bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative outcomes of lung separation with double-lumen tubes and bronchial blockers
Authors: Yu Chia-Hung , Chen Yi-Chen , Chang Ying-Jen , Liang Fu-Wen , Chen Jen-Yin , Ho Chung-Han , Chu Chin-Chen 
Published: July 2019

Abstract
Objectives

The choice between a double-lumen tube (DLT) and a bronchial blocker (BB) for lung isolation remains controversial. The aim of this study was to determine if the features of these lung isolation devices affect postoperative pulmonary outcomes.

Methods

We retrospectively identified claims by patients who underwent surgery under lung isolation in 2000–2012 in the Taiwan National Health Insurance Research Database. After matching for age, sex, and year of surgery, 1898 patients were enrolled in the BB group and 5694 in the DLT group. The risks of readmission in the first postoperative year with pulmonary complications, in-hospital death, and one-year mortality were estimated using conditional logistic regression analysis.

Results

Patients in the BB group had higher risks of readmission with pulmonary infection (adjusted odds ratio [aOR], 1.46; 95% confidence interval [CI], 1.22–1.74), respiratory failure (aOR, 1.38; 95% CI, 1.09–1.76), in-hospital deaths (aOR, 2.03; 95% CI, 1.40–2.94), and one-year mortality rate (aOR, 1.94; 95% CI, 1.60–2.35) in the first postoperative year than did those in the DLT group after adjusting for the type of surgery, difficult airway condition, hospital accreditation level, and underlying comorbidity. Patients in the BB group had longer median (interquartile range) stays in the intensive care unit (1 [0–4] versus 1 [0–3] days, P < 0.001) and in hospital (16 [10–26] versus 13 [8–22] days, respectively, P < 0.001).

Conclusions

Patients undergoing thoracic surgery are more likely to experience postoperative pulmonary complications related to BB than to DLT.
Effects of methanandamide on human periodontal ligament cells
Authors: Zhang Fengqiu , Özdemir Burcu , Nguyen Phuong Quynh , Andrukhov Oleh , Rausch-Fan Xiaohui 
Published: July 2019

Abstract
Background

Endocannabinoid system is involved in the regulation of periodontal tissue homeostasis. Synthetic cannabinoid methanandamide (Meth-AEA) has an improved stability and affinity to cannabinoid receptors compared to its endogenous analogue anandamide. In the present study, we investigated the effect of methanandamide on the production of pro-inflammatory mediators in primary human periodontal ligament cells (hPdLCs).

Methods

hPdLCs were treated with Meth-AEA for 24 h and resulting production of interleukin (IL)-6, IL-8, and monocyte chemotactic protein (MCP)-1 was measured under normal condition as well as under inflammatory conditions mimicked by the presence of Porphyromonas gingivalis lipopolysaccharide (LPS). Additionally, the effect of Meth-AEA on the proliferation/viability of hPdLCs was measured by MTT method.

Results

Methanandamide at concentration of 10 µM significantly inhibited P. gingivalis LPS induced production of IL-6, IL-8, and MCP-1. Basal production of IL-6 and IL-8 was slightly enhanced by 10 µM Meth-AEA. No effect of Meth-AEA on the basal production of MCP-1 was observed. Proliferation/viability of hPdLCs was not affected by Meth-AEA in concentrations up to 10 µM and was significantly inhibited by 30 µM Meth-AEA.

Conclusion

Our study supports the influence of cannabinoid system on the inflammatory processes in periodontal tissue and its potential involvement in the progression of periodontal disease.
Vitamin D recommendations in nutritional guidelines: A systematic quality evaluation using AGREE-2 and analysis of potential predictors
Authors: Navarro David Fraile , López-García-Franco Alberto , Niño-de-Guzmán Ena , Pardo-Hernandez Hector , Aybar Carlos Canelo , Kuindersma Jesse , Saladich Ignasi Gich , Alonso-Coello Pablo 
Published: July 2019

Abstract
Background

Vitamin D has been widely promoted for bone health through supplementation and fortification of the general population. However, there is growing evidence that does not support these strategies. Our aim is to review the quality and recommendations on vitamin D nutritional and clinical practice guidelines and explore predictive factors for their direction and strength.

Methods

We searched Medline, TRIP, G-I-N and guidelines.gov databases for guidelines from January 2010 to January 2018. We performed a descriptive analysis, a quality appraisal using AGREE II scores (Appraisal of Guidelines Research and Evaluation) and a bivariate analysis evaluating the association between direction and strength of recommendations, three AGREE II domains’ scores (Rigor of development, Applicability and Editorial Independence) and pre-specified characteristics.

