bluuebunny/crossref_metadata_2025_split huggingface dataset:
Magnitude, pattern and management outcome of intestinal obstruction among non-traumatic acute abdomen surgical admissions in Arba Minch General Hospital, Southern Ethiopia
Authors: Atalay Mulatie , Gebremickael Abinet , Demissie Solomon , Derso Yonas 
Published: June 2021

Abstract
Background
Intestinal obstruction is defined as a blockage or partial blockage of the passage of the intestinal contents. It is a potentially risky surgical emergency associated with high morbidity and mortality. Its pattern differs from country to country and even from place to place within a country. Therefore, this study aimed to find out the magnitude, pattern and management outcome of intestinal obstruction in Arba Minch General Hospital.

Methods
A retrospective cross-sectional study was conducted in Arba Minch General hospital from January 09, 2015, to November 09, 2018. The data collection period was from December 15, 2018, to February 09, 2019. A simple random technique was applied to select 801 study participants. Then, the required data entered into Epi Info version 7.2.1.0 and exported to the statistical package for the social sciences software package version 20 for analysis. The binary logistic regression analysis has been done to determine crude statistical associations between independent variables and dependent variables. Linearity, Multivariate normality and multicollinearity were checked between independent and dependent variables by using scatter plot and Q–Q plot respectively. Variables with a p-value of less than 0.25 in the binary logistic regression analysis were entered into multivariable logistic regression. Statistical significance factors were identified based on a p-value of < 0.05 and with a 95% confidence interval.

Result
This study revealed that the overall magnitude of intestinal obstruction was 40.60% with 95% CI (34.95–45.95). The magnitude of unfavorable management outcomes and deaths during the study period were 22.3% with 95% CI (18.00–27.00) and 7.1% with 95% CI (4.00–10.00) respectively. Persistent tachycardia 10.3 (3.28–32.42), Dehydration 13.7 (3.34–56.56), elevated serum creatinine 10.2 (1.89–54.94), gangrenous small bowel volvulus 2.7 (1.27–5.84), ischemic bowel 3.4 (1.17–9.81) and perforated bowl 7.68 (2.96–19.93) were significantly associated with the management outcome of intestinal obstruction.

Conclusion and recommendation
Intestinal obstruction was the most common among all acute abdomen cases and its management outcome highly associated with dehydration. Adequate early preoperative resuscitation and proper post-operative care with appropriate surgical techniques and wound care with sterile techniques would help to reduce further mortality. This could be achieved by increasing public awareness of health-seeking behavior. Moreover, health facilities capable of handling patients with small bowel obstruction should be available within the reach of the community.
X-linked congenital adrenal hypoplasia: a case presentation
Authors: Ouyang Hong , Chen Bo , Wu Na , Li Ling , Du Runyu , Qian Meichen , Yu Wenshu , He Yujing , Liu Xinyan 
Published: June 2021

Abstract
Background
Most patients with congenital adrenal hypoplasia (AHC) develop symptoms during infantile and juvenile periods, with varying clinical manifestations. AHC is a disease that is easily misdiagnosed as Addison’s disease or congenital adrenal hyperplasia (CAH). There was also a significant time difference between the age at which patients developed symptoms and the age at which they were diagnosed with AHC. Most patients showed early symptoms during infantile and juvenile periods, but were diagnosed with AHC many years later.

Case presentation
We are currently reporting a male patient who developed systemic pigmentation at age 2 and was initially diagnosed with Addison’s disease. At 22 years of age, he experienced a slipped capital femoral epiphysis (SCFE), a disease mostly seen in adolescents aged 8–15 years, an important cause of which is endocrine disorder. Testes evaluated using color Doppler Ultrasonography suggested microcalcifications. Further genetic testing and auxiliary examinations revealed that the patient had hypogonadotropic hypogonadism (HH) and DAX-1 gene disorders, at which time he was diagnosed with AHC complicated by HH. He was given hormone replacement therapy, followed by regular outpatient review to adjust the medication.

