bluuebunny/crossref_metadata_2025_split huggingface dataset:
Structural and Functional Relations between the Connective Tissue and Epithelium of Enamel Organ and their Role during Enamel Maturation
Authors: Mahdee Anas F , Ali Ahmed H , Gillespie James I 
Published: February 2021

Abstract
The morphological and possible functional interactions between the connective tissue and epithelial elements of enamel organ were examined during the maturation phase, using immunohistochemical techniques. Decalcified mandibular sections (10µm) including incisors from Wistar rats ages 10–12 weeks were used. Sections were incubated with one or two primary antibodies targeting cell cytoskeleton (vimentin, α-actin, α-tubulin), dendritic marker (OX6), gap junctions (cx-43), enzymes (nitric-oxide synthase (nos1) and cyclooxygenase (cox1)), and ion transporters (Na+/H+ exchanger (NHE1) and Na+/Ca2+ exchanger (NCX)) for 24h, before incubation with the appropriate conjugated fluorescent secondary antibodies. Sections were then examined by fluorescence microscopy. Haematoxylin-eosin slides were also employed. Cellular heterogeneity and morphological modulations were identified within the epithelial and connective tissue elements of the enamel organ suggesting complex cellular interactions and indicating the use of enamel organ term to represent all these regions. Also, some ion transportation activity, and nos1 and cox1 signalling pathways have been identified, indicating intercellular communication between these regions. A hypothesis was suggested, to explain the morphological modulation of ameloblasts and papillary cells during enamel maturation aimed to increase the transporting membrane surface area to accomplish faster and bulker ion transportation to achieve controlled pH and to direct Ca2+ towards enamel. Connective tissue covering epithelial cells of the enamel organ showed morphological and physiological interaction during enamel maturation, suggesting new functional concepts.
Impact of Maternal and Child Health Interventions On Under-Five Mortality in Ghana: A Quasi-Experimental Study Design With Coarsened Exact Matching
Authors: Kolekang Augusta , Sarfo Bismark , Danso-Appiah Anthony , Dwomoh Duah , Akweongo Patricia 
Published: February 2021

Abstract
Background Despite a 53% decline in under-five mortality (U5M) worldwide during the period of the Millennium Development Goals (MDGs), U5M remains a challenge. Under-five mortality decline in Ghana is slow and not parallel with the level of coverage of child health interventions. This study sought to assess the effectiveness of these interventions on U5M in Ghana. Methods A quasi-experimental study was conducted using secondary data of the 2008 and 2014 Ghana Demographic and Health Surveys. Coarsened Exact Matching and logistic regression were done. Results There were 6,098 children under-five years old and 93 (1.46%) died. Among the children who died, 47 (47%) were less than one month old. Coverage of antenatal care visits was the highest coverage level with 5,045 (84.0%) while water connection in the home was the lowest coverage level of 469 (8.1%). Less than 1.5% (58) of children received all eight (8) interventions and none of those who received all the eight interventions died. After controlling for potential confounders, clean postnatal care for babies within 2 days after delivery caused a 64% reduction in the average odds of death (aOR=0.36, 95%CI:0.15, 0.90) while early initiation of breastfeeding caused a 61% reduction in the average odds of death (aOR=0.39, 95% CI: 0.22-0.71). In the midst of the various interventions, some socio-demographic factors placed children at higher odds of death. Children with less than two years preceding birth interval, being a neonate, multiple birth, or from a polygamous home put children at a higher odds of under-five mortality.Conclusion Two out of eight interventions caused reduction in the average odds of death. A further decline in under-five mortality in Ghana will require increase in the coverage levels of these two high impact interventions. Additionally, attention should be paid to children at higher risk of dying including neonates, multiple births, children from polygamous homes and those with preceding birth interval less than two years.
Confirming Putative Variants at ≤5% Allele Frequency Using Allele Enrichment and Sanger Sequencing
Authors: Yan Yan Helen , Chen Sherry X. , Cheng Lauren Y. , Rodriguez Alyssa Y. , Tang Rui , Cabrera Karina , Zhang David Yu 
Published: February 2021

