bluuebunny/crossref_metadata_2025_split huggingface dataset:
Discontinuation and switching of postpartum contraceptive methods over twelve months in Burkina Faso and the DRC: a secondary analysis of the Yam-Daabo trial
Authors: Coulibaly Abou , Millogo Tieba , Baguiya Adama , Tran Nguyen Toan , Yodi Rachel , Seuc Armando , Cuzin-Kihl Asa , Thieba Blandine , Landoulsi Sihem , Kiarie James , Mashinda Désiré , Kouanda Seni 
Published: October 2020

Abstract
Introduction : Women who use contraceptive methods sometimes stop early, use methods intermittently or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use.Methods: We conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis by using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching.Results: In total, 637 out of the 1,120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. Modern methods were used by 179 women of control group compared to 279 women of intervention group with 24 and 32 who discontinued, respectively. We observed no statistically significant association between interventions and modern methods discontinuation and switching. However, the discontinuation of modern methods was higher in pills and injectables users than implants and IUDs users. The pooled data comparison showed that, in reference to the women who had not switched while using a modern method, the likelihood of switching to a less or equal effectiveness method among the women of the control group was 3.8(95% CI: 1.8-8.0) times the likelihood of switching to a less or equal effectiveness method among the women of the intervention group. And this excess was statistically significant (p<0.001). The main reason for discontinuation and switching was method-related (141 over 199), followed by partner opposition with 20 women.Conclusion: The results of this study show no statistically significant association between interventions and modern methods discontinuation. Discontinuation is more related to the methods themselves than to any other factor. It is also important to set up specific actions targeting women's partners and influential people in the community to counter inhibiting beliefs.Trial registration: Pan African Clinical Trials Registry (PACTR201609001784334, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1784).
‘They Just Came with the Medication Dispenser’ – A Qualitative Study of Service User Involvement and Welfare Technology in Public Home Care Services
Authors: Glomsås Heidi Snoen , Knutsen Ingrid Ruud , Fossum Mariann , Halvorsen Kristin 
Published: October 2020

Abstract
BackgroundPublic home care for the elderly is a key area in relation to improving health care quality. It is an important political goal to increase elderly people’s involvement in their care and in the use of welfare technology. The aim of this study was to explore elderly service users’ experience of user involvement in the implementation and everyday use of welfare technology in public home care services.MethodThis qualitative study has an explorative and descriptive design. Sixteen interviews of service users were conducted in five different municipalities over a period of six months. The data were analysed using reflexive thematic analysis. Results Service users receiving public home care service are not a homogenous group, and the participants had different wishes and needs as regards user involvement and the use of welfare technology. The analysis led to four main themes: 1) diverse preferences as regards user involvement, 2) individual differences as regards information, knowledge and training, 3) feeling safe and getting help, and 4) a wish to stay at home for as long as possible.ConclusionThe results indicated that user involvement was only to a limited extent an integral part of public home care services. Participants had varying insight into and interest in welfare technology, which was a challenge for user involvement. User involvement must be facilitated and implemented in a gentle way, highlighting autonomy and collaboration, and with the focus on respect, reciprocity and dialogue.
A Neonate with Amniotic Band Syndrome and Osteomyelitis
Authors: Zafaranloo Nazanin , Moshfegh Fereshteh , Mohagheghi Parisa , Beigi Babak , Nourozi Elahe 
Published: October 2020

Abstract
Background: Amniotic band syndrome (ABS) comprises of a spectrum of congenital malformations involving the limbs more often, but any other anatomic region of fetus could be involved (1). Its prevalence has been reported to range from 0.19 to 8.1 per 10000 live births (2). There are different theories for explaining the etiology of amniotic bands, but it has been considered to have a multifactorial etiology. (2) Fetoscopic release of amniotic bands affecting one or more extremities can prevent limb loss or preserve limb function when distal fellow is still identifiable on preoperative ultrasound scans (3)(4). ABS occurs in 77% of fetuses with multiple anomalies (5). Both males and females are equally affected (6). Osteomyelitis in neonates is relatively uncommon, but burdened with an increased hospital stay and possible long‐term sequela if not diagnosed on time (18). The long bones are the most frequently affected sites (18).Case presentation: Here we are introducing a neonate with left upper extremity necrosis due to ABS which needed amputation and it was associated with severe chronic osteomyelitis.Conclusion: Amniotic band syndrome mostly involves the limbs. It is important to diagnose it as soon as possible, because with the interprofessional teamwork approach, an optimal patient result with fetoscopic or surgery procedures could be achieved.
The Value of Epicardial Adipose Tissue for the Patients Treated with Percutaneous Coronary Intervention: A Systemic Review and Meta-analysis
Authors: Xu Tan , Xu Ming 
Published: October 2020