Conclusions
The typical early symptoms of AHC are hyperpigmentation and ion disturbance during infantile and juvenile periods, while few patients with AHC develop puberty disorders as early symptoms. AHC is prone to being misdiagnosed as Addison’s disease, and then gradually develops the symptoms of HH in adolescence. The definitive diagnosis of AHC ultimately is based on the patient’s clinical presentation, laboratory results and genetic testing results.
Effectiveness of photon-initiated photoacoustic streaming in root canal models with different diameters or tapers
Authors: Wen Cheng , Kong Yuanyuan , Zhao Jian , Li Yang , Shen Ya , Yang Xuechao , Jiang Qianzhou 
Published: June 2021

AbstractBackgroundThis study aimed to compare the use of photon-initiated photoacoustic streaming (PIPS) and conventional needle irrigation (CNI) in conjunction with different concentrations of sodium hypochlorite (NaOCl) to removeEnterococcus faecalis(E. faecalis) suspended bacteria and biofilms from root canal systems with different diameters or tapers.MethodsArtificial root canal samples (n = 480) were randomly divided into three groups (n = 160/group). The canals were prepared to fit file sizes #10/.02, #25/.02, or #25/.06. The size #10/.02 group was incubated for seven days. The size #25/.02 or #25/.06 group was incubated for 2 days. A stable biological model ofE. faecalisinfection was established. The root canals were washed with distilled water or with 1%, 2%, or 5.25% NaOCl combined with CNI or PIPS. Bacterial suspensions and biofilms were assessed using an ATP assay kit and fluorescence microscopy. Image-Pro Plus was used to analyse the average fluorescence intensity to determine the most suitable root canal irrigation solution.ResultsIn the CNI and PIPS groups, the ATP value of the 5.25% NaOCl subgroup was the lowest, followed by that of the 2% and 1% NaOCl subgroups. The ATP value of the distilled water subgroup was the highest (P < 0.05). When the root canal taper was 0.02, the ATP value of the #10/.02 + PIPS group was significantly lower than that of the #25/.02 + CNI group (P < 0.05). The average fluorescence intensity of the #10/.02 + PIPS group was lower than that of the #25/.02 + CNI group (P < 0.05). When the apical diameter was #25, the ATP value of the 0.02 taper in the PIPS group was lower than that of the 0.06 taper in the CNI group (P < 0.05), and the average fluorescence intensity of the 0.02 taper + PIPS group was lower than that of the 0.06 taper + CNI group (P < 0.05). PIPS combined with 2% and 5.25% NaOCl effectively improved the long-term antibacterial effect after irrigation and re-culture for 6 h.ConclusionsCompared with CNI, PIPS has greater ability to remove bacteria in root canals with a small preparation diameter and a small taper. PIPS with 2% and 5.25% NaOCl exhibited superior antibacterial and bacteriostatic effects.
Modified laparoscopic lateral suspension with a five-arm mesh in pelvic organ prolapse surgery
Authors: Akbaba Eren , Sezgin Burak 
Published: June 2021

Abstract
Background
Laparoscopic lateral suspension (LLS) is a laparoscopic technique used to treat pelvic organ prolapse (POP) in apical and anterior compartment defect with the use of a synthetic T-shaped mesh graft. The posterior compartment is repaired using a second mesh or a procedure along with LLS, such as posterior colporrhaphy. The aim of this study was to evaluate the clinical results of LLS for POP using a five-arm mesh instead of a T-shaped mesh graft to repair the defect of the posterior compartment in addition to the apical and anterior compartments.

Methods
Data from 37 patients with a diagnosis of advanced-stage (≥ 3) POP undergoing LLS with the use of a five-arm mesh were retrospectively analysed. Pre-operative and post-operative examinations and, surgical outcomes were determined. The results of measurements and examinations, reoperation rates, erosion rates, lower urinary tract symptoms, and complications were analysed. The Prolapse Quality of Life Questionnaire (P-QOL) was also used.