Abstract
Whole exome sequencing (WES) is used to identify mutations in a patient’s tumor DNA that are predictive of tumor behavior, including the likelihood of response or resistance to cancer therapy. WES has a mutation limit of detection (LoD) at variant allele frequencies (VAF) of 5%. Putative mutations called at ≤5% VAF are frequently due to sequencing errors, therefore reporting these subclonal mutations incurs risk of significant false positives. Here we performed ~1000x WES on fresh-frozen and formalin-fixed paraffin-embedded (FFPE) tissue biopsy samples from a non-small cell lung cancer patient, and identified 226 putative mutations at between 0.5% and 5% VAF. Each variant was then tested using NuProbe NGSureTM, to confirm the original WES calls. NGSure utilizes Blocker Displacement Amplification to first enrich the allelic fraction of the mutation and then uses Sanger sequencing to determine mutation identity. Results showed that 52% of the 226 (117) putative variants were disconfirmed, among which 2% (5) putative variants were found to be misidentified in WES. In the 66 cancer-related variants, the disconfirmed rate was 82% (54/66). This data demonstrates Blocker Displacement Amplification allelic enrichment coupled with Sanger sequencing can be used to confirm putative mutations ≤5% VAF. By implementing this method, next-generation sequencing can reliably report low-level variants at a high sensitivity, without the cost of high sequencing depth.
Community Health Workers’ Augment The Cascade of TB Detection To Care In Urban Slums of Two Metro Cities In India
Authors: Potty Rajaram Subramanian , K Karthikeyan , A Rajesham , Reddy Ramesh Chandra , Singarajipura Anil , Siddappa Poornima Bathi , BS Prarthana , T Raghavendra , HL Mohan , Swamickan Reuben , Shah Amar , Panibatla Vikas , Dasari Ramesh , Washington Reynold 
Published: February 2021

Abstract
Background:Tuberculosis Health Action Learning Initiative (THALI) funded by USAID is a person-centered initiative, supporting vulnerable urban populations to gain access to TB services. THALI trained and placed 112 Community health workers (CHWs) to detect and support individuals with TB symptoms or disease within urban slums in two cities, Hyderabad and Bengaluru, covering a population of about 3 Million. Method: CHWs visited the slums once in a fortnight. They conducted TB awareness activities. They referred individuals with TB symptoms for sputum testing to nearest public sector labs. They visited those testing TB positive, once a fortnight in the intensive phase, and once a month thereafter. They supported TB patients and families with counselling, contact screening and social scheme linkages. They complemented the shortfall in urban TB government field staff numbers and their capacity to engage with TB patients. Data on CHWs’ patient referral for TB diagnosis and treatment support activities was entered into a data-base and analyzed to examine CHWs’ role in the cascade of TB care. We compared achievements of six monthly referral cohorts from September 2016 to February 2019.Results:Overall, 31617 (approximately 1%) of slum population were identified as TB symptomatic and referred for diagnosis. Among the referred persons, 23976 (76%) underwent testing of which 3841 (16%) were TB positive. Overall, 3812 (99%) were initiated on treatment and 2760(72%) agreed for regular followed up by CHWs. Fifty-seven percent of 2952 referred were tested in the first cohort, against 86% of 8315 in the last cohort. The annualized case detection rate through CHW referrals in Bengaluru increased from 5.5 to 52.0 per 100000 during the period, while in Hyderabad it was 35.4 initially and increased up to 118.9 per 100000 persons. The treatment success rate was 87.1% among 193 in the first cohort versus 91.3% among 677 in the last cohort. Conclusions CHWs in urban slums augment TB detection to care cascade. Their performance and TB treatment outcomes improve over time. It would be important to examine the cost per TB case detected and successfully treated.
The use of Fretsaw as a Substitute Osteotomy Tool while Oscillating Saw Malfunction in Hip Arthroplasty
Authors: Zhai Zanjing , Chang Yongyun , Yu Degang , Li Huiwu , Mao Yuanqing , Zeng Yiming , Yan Mengning 
Published: February 2021