Results

We included 24 guidelines in our review. Nine recommended supplementations, eight suggested its use, and seven did not recommended it. AGREE II mean scores were 40.1% for “Rigor of development”, 34.5% for “Applicability, and 39.6% for “Editorial independence”. Guidelines with higher scores in these domains were less likely to recommend or suggest vitamin D supplementation (64% recommending against vs 29% suggesting for, and 27% recommending for; p=0.002, 52% vs 26% and 25%; p=0.003, 61% vs 35% and 24%; p=0.001, respectively). Guidelines with potential conflicts of interest were more likely to recommend or suggest vitamin D supplementation (likelihood ratio: p=0.018).

Conclusions

Policy makers, clinicians and patients should be aware that lower quality guidelines, and those reporting conflicts of interest are more likely to promote vitamin D supplementation. Guideline organizations should improve the quality of their recommendations’ development, and the management of conflicts of interest. Users and editors should be aware of these findings when using and appraising guidelines.
Factors associated with malnutrition in children &lt;5 years in Western Kenya. A hospital based unmatched case control study
Authors: Ransom James Anthony , Gudu Edwin , Obonyo Mark , Omballa Victor , Oyugi Elvis , Kiilu Cecilia , Githuku Jane , Gura Zeinab 
Published: July 2019

Abstract
Background

Globally, under-nutrition accounts for >3 million deaths annually among children <5 years, with Kenya having ~35,000 deaths. We sought to identify factors associated with malnutrition in children aged <5 years in Western Kenya.

Methods

We conducted a hospital-based unmatched case-control study carried out between December 2016 and March 2017. Cases were defined as children aged 6-59 months with either z-score for weight-for-height, ≤-2SD or ≥+2SD; weight-for-age, ≤-2SD or ≥+2SD; or height-for-age of ≤-2SD. Controls were children aged 6-59 months with age-appropriate anthropometric measurements. Cases were consecutively recruited while systematic random sampling was used to select three controls. Unconditional logistic regression using backward elimination was used to identify independent associative factors using Epi-Info.

Results

A total 94 cases and 281 controls were recruited. Of the cases, 86% (81/94) were under-nourished. Mother not having attended ante-natal clinic (OR=7.9; 95% CI: 1.5-41.2), deworming (OR=0.8; 95% CI: 0.4-1.2) and pre-lacteal feeding (OR=1.8; 95% CI: 1.1-3.0) were associated with under-nutrition. Delayed developmental milestones (AOR=13.9; 95% CI: 2.8-68.6); low birth weight (AOR=3.3; 95% CI: 1.4-7.6) and paternal lack of formal education (AOR=4.9; 95% CI: 1.3-18.9) were independently associated with under-nutrition. Urban residence (OR=5.4; 95% CI: 0.5-68.8) and male gender (OR=2.7; 95% CI: 0.7-11.8) were associated with over-nutrition with age <12 months (AOR=6.8; 95% CI: 1.6-29.7) and family income >5,000 Kenya shillings (AOR=4.6; 95% CI: 1.2-17.8) being independently associated.

Conclusion

Proper pre-natal care, child feeding practices and deworming programs should be enhanced to reduce pediatric malnutrition.
Measuring Governance: Developing a Novel Metric for Assessing the Translation of Policies into Action in Nepal
Authors: Namirembe Grace , Shrestha Robin , Houser Robert , Ghosh Shibani , Baral Kedar , Davis Dale , Webb Patrick 
Published: July 2019

Abstract
Background

The Nutrition Governance Indicator (NGI) defines a first standardized approach to quantifying the ‘quality of governance’ in relation to national plans of action to accelerate improvements in nutrition. It was created in response to growing demand for evidence-based measures that reveal opportunities and challenges as nutrition-related policies on paper are translated into outcomes on the ground. Past efforts to measure ‘governance’, most notably the WHO’s Nutrition Governance Indicator and Hunger and Nutrition Commitment Index (HANCI) lack granularity below the national level, and failure to capture pinch points relating to necessary cross-sectoral actions.

The NGI addresses these caveats. This paper introduces the approach that underpins the NGI, discusses its methodology and demonstrates its application in the context of Nepal.

