bluuebunny/crossref_metadata_2025_split huggingface dataset:
What are the Complications Associated with Female Genital Mutilation Among Postnatal Women in Chuko Primary Hospital, Sidama Regional State, Ethiopia?
Authors: Yosef Yirgalem , Borsamo Abebe , Abeje Seblework 
Published: February 2021

Abstract
Objectives: - To assess female genital mutilation associated birth complications among postnatal women in Chuko Primary Hospital, Sidama National Regional state, Ethiopia, 2020Method: An institutional-based cross-sectional study was conducted in Chuko Primary Hospital, Sidama Regional State, Southern Ethiopia from May 1 to June 15, 2020. Two hundred fifty postnatal women were involved in the study. A systematic random sampling technique was used. The data was collected using pretested and structured interviewers administered questionnaire adapted from a validated questionnaire, content validity was checked by experts, and reliability of the scaled tools was tested by Cronbach's alpha test (0.70). Before analysis data was entered and checked using Epi data and exported into Statistical Package for Social Sciences version 25.00. Bivariate analysis was carried out between the dependent and independent to identify candidate variables for multivariable logistic regression. Multivariable logistic regression analysis was made to obtain the odds ratio and the confidence interval of statistical associations between Female Genital Mutilation associational Birth complications.Result: Two hundred fifty postnatal women were included in the study. The prevalence of FGM was 76.8% with 95% CI: [71.6- 81.6]. Episiotomy (AOR= 7.25[95% CI: 2.27, 23.2] and prolonged labour (AOR= 2.16[95% CI: 0.03, 0.82] were significantly associated with Female Genital Mutilation.Conclusion and recommendations: The prevalence of female genital mutilation among postnatal women in Chuko Primary Hospital was high. Family members, health and social care professionals have crucial roles in determining FGM and associated birth complication of women. Therefore, Stakeholders who are working on the improvement of maternal and neonatal health during delivery should try to reduce FGM by intervening at the individual level, family and community level to lessen the problem to some extent. Further researches in more detail to fully understand the problems and the findings will be used as inputs for concerned bodies.
Restoring Trust in Healthcare: Information Impact Case Study in Poland
Authors: Goncharuk Anatoliy , Lewandowski Roman , Cirella Giuseppe 
Published: February 2021

Abstract
Background: This study empirically evaluates the influence of information on trust at the physician level, the medical profession, hospitals, and with the payer. Restoring trust in a medical setting appears to be significantly affected due to the coronavirus pandemic. Trust improves results from medical treatment, raises perception of healthcare performance, and smoothens the overall functionality of healthcare systems.Methods: In order to study trust volatility, participants took part in a three-stage experiment designed via: (1) measured level of trust, (2) randomly dividing participants into two groups—control (i.e., re-examination of level of trust) and experimental (i.e., being exposed to a piece of certain manipulative information), and (3) checking whether observational changes were permanent.Results: Results indicate that in the experimental group the increase of trust was noticed in the payer (27.7%, p < 0.001), hospitals (10.9%, p = 0.011), and physicians (decrease of 9.2%, p = 0.036).Conclusions: The study indicated that in Poland information is likely to influence trust in healthcare while social and interpersonal trust levels may be related to increases of trust in hospitals and in the payer versus decreases in physicians.
Fire-resistant cellulose boards from waste newspaper, boric acid salts and protein binders
Authors: Moreno Paalo , Villamizar Nicole , Perez Jefferson , Bayona Angelica , Roman Jesús , Moreno Nicolas , Cardozo Nilo Sergio Medeiros 
Published: February 2021

Abstract
Housing construction consumes more materials than any other economic activity, with a total of 40.6 Gt/year. Boards are placed between construction materials to serve as non-load-bearing partitions. Studies have been performed to find alternatives to conventional materials using recycled fibers, agro-industrial waste, and protein binders as raw materials. Here, fire-resistant cellulose boards with low density and adequate flexural strength were produced for use as non-load-bearing partitions using waste newspapers, soy protein, boric acid, and borax. A central composite design (CCD) was employed to study the influence of the board component percentage on flame retardancy (UL 94 horizontal burning test), density (ASTM D1037-12) and flexural strength (ISO 178–2010). The cellulose boards were characterized by thermal analysis (ASTM E1131-14) and scanning electron microscopy. Fire-resistant cellulose boards were successfully made with low densities (120–170 kg/m3) and flexural strength (0.06–0.64 MPa). The mechanical performance and fire resistance of cellulose boards suggest their suitability for use as building materials. A useful and sustainable construction material with great potential is produced with the valorization of waste materials.
Architecture And Technical Realization Of Operation Analysis System Based On Multidimensional Data Of Power Plant
Authors: Bai Geliang , Zhang Hao , Liu Xiaojia , Wang Baoping , Cao Lixing 
Published: February 2021