Abstract
Background: The occurrence of oscillating saw malfunction, power shortage, or contamination occurs frequently when implementing femoral neck osteotomy during total hip arthroplasty (THA). This study aimed to introduce the fretsaw as a novel substitute osteotomy tool with various advantages.Methods: Twenty patients (20 hips) who underwent primary THA were included. Ten patients underwent femoral neck osteotomy using a fretsaw, while the other 10 patients underwent the procedure using an oscillating saw. Intraoperative evaluation and radiographic data were obtained for all patients during and after surgery.Results: The mean osteotomy time was 20.60 ± 1.08s (range 16–27) and 22.10 ± 1.49s (range 16–31) in the oscillating saw and fretsaw groups, respectively. The mean osteotomy height was 1.21 ± 0.16 (range 1.01–1.43) cm and 1.14 ± 0.08 (range 1.02–1.28) cm in the oscillating saw and fretsaw groups, respectively. The use of fretsaw did not result in bone notch or blood splashes.Conclusion: The fretsaw can be a substitute femoral neck osteotomy tool with various advantages in THA while oscillating saw malfunction.
Changes in UPR-PERK pathway and muscle hypertrophy following resistance training and creatine supplementation in rats
Authors: Nouri Hersh , Sheikholeslami-Vatani Dariush , Moloudi Mohammad Raman 
Published: February 2021

Abstract
The unfolded protein response (UPR) plays a pivotal role in some exercise training induced-physiological adaptation. Our aim was to evaluate the changes in the protein kinase R-like endoplasmic reticulum kinase (PERK) arm of the UPR and hypertrophy signaling pathway following 8 weeks of resistance training and creatine (Cr) supplementation in rats. Thirty-two adult male Wistar rats (8 weeks old) were randomly divided into 4 groups of 8: untrained + placebo (UN + P), resistance training + placebo (RT + P), untrained + Cr (UN + Cr) and resistance training + Cr (RT + Cr). Trained animals were submitted to the ladder-climbing exercise training 5 days per week for a total of 8 weeks. Cr supplementation groups received creatine diluted with 1.5 ml of 5% dextrose orally. The flexor hallucis longus (FHL) muscle was extracted 48 hours after the last training session and used for western blotting. After training period, the RT + Cr and RT + P groups presented a significant increase in phosphorylated and phosphorylated /total ratio hypertrophy indices, phosphorylated and phosphorylated/total ratio PERK pathway proteins and other downstream proteins of the PERK cascade compared with their untrained counterparts (P < 0.05). The increase in hypertrophy indices were higher but PERK pathway proteins were lower in the RT-Cr group than in the RT + P group (P < 0.05). There was no significant difference between the untrained groups (P > 0.05). Our study suggests that resistance training in addition to Cr supplementation modifies PERK pathway response and improves skeletal muscle hypertrophy.
Efficacy of Anastomosis Enhancing Suture in Laparoscopic Anterior Resection of Middle-Low Rectal Cancer: A Prospective Cohort Study
Authors: Chen Jin-Shui , Zang Jia , Wei Shu-Xun , Yan Wen-Tao , Zhou Hai-Yang , Ruan Can-Ping , Wang Wei-Jun , Wang Yi , Sun Yan-Ping , Zhang Jian , Hu Zhi-Qian 
Published: February 2021

Abstract
Background：Anastomotic leakage (AL) limits the outcome after laparoscopic anterior resection (LAR) for middle-low rectal cancer. The study investigated the efficacy of laparoscopic anastomosis enhancing suture (LAES), preventive ileostomy and transanal drainage tube placement in reducing anastomotic leakage after LAR for middle-low rectal cancer.Methods：From April 2016 to April 2019, a prospective cohort study was performed on consecutive patients who underwent LAR for middle-low rectal cancer in Changzheng hospital. The patients were divided into group A, B, C and D in which LAES, transanal drainage tube placement, protective ileostomy, and no preventive treatment were applied, respectively. Clinical characteristics, operative variables and postoperative complication were compared between the groups.Results：Among 320 patients, 24 (7.5%) developed AL and incidence rate of AL was 1.3%, 12.5%, 1.3% and 15.0% in the four groups, respectively. Left colic artery preservation and neoadjuvant chemotherapy were found not associated with the incidence of AL. A total of 0, 2, 2 and 5 patients had anastomotic bleeding in the four groups, respectively. No patient underwent reoperation in group A and group C, while 5.0% (4/80) of the patients had reoperation in group B and group D due to grade C AL with severe symptoms.Conclusions：Compared with preventive ileostomy, LAES was effective in preventing AL after LAR for middle-low rectal cancer and relieving the complications of AL. The transanal drainage tube placement did not reduce the risk of AL.The study was retrospectively registered with the Chinese Clinical Trial Registry on 28th June 2016 (code: ChiCTR-IOR-17011777).
Awareness, Knowledge and Prevention Practices Related to Lassa Fever Among Residents of Rural Communities in Southwest Nigeria: Implications for Prevention and Control
Authors: Aromolaran Olukemi 
Published: February 2021