Abstract
BackgroundAccumulating evidences suggest that the prognostic value of epicardial adipose tissue (EAT) on no-reflow, in-stent restenosis (ISR), infarct size, and main adverse cardiovascular events (MACE) for the patients treated with percutaneous coronary intervention (PCI). The relationship between EAT and outcomes of patients underwent PCI is still partly elusive. MethodsTo elucidate the relationship in detail, we searched PubMed, web of science, and the Cochrane Library for studies evaluating the association of EAT and patients treated with PCI. Thirteen studies enrolling 3683 patients were eventually include in our systemic review and meta-analysis. ResultsThe EAT measured by thickness or volume was significantly higher in the ISR group compared to those in the non-ISR group (The standard mean difference -0.34, 95% CI, -0.49, -0.18, p <0.0001; I2 =36%). The incidence of no-reflow was significantly higher in thicker EAT group compared to thin EAT group (pooled relative ratio 1.52, 95%CI 1.29-1,80, p <0.0001; I2 =0%). Thicker EAT was significantly associated with MACEs (pooled relative ratio 1.50, 95% 1.18-1.90, p =0.008). A lower EAT volume is associated with larger infarct size in ST elevated myocardial infarction patients treated with primary PCI (standard mean difference was -5.45, 95% CI -8.10, -2.80; p <0.0001; I2 =0%). In summary, our systemic review and meta-analysis suggest that high EAT is related with a significant increased risk of non-reflow, MACE and decreased infarct size in patients with coronary artery disease treated with PCI. This paradox phenomenon demonstrates that the quality of EAT may play more important role than the solely thickness or volume of EAT.
Effect of Periodontal Debridement Plus Systemic Azithromycin v/s&nbsp;Periodontal Debridement as Unique Therapy in Subjects with Periodontitis: A Randomized Controlled Clinical Trial.
Authors: Navarrete Mariely , Oñate Héctor , Loyola Katarina , Olivares Pamela 
Published: October 2020

Abstract
Background: Recently, it has been suggested that azithromycin (AZM) may be a useful adjunct to non-surgical periodontal therapy (NSPT). However, current scientific evidence is still not conclusive as to its efficacy as an adjunct of NSPT. This study aimed to evaluate the effect of the systemic administration of AZM as an adjunct to NSPT on the clinical and microbiological variables of patients with periodontitis.Methods: Eighteen volunteers with Periodontitis received NSPT combined with placebo or AZM (500 mg/day) for 3 days (n=9/group). They were monitored clinically for probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI) and bleeding on probing (BoP) at baseline and during the first, third and sixth month and monitored microbiologically at baseline and at 3 and 6 months after therapy. The microbiological variables were detected by conventional polymerase chain reaction tests. The normality was checked using the Shapiro-Wilk test. The level of statistical significance was measured by the unpaired t-test, Mann-Whitney U, Fisher’s exact and Chi-Square tests.Results: Fourteen patients completed the study (n=7/group). The group receiving NSPT + AZM presented with a significantly lower mean PPD at 3 (p = 0.05) and 6 months (p = 0.04) with a greater probing depth reduction (p = 0.02). Moreover, at the third month post NSPT, there was a significant increase in the number of sites with a PPD 1–3 mm (p < 0.001) and a decrease in the number of sites with a PPD 4–6 mm (p < 0.001). In addition, a significant decrease in the mean number of sites with a PPD ≥ 7 mm (p = 0.04) was detected at 6 months post treatment. There was also a significant decrease in BoP at 1 (p = 0.01), 3 (p < 0.001) and 6 (p = 0.01) months post intervention. Conclusions: AZM as an adjuvant to NSPT provides additional beneficial effects for PPD and BoP compared to NSPT alone. This could be related to its anti-inflammatory properties more than to its antibiotic characteristics.Trial registration: ClinicalTrials.gov: NCT03629288. https://clinicaltrials.gov/ct2/show/NCT03629288Retrospectively registered on August 14, 2018.
A Simple Noninvasive Model to Predict Significant Fibrosis in Children with Chronic Hepatitis B
Authors: Zhang Kang-Ling , Chen Xiu-Qi , Lv Zi-Li , Huang Li , Yun Xiang , Yang Mei-Xiong , Lan Lian-Chen , Tang Qing , shan qingwen 
Published: October 2020