Abstract
Flexible analysis and use of multi-source data from power plants to accurately predict system failures and scan potential risks are of great significance for achieving efficient and accurate system operation analysis and decision-making. The article introduces the overall architecture and function design of a system operation analysis system based on massive data and demonstrates the functions and operation analysis results of each module of the system through application examples. The system integrates system data such as plant load information, equipment layout, (automation) electrical equipment control, signal and measurement systems, and relay protection configuration, and uses improved machine learning algorithms and weak point identification methods to expand the correlation analysis of target data. The function of fault risk level prediction and weak point identification is conducive to the power plant operation and maintenance management department to propose corresponding technologies and management methods for operation, maintenance, and repair work, which improves the scientificity and practicability of the existing analysis system. It has laid the foundation for the realization of informatization, intelligence, and lean operation analysis.
Prevalence and Risk Factors for Subclinical Rheumatic Heart Disease Among Primary School Children in Dar es Salaam, Tanzania: A Community Based Cross-Sectional Study.
Authors: Kazahura Parvina , Mushi Theophylly L. , Pallangyo Pedro , Janabi Mohamed , Kisenge Rodrick , Albaghdadi Mazen , Majani Naizihijwa , Kija Edward 
Published: February 2021

Abstract
Background: Rheumatic heart disease (RHD) is the most common acquired heart disease occurring in children and adolescents. RHD is associated with significant morbidity and mortality particularly in low and middle- income countries (LMICs) where the burden is estimated to be higher compared to high income countries. Subclinical RHD is the presence of valvular lesion diagnosed by echocardiography in a person with no clinical manifestation of RHD. This study aimed at determining the prevalence, types and factors associated with subclinical RHD among primary school children in Dar Es Salaam, Tanzania.Methods: We conducted a cross-sectional, descriptive community-based study which recruited primary school children from February to May 2019. A standardized structured questionnaire was used to collect demographic data and information related to prior history of upper respiratory tract infections (URTIs). Anthropometric measurements were taken and chest auscultation and echocardiographic screening were done to all study participants. World Heart Federation echocardiographic classification was used to define the types and prevalence of subclinical RHD. Results: A total of 949 primary school children were enrolled with females being predominant (57.1%). The prevalence of subclinical RHD was 34 per 1000. All the participants had mitral valve disease only whereby 17 had definite disease and 15 had a borderline disease. The associated factors for subclinical RHD were older age of more than 9 years (OR 10.8, 95% CI 1.4-82.2, P=0.02) having three or more episodes of URTI in previous six months (OR 21, 95% CI 9.6-46, P=0.00) and poor hygiene (OR 3, 95% CI 1.3-6.8, P=0.009) Conclusion: Subclinical RHD as detected by echocardiographic screening is prevalent in primary school children, uniformly affects the mitral valve, and is associated with potentially modifiable risk factors. Children with a history of more than three episodes of URTI in six months may represent a particularly high-risk population that should be targeted for RHD.
Assessing the need for resuscitative endovascular balloon occlusion of the aorta (REBOA) for management of non-compressible hemorrhage at a Canadian urban trauma centre
Authors: Purssell Elizabeth , Patrick Sean , Haegert Joseph , Ivkov Vesna , Taylor John 
Published: February 2021

Abstract
Introduction

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a less invasive alternative to resuscitative thoracotomy (RT) for life threatening, infra-diaphragmatic, non-compressible hemorrhage from trauma. Existing evidence surrounding the efficacy of REBOA is conflicting; nevertheless, expert consensus suggests that REBOA should be considered in select trauma patients. There has been a paucity of studies that evaluate the potential utility of REBOA in the Canadian setting. The study objective was to evaluate the percentage of trauma patients presenting to a Level 1 Canadian trauma centre that would have met criteria for REBOA.
Methods

