Management of liver trauma in urban university hospitals in India: an observational multicentre cohort study
Authors: Sinha Yash , Khajanchi Monty U , Prajapati Ramlal P , Dharap Satish , Soni Kapil Dev , Kumar Vineet , Mahindrikar Santosh , Roy Nobhojit 
Published: September 2020

Abstract
Background

Low- and Middle-Income Countries (LMICs) contribute to 90% of injuries occurring in the world. Liver is the one of the commonest organ injured in abdominal trauma. This study aims to highlight the demographic and management profile of liver injury patients, presenting to four urban Indian university hospitals in India.

Methods

This is a retrospective registry-based study. Data of patients with liver injury either isolated or concomitant with other injuries was used using the ICD-10 code, S36.1 for liver injury. The severity of injury was graded based on the World Society of Emergency Surgery (WSES) grading for liver injuries.

Results

A total of 368 liver injury patients were analysed. 89% were males, with road traffic injuries being the commonest mechanism. As per World Society of Emergency Surgery (WSES) liver injury grade, there were 126 (33.7%) grade I, 87(23.6%) grade II, 67(18.2%) grade III & 88 (24.5%) grade IV injuries. The overall mortality was 16.6%. 262 patients (71.2%) were managed non-operatively (NOM) & 106 (38.8%) were operated. 90.1% of those managed non-operatively, survived.

Conclusion

In this multi-centre cohort of liver injury patients from urban university hospitals in India, the commonest profile of patient with a was a young male, with a blunt injury to the abdomen due to a road traffic accident. Success rate of non-operative management of liver injury is comparable to other countries.
Design and Evaluation of Mobile Clinical Education via Interactive APP
Authors: Wang Jin , Ma Xianghua , Cai Jinxin , Gao Shiqi , Zhao Ting , Wang Fujie , Pan Chen 
Published: September 2020

Abstract
Background: To design and evaluate the feasibility and efficacy of Mobile Clinical Education (MCE) based on the intelligent and social mobile app.Candidates: 181 students from Nursing Department of Nanjing Medical University. Methods: Those students were previously assigned into two classes based on their admission evaluation. MCE was randomly assigned for one class including 97 students, while control group had 84. The MCE app was developed and applied for Nutrition course during the whole semester, while the control group was taught by the traditional method.Results: MCE group had better performance for the theoretical test scores (t = 1.127, P = 0.26) and he final evaluation (t = 7.419, P < 0.001). Based on teaching evaluation questionnaire, students under MCE presented more positive feedback: active communication, personal participation, update for the cutting-edge development, satisfaction of teaching quality, and overall course satisfaction. Conclusion: Mobile Clinical Education (MCE) improved the quality and efficacy of course teaching. With real-time and social advantage, MCE might arouse learning interest, bring various strategies for teaching theoretical knowledge and practical operation, and engage learning communication and collaboration. Mobile Clinical Education should be recommended for the future teaching and training.
Self-Management in Patients with Heart Valve Replacement and Its Clinical Outcomes: A Systematic Review
Authors: Zandi Shirdel , Imani Behzad , khazaei Salman , Safarpor GHolamreza 
Published: September 2020

Abstract
Background: For patients with heart valve replacement, self-management can play an important role in controlling the patient's condition, therefore, the purpose of this review was to identify the aspects of self-management and its clinical outcomes in patients with heart valve replacement. Methods: We conducted a systematic review of peer-reviewed research literature focused on self-management in patients with heart valve replacement. The databases of PubMed, Scopus, and web of science were searched until May 2020 free from time and language limitation. Al documents were assessed for eligible articles by title or abstract according to the search strategy.The screening process of articles was conducted by two independent authors. The selected articles were checked regarding to inclusion and exclusion criteria.Results: Finally, 25 studies were considered in this systematic review. Self-management of these patients has prerequisites and requires appropriate training. Self-management in these patients is applicable in the aspects of Anticoagulation therapy self-management, INR self-testing, Low-dose INR Self-management, and Heart valve function self-monitoring. In this method, with better control of INR levels and Anticoagulation therapy, the incidence of complications will be reduced and patients will be able to diagnose functional disorders in the early stages by monitoring the function of valve, which will prevent the progression of complications. Conclusion: The results of this review clearing that self-management is applicable in the aspects of Anticoagulation therapy, INR control, low dose INR management, and monitoring of cardiac valve function and by improving care standards, it will improve the quality of treatment for these patients.