Abstract
Background: To develope a noninvasive model for significant fibrosis in children with chronic hepatitis B (CHB). Methods: A total 116 CHB pediatric patientswere who had undergone liver biopsy were included in the study. The gold standard of fibrosis was assessed by liver histology. blood routine examination, coagulation function, liver biochemistry, viral serology and viral load were analyzed. Receiver operating characteristic (ROC) curve analysis was used to analyze sensitivity and specificity of all possible cut-off values.Results: Based on the correlation and difference analysis, 7 available clinical parameters [Total bile acid (TBA), Gamma-glutamyl transpeptidase(GGT)，Aspartate transaminase(AST)，Direct bilirubin to total bilirubin ratio (D/T)，Alanine aminotransferase(ALT)，Prealbumin，(PA)，and Cholinesterase（CHE）were included for modeling analysis. A model to predict significant liver fibrosis (Ishak fibrosis score ≥2) was derived using the two best parameters (PA and GGT) The original model was. After mathematical calculation, the G index 600×GGT/PA2 predicts significant fibrosis with an area under the receiving operating characteristics (AUROC) curve of 0.733，95% IC (0.643-0.811). The area under the receiver operating characteristic curve (AUROC) of G index (0.733,) was higher than that of APRI (0.680) and FIB-4(0.601) to predict significant fibrosis in children with CHB. If the G index's values outside 0.28-1.16, 52% of children with CHB could avoid liver biopsy with an overall accuracy of 75%.Conclusions: The G index can predict and exclude significant fibrosis in children with HBV, which may reduce the liver biopsy need for children with CHB.
Efficacy of Acupuncture for Persistent and Intractable Hiccups: A Protocol for Systematic Review and Meta Analysis of Randomized Controlled Trials
Authors: Zhang Yu , Jiang Xudong , Wang Zhijie , He Mingming , Lv Zimeng , Yang Gaiqin , Qin Weixun 
Published: October 2020

Abstract
Background: Persistent and intractable hiccups are a common clinical symptom that cause considerable physical pain to patients and severely damage their quality of lives. An increasing number of studies have demonstrated that acupuncture applied at acupoints dominated by Cuanzhu (BL2) can be used as one of the nonpharmacological therapies for controlling intractable hiccups. However, there is insufficient evidence evaluating the safety and effectiveness of those interventions. Therefore, this study is intended to conduct a systematic review and meta-analysis to provide evidence for a further study investigating alternative treatment options for persistent and intractable hiccups.Methods: Randomized controlled trials (RCTs) of adult patients aged >18 years who meet the criteria for intractable hiccup diagnosis will be included, regardless of gender, nationality, and education level. Eight electronic databases will be searched, including four Chinese databases (CNKI, SinoMed, Wanfang Database, and Chinese Scientific Journal Database), four English databases (Web of Science, Medline, Embase, and Cochrane Library), from their date of establishment to September 2020. Two independent reviewers will evaluate the title summary for each RCT. Disagreements will be discussed with a third commentator. Data integration, heterogeneity analysis, subgroup analysis, and sensitivity analysis, will be performed using R-3.3.2 software. The RevMan 5.3 software will be used for the meta-analysis, and the “risk of bias” assessment will be conducted based on the methodological quality of the included trials recommended by the Cochrane Handbook 5.1. The quality evaluation of this study will be completed by the Grading of Recommendations, Assessment, Development, and Evaluation.Discusstion: This systematic review will provide evidence to assess the validity and safety of applying acupuncture at acupoints dominated by Cuanzhu (BL2) for persistent and intractable hiccups, which may provide clinicians with more choices in the treatment of this disease.Systematic review registration: PROSPERO CRD42020114900
Intraoperative 18F-FDG Flexible Autoradiography for Tumour Margin Assessment in Breast-conserving Surgery – A First-in-Human Multicentre Feasibility Study
Authors: Jurrius Patriek A.G.T. , Grootendorst Maarten R , Krotewicz Marika , Cariati Massimiliano , Kothari Ashutosh , Patani Neill , Karcz Paulina Patrycja , Nagadowska Monika , Vyas Kunal N , Purushotham Arnie , Turska-d'Amico Maria 
Published: October 2020