Results
The median post-operative follow-up was 20 (13–34) months. There was a significant improvement in POP-Q scores in all treated compartments, with overall objective cure rates of 94.5% for the apical compartment, 86.4% for the anterior compartment, and 91.8% for the posterior compartment. The median operative time was 96 (76–112) minutes. The median length of hospitalization was 2 (1–3) days. A significant improvement in vaginal bulge, urinary urgency, incomplete voiding, urinary frequency, and constipation was observed after surgery. The sexuality among patients increased from 13 (35.1%) preoperatively to 22 (59.4%) post-operatively. De novo stress urinary incontinence developed in 7 (18.9%) patients. The P-QOL scores improved significantly after surgery.

Conclusions
In advanced-stage POP patients, the posterior compartment damage can also be repaired in LLS with the use of a single five-arm mesh without the need for an additional procedure, and the recurrence rate can be reduced.
Does therapy always need touch? A cross-sectional study among Switzerland-based occupational therapists and midwives regarding their experience with health care at a distance during the COVID-19 pandemic in spring 2020
Authors: Klamroth-Marganska Verena , Gemperle Michael , Ballmer Thomas , Grylka-Baeschlin Susanne , Pehlke-Milde Jessica , Gantschnig Brigitte E. 
Published: June 2021

Abstract
Background
The COVID-19 pandemic impedes therapy and care activities. Tele-health, i.e., the provision of health care at a distance (HCD), is a promising way to fill the supply gap. However, facilitators and barriers influence the use and experience of HCD for occupational therapists (OTs) and midwives.
We identified use of services and appraisal of experiences of Switzerland-based OTs and midwives regarding the provision of HCD during the lockdown as it pertains to the COVID-19 pandemic in spring 2020. 1. Hypothesis: Profession, age in years, and area of work have a significant and meaningful influence over whether HCD is provided. 2. Hypothesis: Profession, age in years, area of work, possibility of reimbursement by health insurance, and application used have a significant and meaningful influence on the experience of HCD.

Methods
In a cross-sectional survey, 5755 OTs and midwives were contacted to fill out an online questionnaire with 13 questions regarding demographic information, use of HCD, and experiences while providing the service. Eleven potential facilitators and barriers and areas where there was desire for support were identified.

Results
The questionnaire was completed by 1269 health professionals (response rate 22.5%). 73.4% of responding OTs (n = 431) and midwives (n = 501) provided HCD during the COVID-19 pandemic lockdown. Profession and area of work had a significant influence on whether HCD was provided. Age only had a significant influence on the use of videotelephony, SMS, and chat services.
OTs experienced HCD significantly more positively than midwives (log odds = 1.3; p ≤ .01). Video-telephony (log odds = 1.1; p ≤ .01) and use of phone (log odds = 0.8; p = .01) were positive predictors for positive experience, while use of SMS (log odds = − 0.33; p = .02) was a negative predictor.
Among OTs, 67.5% experienced HCD as positive or mostly positive, while 27.0% experienced it as negative or mostly negative. Among midwives, 39.5% experienced it as positive or mostly positive, while 57.5% experienced it as negative or mostly negative. Most respondents desired support concerning reimbursement by health insurance (70.8%), followed by law and data protection (60.4%).

Conclusions
HCD during the early COVID-19 pandemic was generally perceived as positive by OTs and midwives. There is need for training opportunities in connection with HCD during the COVID-19 pandemic.
Epidemiology, haematology and molecular characterization of haemoprotozoon and rickettsial organisms causing infections in cattle of Jammu region, North India
Authors: Kaur Rabjot , Yadav Anish , Rafiqi Shafiya I. , Godara Rajesh , Sudan Vikrant , Chakraborty D. , Katoch Rajesh 
Published: June 2021

Abstract
Background
The present study was aimed at establishing the prevalence, epidemiology and molecular characterization of major haemoprotozoons (Babesia and Theileria) and rickettsia (Anaplasma) of cattle in Jammu region (North India) using microscopy and Polymerase Chain Reaction (PCR). Hematology, microscopy and PCR based prevalence studies were undertaken with 278 whole blood samples from cattle. Molecular prevalence studies were followed by genetic characterization of the isolates of Babesia, Anaplasma and Theileria spp. based on 18S rRNA, 16S rRNA and Tams1 gene, respectively. The data related to metrology and epidemiological variables like temperature, rainfall, season, age and type of livestock rearing was analyzed and correlated with occurrence of disease by statistical methods.