Methods

The NGI was developed using principal components analysis techniques. The resulting score was standardized to a more intuitive scale ranging from 0 to 100, and categorized into quintiles. Cronbach’s alpha was used to test for reliability in addition to testing for goodness of fit using confirmatory factor analysis methods. The data used to derive the index were obtained from 520 participants in the Policy and Science for Health, Agriculture and Nutrition (PoSHAN) study, a prospective and nationally representative longitudinal survey conducted across 21 districts and three agro-ecological zones of Nepal.

Results

The NGI passed validity tests with the exception of two fit indices. Two of the six domains passed the reliability test (Understanding nutrition and Collaboration), the Financial resources domain marginally passed at 0.70 criteria of Nunally, while the remaining domains need re-assessment to improve their reliability. The Nepal Health sector showed the most improvement in mean NGI score over a two-year period followed by the Agricultural sector. About half of all health sector representatives were more likely to have a high score compared to other sectors (OR 0.52, 95% CI 0.36 – 0.74).

Conclusion

Using two panels of data collected in Nepal, this paper has shown that policy-to-action translation can be quantified and applied to sub-national institutions. These findings underscore the practical utility of the index and its importance to the nutrition policy realm.
Parenchymal central nervous system involvement in aggressive B-cell lymphoma: retrospective analysis of clinical and MRI features in a Chinese population
Authors: Wu Yuchen , Wang Yaming , Sun Xuefei , Bai Xueyan , Qian Jun , Zhu Hong , Cui Qu , Xing Ruixian , Chen Yuedan , Liu Qing , Guo Jiayuan , Ji Nan , Sun Shengjun , Liu Yuanbo 
Published: July 2019

Abstract
Introduction

Secondary central nervous system lymphoma (SCNSL) was defined as secondary central nervous system (CNS) involvement in patients with systemic lymphoma. Parenchymal involvement of the CNS in aggressive B-cell lymphoma was rare and remains a diagnostic dilemma.

Materials and Methods

In our study, we retrospectively analyzed the clinical and magnetic resonance imaging (MRI) features of 26 parenchymal SCNSL patients. In addition, we compared MRI features between SCNSL and primary CNS lymphoma (PCNSL) patients after 1:1 propensity score matching.

Results

Among SCNSL patients, the median CNS relapse time was 3 months, and multiple lesions were found in 76.9% of the cases. In PCNSL, this percentage was 34.8% (p=0.023). None of the SCNSL patients and 11.5% of the PCNSL patients had solitary infratentorial lesions (p=0.011).

Conclusions

the majority of parenchymal involvement occurred within the first year of systemic lymphoma, in which mostly cases presenting with multiple and supratentorial locations, unlike what was found in PCNSL.
Case Identification of Mental Health and Related Problems in Children and Young People using the New Zealand Integrated Data Infrastructure
Authors: Bowden Nicholas , Gibb Sheree , Thabrew Hiran , Kokaua Jesse , Audas Richard , Merry Sally , Taylor Barry , Hetrick Sarah 
Published: July 2019

Abstract
Background

In a novel endeavour we aim to develop a clinically relevant case identification method for research into the mental health of children and young people in New Zealand using the Integrated Data Infrastructure (IDI). The IDI is a linked individual-level database containing New Zealand government and survey microdata.

Methods

We draw on diagnostic and pharmaceutical information contained within five secondary care service use and medication dispensing datasets to identify cases of mental health and related problems. A systematic classification and refinement of codes, including restrictions by age, was undertaken to assign cases into 13 different mental health problem categories. This process was carried out by a group of seven professionals (a clinical psychologist, one child and adolescent psychiatrist, two child psychiatrists/paediatricians and two research fellows). The case identification algorithm was applied to the New Zealand youth estimated resident population for the 2014/15 fiscal year.

Results

Over 84,000 unique individuals aged 0-24 with at least one specified mental health or related problem were identified using the case identification algorithm for the 2014/15 fiscal year. The most prevalent mental health problem subgroups were emotional problems (31,299 individuals), substance problems with (16,545), and disruptive behaviours (14,091). Overall the pharmaceutical collection was the largest source of case identification data (59,862).