Abstract
Background: Lassa fever (LF) is a haemorrhagic illness caused by Lassa virus. The primary reservoir of the virus is the multimammate rat, Mastomys natalensis. More than 3,000 laboratory-confirmed cases of Lassa fever and over 800 deaths have been recorded in Nigeria. This could be attributed to poor rat control and poor sanitation especially in the rural communities where the rats are often found. Increasing awareness and health education about LF have been advocated for its prevention and control. This study investigated the level of awareness, knowledge and prevention practices related to LF among residents in rural communities within Iwo and Ayedire Local Government Areas, Osun State, southwest Nigeria sequel to an awareness campaign. Methods: Structured questionnaire was administered within rural communities in Iwo and Ayedire and 675 participants responded for the survey by a random sampling technique. Descriptive statistics, Chi-square test of association (p = < 0.05) and logistic regressions were used to determine associations between demographic variables, level of knowledge and prevention practices. Results: The average age range was 25-39 years, 365 (54.07%) were male, 270 (40%) were married, 199 (29.48%) had up to secondary school education and 536 (79.41%) have heard about LF before. Respondents in Iwo town were more aware of LF than respondent from Ayedire. Only 3 (0.44%) had good knowledge of the transmission and symptoms of the disease and 304 (45.04%) do not have effective means of preventing rats into their homes. About 296 (43.85%) will go to a hospital if symptoms occur, while 118 (17.48%) will do self-medication. Forty-four (6.52%) were aware of good prevention practices. Logistic regression analysis showed that respondents aged 25–39 years were significantly more aware of Lassa fever than other age groups. Educated and married respondents showed significant relationship with good prevention practices than those without education and were not married. Conclusions: Although, the awareness of LF among the respondents was high, only very few had good knowledge of the transmission and symptoms of the disease. Therefore, it is important for the people to be well informed about the disease and good prevention practices in order to curtail the spread.
Semi-quantitative Analysis of Adenosine Perfusion Magnetic Resonance Imaging Outperforms Visual Analysis in Identifying Fractional Flow Reserve-Altered Intermediate-grade Coronary Artery Stenosis: A Pilot Study
Authors: Ghekiere Olivier , Dacher Jean-Nicolas , Dewilde Willem , Cools Wilfried , Dendale Paul , Nchimi Alain 
Published: February 2021

Abstract
PurposeTo evaluate the diagnostic accuracy of semi-quantitative adenosine perfusion magnetic resonance imaging(MRI) to determine fractional flow reserve(FFR)≤0.80 intermediate-grade coronary stenoses as compared to visual analysis.Methods Forty-six patients (mean age 61±9 years;33 males) with 49 intermediate-grade stenoses underwent adenosine perfusion MRI and FFR measurement within 4 months between 2010 and 2013. Retrospective interpretation of all prospectively acquired data was performed. MRI was visually assessed by 2 experienced readers twice with one-year interval, the second time with the knowledge of the diseased artery. All myocardial enhancement maximal upslopes were evaluated distal to the coronary stenosis (=RISK) and in remote myocardium supplied by normal arteries (=REMOTE); stress subendocardial relative myocardial perfusion index (RMPI; RISK/REMOTE upslopes) was assessed in predicting FFR≤0.80 stenoses. Deep learning boosting models including all RISK and REMOTE upslopes were fitted to confirm the added value of accounting for perfusion changes in remote myocardium for FFR prediction. Results The average FFR value was 0.84±0.09 and 15/49 (31%) stenoses were FFR≤0.80. Both readers had moderate accuracy (range: 36/49(73%)-38/49(78%)) in predicting FFR≤0.80 stenoses, even with the knowledge of the stenosis location. At a cutoff value of 0.84, stress subendocardial RMPI had higher accuracy (43/49(88%)) than individual visual readings to predict FFR≤0.80 stenoses. The best FFR prediction using the boosting model occurred when accounting for REMOTE myocardial perfusion parameters, leading to diagnostic accuracy of 44/49(90%) for FFR≤0.80. Conclusion Semi-quantitative adenosine perfusion MRI accounting for stress perfusion in remote myocardium predicts FFR≤0.80 intermediate-grade coronary stenoses with a higher accuracy than individual visual analysis.
A Comparative Study of Perioperative and Survival Outcomes of Robot-Assisted Radical Cystectomy in Patients Over 80 and Under 80 Years Old
Authors: Xie Shangxun , Zhao Zihan , Feng Baofu , Zhang Shiwei , Zhang Gutian , Li Xiaogong , Guo Hongqian , Rong Yang 
Published: February 2021