Results
The prevalence based on microscopy was 12.9% (36/278) whereas PCR recorded 30.22% (84/278) animals positive for haemoparasitic infections. All the samples found positive by microscopy were also recorded positive by PCR. Thus the study revealed prevalence of Babesia bigemina, Anaplasma marginale and Theileria annulata to be 9.7, 16.5 and 0.7% respectively. The metrological and epidemiological variables made inroads for the propagation of vector ticks and occurrence of infection. Haematological alterations predominantly related to decrease in haemoglobin, red blood cell count and packed cell volume were evident in diseased animals and collaterally affected the productivity. Further the genetic characterization of Babesia bigemina. (MN566925.1, MN567603, MN566924.1), Anaplasma marginale. (MH733242.1, MN567602.1) and Theileria annulata (MT113479) provided a representative data of the isolates circulating in the region and their proximity with available sequences across the world.

Conclusions
Despite holding much significance to the animal sector, comprehensive disease mapping has yet not been undertaken in several parts of India. The present study provides a blue print of disease mapping, epidemiological correlations and genomic diversity of Babesia bigemina, Anaplasma marginale and Theileria annulata circulating in the region.
Functional interplay between long non-coding RNAs and the Wnt signaling cascade in osteosarcoma
Authors: He Jieyu , Ling Lin , Liu Zhongyue , Ren Xiaolei , Wan Lu , Tu Chao , Li Zhihong 
Published: June 2021

AbstractOsteosarcoma is a common and highly malignant bone tumor among children, adolescents and young adults. However, the underlying molecular mechanisms remain largely unexplored. LncRNAs are transcripts with no or limited protein-coding capacity in human genomes, and have been demonstrated to play crucial functions in initiation, progression, therapeutic resistance, recurrence and metastasis of tumor. Considerable studies revealed a dysregulated lncRNA expression pattern in osteosarcoma, which may act as oncogenes or suppressors to regulate osteosarcoma progression. Wnt signaling pathway is an important cascade in tumorigenesis by modulation of pleiotropic biological functions including cell proliferation, apoptosis, differentiation, stemness, genetic stability and chemoresistance. Hyperactivation or deficiency of key effectors in Wnt cascade is a common event in many osteosarcoma patients. Recently, increasing evidences have suggested that lncRNAs could interplay with component of Wnt pathway, and thereby contribute to osteosarcoma onset, progression and dissemination. In this review, we briefly summarize Wnt signaling-related lncRNAs in osteosarcoma progression, aiming to gain insights into their underlying crosstalk as well as clinical application in osteosarcoma therapeutic modalities.
Biomedical signals and machine learning in amyotrophic lateral sclerosis: a systematic review
Authors: Fernandes Felipe , Barbalho Ingridy , Barros Daniele , Valentim Ricardo , Teixeira César , Henriques Jorge , Gil Paulo , Dourado Júnior Mário 
Published: June 2021

AbstractIntroductionThe use of machine learning (ML) techniques in healthcare encompasses an emerging concept that envisages vast contributions to the tackling of rare diseases. In this scenario, amyotrophic lateral sclerosis (ALS) involves complexities that are yet not demystified. In ALS, the biomedical signals present themselves as potential biomarkers that, when used in tandem with smart algorithms, can be useful to applications within the context of the disease.MethodsThis Systematic Literature Review (SLR) consists of searching for and investigating primary studies that use ML techniques and biomedical signals related to ALS. Following the definition and execution of the SLR protocol, 18 articles met the inclusion, exclusion, and quality assessment criteria, and answered the SLR research questions.DiscussionsBased on the results, we identified three classes of ML applications combined with biomedical signals in the context of ALS: diagnosis (72.22%), communication (22.22%), and survival prediction (5.56%).ConclusionsDistinct algorithmic models and biomedical signals have been reported and present promising approaches, regardless of their classes. In summary, this SLR provides an overview of the primary studies analyzed as well as directions for the construction and evolution of technology-based research within the scope of ALS.
The role of personal factors in quality of life among Iranian women with vaginismus: a path analysis
Authors: Velayati Atefeh , Jahanian Sadatmahalleh Shahideh , Ziaei Saeideh , Kazemnejad Anoshirvan 
Published: June 2021

Abstract
Background
The aim of this study was to provide a path model for assessing the direct and/or indirect effects of psychological/behavioral parameters on health-related quality of life among women with vaginismus.