We conducted a retrospective chart review of patients recorded in the British Columbia Trauma Registry who warranted a trauma team activation (TTA) at our institution. We identified REBOA candidates using pre-defined criteria based on published guidelines. Each TTA case was screened by a reviewer, and then each Potential Candidate was reviewed by a panel of trauma physicians for determination of final candidacy.
Results

Fourteen patients were classified as Likely REBOA Candidates (2.2% of TTAs, median age 46.1 years, 64.3% female). These patients had a median Injury Severity Score of 31.5 (IQR 26.8). The main sources of hemorrhage in these patients were from abdominal injuries (71.4%) and pelvic fractures (42.9%).
Conclusion

The percentage of patients who met criteria for REBOA is similar to that of RTs performed at our Canadian institution. While REBOA would be performed infrequently, it is a less-invasive alternative to RT, which could be a potentially life-saving procedure in a small group of the most severely injured trauma patients.
Abducens nerve palsy with associated retinal involvement secondary to rickettsia typhi infection
Authors: Abderrahim Kaies , Zina Sourour , Khairallah Molka , Amor Hager Ben , Khochtali Sana , Khairallah Moncef 
Published: February 2021

Abstract
Objective: To report a case of abducens nerve palsy with associated retinal involvement due to rickettsia typhi infection Material and methods: A single case report documented with multimodal imagingResults: A 18-year-old woman with a history of high-grade fever was initially diagnosed with typhoid fever and treated with fluoroquinolone. She presented with a 5-day history of diplopia and headaches. Her best-corrected visual acuity was 20/20 in both eyes. Ocular motility examination showed left lateral gaze restriction. Lancaster test confirmed the presence of left abducens palsy. Fundus examination showed optic disc swelling in both eyes associated with superotemporal retinal hemorrhage and a small retinal infiltrate with retinal hemorrhage in the nasal periphery in the left eye. Magnetic resonance imaging (MRI) of the brain and orbits showed no abnormalities. A diagnosis of rickettsial disease was suspected and the serologic test for Richettsia Typhi was positive. The patient was treated with doxycycline (100 mg every 12 h) for 15 days with complete recovery of the left lateral rectus motility and resolution of optic disc swelling, retinal hemorrhages, and retinal infiltrate.Conclusion: Rickettsial disease should be considered in the differential diagnosis of abducens nerve palsy in any patient with unexplained fever from endemic area. Fundus examination may help establish an early diagnosis and to start an appropriate rickettsial treatment.
Adjuvant Hysterectomy Following Primary Chemoradiation for Stage IB2 and IIA2 Cervical Cancer: a Retrospective Comparison of Complications for Open Versus Minimally Invasive Surgery
Authors: Miller Heather , Matsuo Koji M , Roman Lynda D , Yessaian Annie A , Pham Huyen Q , Hom Marianne , Castaneda Antonio , Pham Anthony , Ragab Omar , Muderspach Laila , Ciccone Marcia , Brunette Laurie L 
Published: February 2021

Abstract
Background: Adjuvant hysterectomy following chemoradiation for bulky, early stage cervical cancer has been shown to decrease local relapse rate. The objective of this study is to compare complications and recurrences between minimally invasive and open adjuvant hysterectomy for early stage cervical cancer. Methods: Patients were identified who had undergone adjuvant hysterectomy following chemoradiation for 2009 FIGO stage IB2 and IIA2 cervical cancer from August 2006 – June 2018. Demographic information, treatment course, complications, recurrence data were retrospectively extracted from the medical record. Frequency of complications was compared with Fisher exact test or chi-square test as appropriate and inverse probability of treatment propensity score weighting was used to calculate the disease-free survival.Results: Fifty-four patients met inclusion criteria with a median follow up time of 60.4 months. There were 24 (44%) open versus 30 (56%) minimally invasive hysterectomies performed. The overall grade 2 or worse complication rate was 43%. There were 8 (27%) patients with complications in the minimally invasive group compared to 4 (17%) in the open group (OR 1.82 (95% CI 0.5-7.0)). There were 9 vaginal cuff defects, dehiscences and/or fistulas in the minimally invasive group compared to 3 in the open group (OR 3.0 (95% CI 0.8-11.2)). There was no statistically significant difference between disease free survival and overall survival among the two groups, however there was a trend towards decreased disease-free survival in the minimally invasive group.Conclusions: Among women undergoing adjuvant hysterectomy following chemoradiation for bulky, early stage cervical cancer, there was no difference in complication rates between an open or minimally invasive surgical approach. However, the overall complication rate was high, including a high rate of vaginal cuff defect, dehiscence and/or fistulas. Our findings suggest that an adjuvant hysterectomy should be reserved for patients in which chemoradiation is not anticipated to successfully treat the primary tumor and, if performed, an open approach should be considered.
Sensory Transmission is Bi-directionally Modulated by Astrocytic Ca2+ in Barrel Cortex of Behaving Mice
Authors: Gu Simeng , Wang Wei , Zhang Kuan , Feng Rou , Li Naling , Smith Nathan A. , Dong Wei , Wu Erxi , Peng Weiguo , Hirase Hajime , Huang Jason H. , Wang Fushun 
Published: February 2021