Abstract
Background: Radical cystectomy (RC) is the standard treatment for bladder cancer, but the safety and efficacy of this treatment for elderly people need to be considered. We compare perioperative data and survival outcomes between elderly (≥80 years) and younger (＜80 years) patients undergoing robot-assisted radical cystectomy (RARC).Methods: We reviewed demographic, perioperative clinical and follow-up data of 190 consecutive patients with urothelial carcinoma of bladder who received RARC from M ay 2015 to December 2018 in Nanjing Drum Tower Hospital. The patients were divided into 2 groups by age: ≥80 years and ＜80 years. Perioperative outcomes were compared between 2 groups. Logistic regression method was used to analyze the factors that may affect preoperative complications. Cox regression model was employed to analyze the factors affecting 3-year overall survival (OS), recurrence-free survival (RFS), and cancer-specific survival (CSS).Results: Of the 190 patients, 44 (23.2%) were octogenarians. The elderly patients did not statistically differ from younger patients in most of the demographic, perioperative and pathological information. American Society of Anesthesiologists (ASA) score (p=0.045) and Charlson comorbidity index (CCI) (p=0.035) could predicted high-grade and any grade complications, respectively. Positive lymph node and pT≥3 were main factors affecting OS, RFS and CSS. ASA score (p=0.048) and CCI (p=0.003) could predicted OS and RFS, respectively. Elderly group had worse OS (p=0.007) and CSS (p=0.027) but similar RFS (p=0.147) compared with younger group.Conclusion: The elderly who received RARC had similar risk of perioperative complications and RFS compared with younger patients. RARC could be an alternative treatment for select octogenarians.
Self-managed Abortion as a Medico-legal Intervention in Ghana: a Systematic Review
Authors: Gbagbo Fred Yao , Morhe Renee Aku Sitsofe , Morhe Emmanuel Komla Senanu 
Published: February 2021

Abstract
BackgroundWe examined the potential of improving self-managed abortion as a medico-legal intervention of safely and effectively resolving unwanted pregnancies in Ghana.MethodsWe undertook a systematic literature review on self-managed or self-induced abortion within the context of Ghanaian laws. We searched for studies from Advanced PubMed Central and Google Scholar and repositories of Public Universities in Ghana. With search words of self-managed or self-induced abortion and Ghanaian law, we found 13,100 papers. The search was then narrowed to studies conducted between 2015-2020 of which 22 most related papers were selected with Six (6) from the Advanced Google Scholar search, 18 from PubMed and 1 unpublished postgraduate thesis from a public university library.ResultsDespite a liberal law that supported positive and quite well-decentralized service delivery policy, standards, and protocols development on abortion in Ghana, self-induced abortion remains criminalized. Nonetheless, the longstanding practice persists with no evidence of prosecution of the person(s) found violating the law within the period under review. The use of abortifacients procured from pharmacies and chemists that are not recognized abortion care providers has become the leading method of self-induced. Conclusion Despite criminalizing self-induced abortion, Ghana’s law on abortion is fairly liberal enough to permit the development of comprehensive abortion care policy, standards, and protocols that have a good potential of supporting improved self-managed abortion to reduce maternal morbidity and mortality in the country. Further studies are required for the exploration of ways of filling implementation gaps to harness the potentials of improving self-managed abortions in Ghana.