Abstract
IntroductionIn women undergoing breast-conserving surgery (BCS) 20-25% require a re-operation as a result of incomplete tumor resection. An intra-operative technique to assess tumor margins accurately would be a major advantage. A novel method for intraoperative margin assessment was developed by applying a thin flexible scintillating film to specimens - flexible autoradiography (FAR). A single arm, multi-center study was conducted to evaluate the feasibility of intraoperative 18F-FDG FAR for the assessment of tumor margins in BCS.MethodsEighty-eight patients with invasive breast cancer undergoing BCS received ≤300 MBq of 18F-FDG 60-180 minutes pre-operatively. Following surgical excision, intraoperative FAR was performed using the LightPath® Imaging System. The first 16 patients were familiarization patients, the remaining 72 patients were entered into the main study. FAR images were analyzed post-operatively by three independent readers. Areas of increased signal intensity were marked, mean decay corrected radiances and tumor-to-tissue background (TBR) determined, agreement between histopathological margin status and FAR assessed and radiation dose to operating theatre staff measured. Subgroup analyses were performed for various covariates, with thresholds set based on ROC curves.ResultsData analysis was performed on 66 patients. Intraoperative margin assessment using FAR was completed on 385 margins with 46.2% sensitivity, 81.7% specificity, 8.1% PPV, 97.7% NPV and an overall accuracy of 80.5%, detecting both invasive carcinoma and DCIS. A subgroup analysis based on 18F-FDG activity present at time of imaging revealed an increased sensitivity (71.4%), PPV (9.3%) and NPV (98.4%) in the high-activity cohort with mean tumor radiance and TBR of 126.7 ± 45.7 photons/s/cm2/sr/MBq and 2.1 ± 0.5, respectively. Staff radiation exposure was low (38.2 ± 38.1 µSv).Conclusion18F-FDG FAR is a feasible and safe technique for intraoperative tumor margin assessment. Further improvements in diagnostic performance require optimizing the method for scintillator positioning and/or the use of targeted radiopharmaceuticals.Trial registrationClinicalTrials.gov- Identifier: NCT02666079- Date of registration: 28 January 2016- URL: https://clinicaltrials.gov/ct2/show/NCT02666079ISRCTN registry- Reference: ISRCTN17778965- Date of registration: 11 February 2016- URL: http://www.isrctn.com/ISRCTN17778965
Discussion of QOL (with Concise Summary of Newer Clinical Research) in Colorectal Cancer Patients Treated in a Retrospective Trial on the Effect of Surgical Resection Margins on Survival, with Relation to Operation Type
Authors: Arslani Nuhi , RACHIMIS Philip R. 
Published: October 2020

Abstract
Background: the survival of patients treated for CRC is showing a trend of increase and with it increasing concern for the QOL of the operated patient. The aim of this study was to examine the relative influence of distal and circumferential resection margin lenght on survival among a select group patients (undergoing routine treatment) in our institution, with no metastases, and not operated on as an emergency. We also hoped to provide a concise reflection of newer clinical research on the topic.Methods: records of 303 patients, that were operated on between January 2009 and January 2014, were retrospectively reviewed for this study. Patients who underwent emergency surgery and those with metastases were excluded, which left 128 patients suitable for statistical analysis. Results: the number of survivors was noticeably higher than the number of deaths in all groups. Analysis with the Mann-Whitney-Wilcoxon test showed statistically significant differences (p < 0.05) in survival between the group with different CRM-s (p=0.01396), and could not be found between different DRM groups (p=0.1132). The logistic regression model of survival analysis showed that the size CRM is an independent predictor (p = 0.0202, AIC = 92.181) and the size of the DRM is not (p = 0.119, AIC = 109.89). Conclusions: a distal resection margin smaller than 1 cm may be oncologically acceptable in a complete R0 excision, which could theoretically help surgeons perform SSR operations with better oncological and functional results.
In-Vitro Investigation of Antimicrobial Effect of Bark Root Extracts of Solanum Incanum and Croton Macrostachyus
Authors: Shigut Moa Melaku , Serbessa Tagesu Abdisa , Keneni Dele Abdissa , Deressa Feyissa Begna , Debelo Motuma 
Published: October 2020