Conclusion

This study demonstrates the value of utilising IDI data for mental health research, taking us beyond relying solely on diagnostic based incidence, while providing directions for future use, including further linkage of data to the IDI.
Public Preferences regarding Data Linkage for Research: A Discrete Choice Experiment comparing Scotland and Sweden
Authors: Tully Mary P , Bernsten Cecilia , Aitken Mhairi , Vass Caroline Mary 
Published: July 2019

Abstract
Objective: There are increasing examples of linking data on healthcare resource use and patient outcomes from different sectors of health and social care systems (linked data). Linked data are generally anonymised, which means in most jurisdictions there are no legal restrictions to their use in research conducted by public or private organisations. Despite the legality, secondary use of anonymised linked data is contentious in some jurisdictions. In contrast, other jurisdictions are known for their use of linked data. The public’s perceptions of the acceptability of using linked data is likely to depend on a number of factors. This study aimed to quantify the preferences of the public to understand the factors that affected views about types of linked data and its use in two jurisdictions.
Method: An online discrete choice experiment (DCE) was designed, comprising five attributes, to elicit the preferences from a representative sample of the public in Sweden and Scotland. The five attributes (number of levels) were: type of researcher using linked- data (four); type of data being linked (four); purpose of the research using linked data (three); use of profit from using linked data (four); who oversees the research using linked data (four). Each DCE contained 6 choice-sets asking respondents to select their preferred option from two scenarios or state neither were acceptable. Background questions included socio-demographics. DCE data were analysed using conditional and heteroskedastic conditional logit models to create forecasts of acceptability.
Results: The study sample comprised members of the public living in Scotland (n=1,004) and Sweden (n=974). All attributes were important in driving respondents’ choices. Swedish and Scottish preferences were mostly homogenous with the exception of ‘who oversees the research using linked data’, which had relatively less impact on the choices observed from Scotland. For a defined ‘typical’ linked data scenario, the probability (on average) of acceptance was 85.7% in Sweden and 82.4% in Scotland.
Conclusion: This study suggests that the public living in Scotland and Sweden are open to using anonymised linked data in certain scenarios for research purposes but some caution is advisable if the anonymised linked data joins health to non-health data.
Usage of Cloud Storage Facilities by Medical students in a low-middle income country, Sri Lanka: A cross sectional study
Authors: Hettige Samankumara , Dasanayaka Eshani , Ediriweera Dileepa Senajith 
Published: July 2019

Abstract
Introduction

Cloud storage facilities (CSF) has become popular among the internet users. There is limited data on CSF usage among university students in low middle-income countries including Sri Lanka. In this study we present the CSF usage among medical students at the Faculty of Medicine, University of Kelaniya.

Methods

We undertook a cross sectional study at the Faculty of Medicine, University of Kelaniya, Sri Lanka. Stratified random sampling was used to recruit students representing all the batches. A self-administrated questionnaire was given.

Results

Of 261 (90.9%) respondents, 181 (69.3%) were females. CSF awareness was 56.5% (95%CI: 50.3% - 62.6%) and CSF usage was 50.8% (95%CI: 44.4 - 57.2%). Awareness was higher in males (P=0.003) and was low in senior students. Google Drive was the commonest CSF followed by Dropbox and OneDrive. There was no association between CSF awareness and pre-university entrance or undergraduate examination performance. Inadequate knowledge, time, accessibility, security and privacy concerns limited CSF usage. 69.8% indicated that they would like to undergo training on CSF as an effective tool for education.

Conclusion

CSF awareness and usage was nearly 50% among the students and Google drive is the most popular CSF. Lack of knowledge, accessibility, concerns on security and privacy limited CSF usage among students. Majority were interested to undergo training on CSF and undergraduate ICT curricula should introduce CSF as effective educational tools.
A novel pathogenic variant of IHH for Brachydactyly type A1
Authors: Yang Qi , Wang Jin , Tian Xiaoxian , Chen Fei , Lan Jing , Zhang Qiang , Fan Xin , Yi Shang , Li Mengting , Shen Yiping 
Published: July 2019

Abstract
Brachydactyly type A1 (BDA-1, MIM 112500) is a genetically heterogeneous autosomal-dominant disorder mainly characterized by shortening or missing of the middle phalanges. Brachydactyly type A1 (BDA-1) is caused by heterozygous pathogenic variants in a specific region of the N-terminal active fragment of Indian Hedgehog (IHH). In this study, we reported a Chinese family with 8 members affected with Brachydactyly type A1. After performing whole-exome sequencing in the proband, we identified a novel heterozygous missense variant c.299A>G (p.D100G) at the mutational hotspot of IHH gene. The variant co-segregated with BDA-1 in the pedigree, showed 100% penetrance for phalange phenotype with variable expressivity. This finding expanded the Brachydactyly type A1-related mutational spectrum of IHH gene.
Infective patterns of cryptococcosis in patients with connective tissue disease:a retrospective study
Authors: Lao Minxi , Gong Yingying , Shen Chuyu , Wang Cuicui , Liang Liuqin , Zhan Zhongping , Chen Dongying 
Published: July 2019

Abstract
Background: Cryptococcal infection is a life-threatening complication in patients with connective tissue disease (CTD). This retrospective study was performed to explore the clinical features and associated factors of cryptococcosis in patients with CTD from southern China.