Abstract
The authors have requested that this preprint be removed from Research Square.
Modeling the Impact of COVID-19 on Retina Clinic Performance
Authors: Sethi Karan , Levine Emily S. , Roh Shiyoung , Marx Jeffrey L. , Ramsey David J 
Published: February 2021

Abstract
Background: COVID-19, a highly contagious respiratory virus, presents unique challenges to ophthalmology practice as a high-volume, office-based specialty. In response to the COVID-19 pandemic, many operational changes were adopted in our ophthalmology clinic to enhance patient and provider safety while maintaining necessary clinical operations. The aim of this study was to evaluate how measures adopted during the pandemic period affected retina clinic performance and patient satisfaction, and to model future clinic flow to predict operational performance under conditions of increasing patient and provider volumes. Methods: Timestamps were extracted from the electronic medical records of in-person retina encounters from March 15 to May 15, 2020 and compared with the same period in 2019 to assess patient flow through the clinical encounter. Patient satisfaction was evaluated by Press Ganey patient experience surveys obtained from randomly selected outpatient encounters. A discrete-events simulation was designed to model the clinic with COVID-era restrictions to assess operational performance under conditions of increasing patient and provider volumes.Results: Retina clinic volume declined by 62% during the COVID-19 health emergency. Average check-in-to-technician time declined 79%, total visit length declined by 46%, and time in the provider phase of care declined 53%. Of note, patient satisfaction regarding access nearly doubled during the COVID-period compared with the prior year (p < 0.0001), while satisfaction with overall care and safety remained high during both periods. A model incorporating COVID-related changes demonstrated that wait time before rooming reached levels similar to the pre-COVID era by 30 patients per provider in a 1-provider model and 25 patients-per-provider in a 2-provider model (p < 0.001). Capacity to maintain distancing between patients was exceeded only in the two 2-provider model above 25 patients-per-provider.Conclusions: Clinic throughput was optimized in response to the COVID-19 health emergency. Modeling these clinic changes can help plan for eventual volume increases in the setting of limits imposed in the COVID-era.
Association Between Elevated Cardiac Troponin Level and Clinical Outcomes in Patients with Infective Endocarditis: A Meta-Analysis
Authors: Ling Yunfei , Chai Zheng , Li Tiange , Cao Zhongze , Chen Kerun , Qian Yongjun 
Published: February 2021

Abstract
Background: Infective endocarditis is a serious infection associated with high mortality. Timely intervention is paramount to achieve a favorable prognosis in patients with Infective endocarditis. At present, the correlation between cardiac troponin level and Infective endocarditis prognosis is not well established.Methods: Pubmed, Embase, and Cochrane databases were systematically searched for studies examining the relationship between elevated serum cardiac troponin concentration and prognosis in patients with IE. Literature screening, data extraction and quality appraisal were undertaken by two independent reviewers.Results: A total of 7 relevant studies were included in this study. Patients with elevated troponin were significantly associated with higher incidences of in-hospital mortality [OR=5.87, 95% CI (3.37,10.21)], one-year mortality [OR=3.28, 95% CI (1.01,10.62)], surgery or valve replacement [OR=2.18, 95% CI (1.36,3.51)], symptoms of central nervous system (CNS) [OR=3.28, 95% CI (1.01,10.62)], and cardiac abscesses [OR=3.28, 95% CI (1.01,10.62)]. There was no significant correlation between elevated troponin and incidence of renal failure, embolization, or cerebrovascular events in patients with Infective endocarditis.Conclusion: Elevated cardiac troponin in patients with Infective endocarditis is associated with higher risks of several adverse clinical outcomes. Therefore, these patients would warrant a more aggressive approach and early intervention in clinical management to improve prognosis.
Internal Structural Connections in the Popliteal Muscle Tendon Complex and Their Clinical Significance
Authors: Jiang WenBin , Sun Shi-Zhu , Song Ting-Wei , Li Chan , Tang Wei , Xu Fei , Yu Sheng-Bo , Sui Hong-Jin 
Published: February 2021