Abstract
Background: The increasing antibiotic resistance exhibited by pathogenic microbial infectious agents has led to the screening of several medicinal plants for their potential antimicrobial activity. An in vitro experimental investigation was conducted with the aim to evaluate antibacterial effect of bark root extracts of S. incanum and C. macrostachyus against S. aureus and E. coli. It was experimental study from January 2019 to November 2019 in Jimma University. The crude extracts of S. incanum and C. macrostachyus were done using petroleum ether, ethanol and distilled water by maceration methods. The antibacterial activity tests were assessed using agar well diffusion and minimum inhibition concentration methods. Results: C. macrostachyus bark rout ethanol extracts have shown an antibacterial effect against E. coli and S. aureus with maximum mean zone of inhibition of 15±0.58 mm and 17.33±0.89 mm respectively. In case of S. incanum it is also the ethanol extract that showed highest mean zone of inhibition of 22.67±0.89 mm and 22.33±0.89 mm against E. coli and S. aureus respectively. The positive control Gentamicin (10µ gm/disc) inhibited the growth of E. coli and S. aureus with recorded mean zone of inhibition about 23 ±0.58 mm and 24.67± 0.33 mm respectively. Therefore the ethanol extract of Croton macrostachyus and S. incanum showed minimum inhibitor concentration against S. aureus and E. coli than other solvents. Conclusion: Bioactive compounds of medicinal plant extracts have been used to overcome the challenges of antimicrobial resistance. The current experimental study showed that, the bark root extract of Solanum incanum and Croton macrostachyus have high potent of antibacterial activities against E. coli and S. aureus . This study therefore substantiates the use of Solanum incanum and Croton macrostachyus as an antimicrobial medicinal plant.
Impact of Integrated Genetic Information on Diagnosis and Prognostication for Myeloproliferative Neoplasms in the Next-Generation Sequencing Era
Authors: Lee Jong-Mi , Lee Howon , Eom Ki-Seong , Lee Sung-Eun , Kim Myungshin , Kim Yonggoo 
Published: October 2020

Abstract

Background: Since next-generation sequencing has been widely used in clinical laboratory, diagnosis and risk stratification of hematologic malignancies are greatly dependent on genetic aberrations.Methods: In this study, we analyzed the genomic landscape of 200 patients with myeloproliferative neoplasms (MPNs) using targeted panel sequencing covering including 86 genes. Conventional bone marrow karyotyping was also performed to determine chromosomal aberration. We analyzed relationships between genetic profiles and clinical outcomes including acute transformation, bone marrow fibrosis and death.Results: Mutations in JAK2, CALR, and MPL were detected in 76.4% of MPNs. The proportion of patients with clonal genetic markers increased up to 86.4% when all detectable genetic aberrations were included. Significant co-occurring genetic aberrations potentially associated with phenotype and/or disease progression, including those in JAK2/SF3B1 (P = 0.017) and TP53/del(13q), del(5q), -7/del(7q) and complex karyotypes (P = 0.038, P < 0.001, P < 0.001 and P < 0.001, respectively) were detected. We also identified genetic aberrations associated with patient outcomes: TP53 and -7/del(7q) for inferior survival (HR, 95% CI: 64.2, 3.8-1096.5, P = 0.0041, HR, 95% CI: 14.0, 1.5-132.7, P = 0.0219), RUNX1, TP53 and IDH1/2 for leukemic transformation (HR, 95% CI: 68.1, 3.6-1300.4, P = 0.005, HR, 95% CI: 16.3, 1.2-222.7, P = 0.0364, HR, 95% CI: 32.5, 2.8-371.1, P = 0.0051), SF3B1, IDH1/2, ASXL1 and del(20q) for fibrotic progression (HR, 95% CI: 31.5, 4.1-243.3, P = 0.0009, HR, 95% CI: 21.2, 3.4-132.2, P = 0.0011, HR, 95% CI: 4.3, 1.1-16.4, P = 0.0358, HR, 95% CI: 44.5, 6.1-323.0, P = 0.0002). We compared risk stratification systems and found that mutation-enhanced prognostic scoring systems could identify lower risk polycythemia vera and essential thrombocythemia and higher risk primary myelofibrosis (P < 0.001, P < 0.001 and P < 0.001, respectively). Furthermore, the new risk stratification systems showed better predictive capacity of patient outcome. Conclusions: These results collectively indicate that integrated genetic information can enhance diagnosis and prognostication in patients with myeloproliferative neoplasms.