Methods
A cross-sectional study was conducted on a sample of 236 women with vaginismus disorder attending to sex clinics in Tehran, Iran from April 2017 to March 2018. Data were collected using a demographic questionnaire, the marital satisfaction scale, the hospital anxiety and depression scale, the rosenberg self-esteem scale, the body image concern inventory, the short-form health survey (SF-12) and the female sexual quality of life questionnaire. In addition to descriptive statistical data, the fitness of the proposed model was investigated using path analysis.

Results
The results of path analysis demonstrated that the final model had a good fit to the data (Chi-Square/degrees of freedom (Normed Chi2) = 2.12, root mean square error of approximation = 0.069, goodness fit index = 0.99, both comparative fit index = 0.99 and Tucker–Lewis index = 0.96). In this model, anxiety and depression significantly predicted health-related quality of life as measured by the SF-12.

Conclusions
Anxiety and depression are important components in predicting health-related quality of life among those suffering from vaginismus.
Effect of mistletoe extract on tumor response in neoadjuvant chemoradiotherapy for rectal cancer: a cohort study
Authors: Baek Jeong-Heum , Jeon Youngbae , Han Kyoung-Won , Jung Dong Hae , Kim Kyung-Ok 
Published: June 2021

Abstract
Background
Mistletoe extract, used as a complementary chemotherapeutic agent for cancer patients, has anticancer effects against various malignancies. The aim of the present study was to evaluate the effect of mistletoe extract (Abnoba Viscum Q®) on tumor responses to neoadjuvant chemoradiotherapy (NCRT) for locally advanced rectal cancer.

Methods
This study included patients with rectal cancer who underwent NCRT between January 2018 and July 2020. In the mistletoe group (MG), the patients were administered Abnoba Viscum Q® subcutaneously during chemoradiotherapy—maintained just before surgery. Patient demographics, clinical outcomes, histopathological outcomes, and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling (TUNEL) assay results were compared between the MG and non-mistletoe group (NMG). Two rectal cancer cell lines (SNU-503 and SNU-503R80Gy) were treated with Abnoba Viscum Q® to assess its mechanistic effects in vivo.

Results
Overall, the study included 52 patients (MG: n = 15; NMG: n = 37). Baseline demographics between the two groups were similar, except carbohydrate antigen 19-9 levels and tumor location from the anal verge. There was no difference in the clinical stage between the two groups. A better tumor response in the MG, relative to the NMG, was observed with respect to tumor regression grade (TRG), T stage, and overall tumor–node–metastasis stage. Tumor response was significantly better in the MG than in the NMG in terms of pathologic complete response rate (53.3% vs. 21.6%, P = 0.044), good TRG response (66.7% vs. 32.4%, P = 0.024), T downstaging (86.7% vs. 43.2%, P = 0.004), and overall downstaging (86.7% vs. 56.8%, P = 0.040). The toxicities during NCRT were minimal in both groups. More apoptotic cells were noted in MG samples than in the NMG samples on TUNEL staining. Cleaved caspase-3 level following treatment with Abnoba Viscum Q® was higher in SNU-503R80Gy cells than in SNU-503 cells.

Conclusion
Patients treated with chemoradiation combined with mistletoe extract showed better outcomes than patients not treated with mistletoe extract in terms of tumor responses. This diversity in treatment may improve the efficacy of NCRT, leading to better oncologic outcomes. Prospective and randomized studies with long-term follow-up are warranted to confirm and extend these results.