Abstract
Background:The popliteal muscle-tendon complex (PMTC) belongs to the deep structure of the posterolateral complex (PLC) of human knee, which plays an important role in the posterolateral stability of the knee joint. At present, the anatomical relationship between the popliteal muscle and its adjacent structures remains controversial, especially the posterior cruciate ligament (PCL) and popliteal muscle. The revealation of anatomical connection between the popliteus muscle and its deep structures could provide an anatomical basis for the reconstruction of the PLC injury.Methods: To observe and analyze the relationship between popliteal muscle and the PCL, posterior meniscofemoral ligament (PMFL), lateral meniscus and articular capsule (AC). The dissection of 7 cases of adult human knee joint fixed with formalin, and 9 cases of sagittal P45 plastinated section of the knee joint were involved in this study. Results: For the popliteal muscle, the anatomical dissection showed that at the posterior edge of the platform of the lateral condyle of the tibia, at the tendon-muscle transition, from medial to lateral, separately sent out: dense connective tissue to connect with the PCL, dense fiber bundles to connect with the PMFL, and dense connective tissue band to connect the lateral meniscus. Meanwhile, the results of the P45 section revealed that the popliteal muscle fascia ran superiorly over the posterior edge of the tibialintercondylar eminence, andturned forward to be integrated into the PCL. Laterally, near the posterior edge of the lateral tibial plateau, the popliteal tendon penetrates through the articular capsule, where two dense fiberous bundleswere given off upwards by the popliteal tendon: one was the ventral fiber bundle,which ran superiorly over the posterior edge of the tibial plateau and then moved forwards to connect with the lateral meniscus; the dorsal fibersbundle ascended directly and participated in the AC.Conclusion: Popliteus muscle was connected with PCL, AC, lateral meniscus, and PMFL via the dense connective tissues near its tendon-muscle transition.
Extending the Straight Leg Raise Test for Improved Clinical Evaluation of Sciatica: Reliability of Hip Internal Rotation and Ankle Dorsiflexion
Authors: Pesonen Janne , Shacklock Michael , Rantanen Pekka , Karttunen Lauri , Mäki Jussi , Kankaanpää Markku , Airaksinen Olavi , Rade Marinko 
Published: February 2021

Abstract
Background: The straight leg raise (SLR) is the most commonly applied physical tests on patients with sciatica, but the sensitivity and specificity ratings for disc hernia and neural compression leave areas for improvement. Hip internal rotation tensions the lumbosacral nerve roots and ankle dorsiflexion tensions the sciatic nerve along its course. We added these movements to the SLR (extended SLR=ESLR) as structural differentiators and tested inter-rater reliability in patients with LBP, with and without sciatica.Methods: Forty subjects were recruited to the study by the study controller (SC), 20 in the sciatic group and in the control group. Two independent examiners (E1&E2) performed the ESLR and did not communicate to the subjects other than needed to determine the outcome of the ESLR. First, SLR was performed traditionally until first responses were evoked. At this hip flexion angle, a location-specific structural differentiation was performed to confirm whether the emerged responses were of neural origin. Cohen’s Kappa score (CK) for interrater reliability was calculated with sensitivity and specificity to detect sciatic patients was calculated.Results: CK of the ESLR result between the independent examiners was 0.85. CK between SC/E1 was 0.90, and 0.95 between SC/E2. Sensitivity and specificity to detect sciatic patients were 0.95 and 0.98, respectively.Conclusions: ESLR with the addition of location-specific structural differentiation is a reliable and repeatable tool in discerning neural symptoms from musculoskeletal in patients with radiating low back pain. We recommend adding these movements to the standard SLR with aim of improving diagnostic efficacy.