Methods: Demographic and clinical data were collected between 2007 and 2018. Associated factors were analyzed by logistic regression analysis.

Results: A total of 6809 inpatients with CTD were included. Cryptococcosis was diagnosed in 30 patients (prevalence, 0.4%). Cryptococcosis was predominant in patients with ANCA-associated vasculitis (AAV) (prevalence, 6/530, 1.1%). Lung was commonly involved (18/30, 60.0%), followed by meninges (6/30, 20.0%), blood stream (5/30, 16.7%) and disseminated cryptococcosis (1/30, 3.3%). Infiltrates (10/18, 55.6%) and small nodules (8/18, 44.4%) were the main radiographic manifestation of pulmonary cryptococcosis (PC). The positive rate of serum cryptococcal antigen (CrAg) in patients with PC was 88.2%. Cryptococcus spp. were found in 75% (3/4) patients who underwent lung biopsy. Most of the patients with cryptococcal meninges (CM) had elevated cerebrospinal fluid (CSF) opening pressure (6/7, 85.7%) and decreased CSF glucose level (5/7, 71.4%). Positive blood culture confirmed the diagnosis of cryptococcal sepsis (CS). Three patients died (10.0%), including one with CM and two with PC. Multivariate logistic regression analysis showed that accumulated dose of glucocorticoid (GC) [odds ratio (OR) = 1.42, 95% confidence interval (CI) 1.08-1.87, P = 0.01] was associated with cryptococcosis in patients with CTD.

Conclusions: Cryptococcosis developed in various organs. Typical radiological manifestation accompanied with positive serum CrAg were helpful clues for diagnosis. Lumbar puncture was a critical diagnostic method to distinguish CM. The accumulated dose of GC was associated with cryptococcosis in patients with CTD.
Youth StepCare: A pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice.
Authors: Parker Belinda , Achilles Melinda Rose , Subotic-Kerry Mirjana , O'Dea Bridianne 
Published: July 2019

Abstract
Background:

General Practitioners (GPs) are ideally placed to identify and manage emerging mental illness in young people, however, many report low levels of confidence in doing so. A web-based universal screening service delivered via a mobile tablet, Youth StepCare, was developed to assist GPs in identifying depression and anxiety symptoms in youth patients providing evidence-based treatment recommendations and fortnightly monitoring of symptom progress. The current study assessed the feasibility and acceptability of delivering the Youth StepCare service in Australian general practices among GPs, practice staff, and youth patients.

Methods:

A 12-week uncontrolled trial was undertaken between August 2018 and January 2019 in two general practices in NSW, Australia. The service was offered to all youth patients aged 14-17 years who visited their participating GP during the screening period alongside their parent or guardian. Youth patients reported the presence of depressive and anxiety symptoms using the self-report Patient Health Questionnaire-9 and the Generalised Anxiety Disorder Questionnaire-7. New cases were defined as those who were experiencing symptoms and were not currently visiting their GP, nor had previously sought help for mental health issues. Feasibility and acceptability of the service among GPs, practice staff, and youth patients was assessed using a battery of questionnaires.

Results:

Five GPs and 6 practice staff participated in the trial. A total of 46 youth patients were approached and 28 consented to participate. Of these, 19 completed the screener (67.9%). Nine reported symptoms of anxiety or depression, two of which were new cases (22.2%). GPs and practice staff were satisfied with the service, reporting that there was a need for the service, and that they would use it again. Youth patients also reported the service was easy to understand and didn’t cause distress.

Conclusions:

Although young people account for a small proportion of patients visiting their GP, the Youth StepCare service appears to be a useful tool for identifying youth with undeclared symptoms which can be easily embedded into general practice. Further research would benefit from exploring reasons for lower GP uptake and a larger trial is required to determine the efficacy of the service on symptom reduction.