bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors determining recurrence in transient global amnesia
Authors: Tynas Rebecca , Panegyres Peter K 
Published: September 2019

Abstract
Aetiology of transient global amnesia (TGA) remains uncertain, though many have been proposed, including ischaemic, migrainous or epileptic pathologies. We attempted to determine risk factors for TGA, as well as prognostic factors that may cause recurrence. We evaluated clinical history, family history and magnetic resonance diffusion-weighted imaging (DWI) studies of 93 prospective patients with TGA. Patients were followed up regarding recurrence and prognostic factors. Fifteen of 93 (16%) patients experienced a recurrence of TGA. Among precipitating events, physical activities inducing Valsalva-like manoeuvres were most common, followed by emotional stress. Eighty-four patients had possible comorbidities or risk factor for TGA, though no single risk factor was ubiquitous. Risk factors associated with recurrence were head injury (isolated vs. recurrent, 16,7% vs. 53.5%, p < 0.01), depression (isolated vs. recurrent, 15.4% vs 46.7%, p = 0.01) and family history of dementia (isolated vs. recurrent, 20.5% vs 46.7%, p = 0.03). Of 15 patients with confirmed recurrent TGA, two developed dementia and four subjective memory impairment. DWI lesions were observed in 24 patients and located anywhere within the hippocampus. DWI lesions were not significantly associated with outcomes (recurrence, subjective memory impairment, dementia). Findings suggest TGA is a heterogeneous syndrome. Among those with recurrence, depression, previous head injury and family history of dementia may be predictive factors. Encouraging primary prevention of head injury, managing depression and assisting in development of adequate coping mechanisms may decrease incidence. Education of healthcare works will also increase diagnostic rates, allowing for improved education and comfort for patients and families.
Gray matter abnormalities in pediatric focal and generalized epilepsy: A voxel-based morphometry study with MRI at 3.0 T
Authors: zhang huanrui , Liu Hongsheng , Chen Wenxiong , Liu Guangjian , Zhou Baosen , Liang Huiying 
Published: September 2019

Abstract
Background : Our aims were to explore gray matter volume (GMV) abnormalities in focal and generalized epilepsy children compared to healthy group using a voxel-based morphometry (VBM) methodology, and to determine whether the regions of any observed structural changes are correlated with clinical characteristics.
Methods: Thirty-two epilepsy children ( 18 with focal epilepsy, 14 with generalized epilepsy) and 18 control subjects were recruited. All participants were imaged structural MRI scans with a 3.0 T MR system. VBM analysis using statistical parametric mapping 8 (SPM8) was first performed to detect gray matter reduction in focal and generalized epilepsy children compared to controls. Then we analyzed the correlations between GMV changes and clinical features of epilepsy patients.
Results: In the patient-control group comparison of VBM, the left hippocampus, left thalamus, left paraHippocampal and bilateral putamen exhibited a significantly GMV decreased. In stratified analysis, the focal epilepsy children showed GMV reductions in left thalamus, left hippocampus and bilateral putamen relative to controls; the GMV exhibited extensive reductions in left parahippocampal, left putamen, and right supplementary motor area in generalized epilepsy children compared to controls. No significant difference was found in regions of GMV abnormalities correlated with disease durationand age of onset in both the focal and generalized epilepsy groups.
Conclusions: By performing VBM to detect GMV changes in children, our study demonstrates the GMV reductions exist in different regions in focal and generalized epilepsy patients. Our study further provides structural neuroimaging evidence on the pathophysiology of focal and generalized epilepsy children.
Transcriptomic analysis of the testicular fusion in Spodoptera litura
Authors: Liu Lin , Chen Yaqing , Ou Jun , Liu Yucheng , Wu Qiong , Wen Liang , Zheng Sichun , Li Sheng , Feng Qili 
Published: September 2019

Abstract
Background Lepidoptera is one group of the largest plant-feeding insects and Spodoptera litura (Lepidoptera: Noctuidae) is one of the most serious agricultural pests in Asia countries. An interesting and unique phenomenon for gonad development of Lepidoptera is the testicular fusion. Two separated testes fused into a single one during the larva-to-pupa metamorphosis, which is believed to contribute to sperm production and the prevalence in field. To study the molecular mechanism of the testicular fusion, RNA sequencing (RNA-seq) experiments of the testes from 4-day-old sixth instar larvae (L6D4) (before fusion), 6-day-old sixth instar larvae (L6D6, prepupae) (on fusing) and 4-day-old pupae (P4D) (after fusion) of S. litura were performed.Results RNA-seq data of the testes showed that totally 12,339 transcripts were expressed at L6D4, L6D6 and P4D stages. A large number of differentially expressed genes (DEGs) were up-regulated from L6D4 to L6D6, and then more genes were down-regulated from L6D6 to P4D. The DEGs mainly belongs to the genes related to the 20E signal transduction pathway, transcription factors, chitin metabolism related enzymes, the families of cytoskeleton proteins, extracellular matrix (ECM) components, ECM-related protein, its receptor integrins and ECM-remodeling enzymes. The expression levels of these genes that were up-regulated significantly during the testicular fusion were verified by qRT-PCR. The matrix metalloproteinases (MMPs) were found to be the main enzymes related to the ECM degradation and to contribute to the testicular fusion. The testis was not able to fuse if MMPs inhibitor GM6001 was injected into the 5th abdomen region.Conclusions The transcriptome and DEGs analysis of the testes at L6D4, L6D6, P4D stages provided genes expression information related to the testicular fusion in S. litura . These results indicated that cytoskeleton proteins, ECM-integrin interaction genes and ECM-related proteins was involved in cell migration, adhesion and fusion during the testicular fusion. The ECM degradation enzymes MMPs probably play a critical role in the fusion of testis.
Perceptions and practices of general practitioners on providing oral health care to people with diabetes - A qualitative study
Authors: Poudel Prakash , Griffiths Rhonda , Wong Vincent W , Flack Jeff R , Arora Amit , Khoo Chee L , George Ajesh 
Published: September 2019

Abstract
Background

Poorly controlled diabetes leads to multiple complications including oral health problems. General practitioners (GPs) are at the forefront of management of chronic diseases in primary health care. Diabetes guidelines encourage a proactive role for GPs in oral health complications management in people with diabetes, yet little is known about this area of care. This study aimed to explore current practices, perceptions and barriers of GPs towards oral health care for people with diabetes.

Methods

We employed a qualitative research method utilising telephone interviews. Purposive and snowball sampling were used to recruit 12 GPs from the Greater Sydney region. A thematic analysis involving an inductive approach was used to identify and analyse contextual patterns and themes.

Results

A majority of participants were males (n=10), working in group practices (n=11) with a mean±SD age of 55±11.4 years and 25±13.6 years work experience. Three major themes emerged: oral health care practices in general practice settings; barriers and enablers to oral health care; and diabetes care provider’s role in promoting oral health.

Most GPs acknowledged the importance of oral health care for people with diabetes, identifying their compromised immune capacity and greater risks of infections as risk factors. GPs reported 20-30% of their patients having oral health problems, however their current oral health care practices relating to education, risk assessment and referrals were reported as very limited.

GPs identified several barriers including time constraints, absence of referral pathways, and limited knowledge and training in promoting oral health care. They also reported patient barriers including oral health care costs and lower oral health awareness. GPs perceived that resources such as education/training, a standardised assessment tool and patient education materials could support them in promoting oral health care. GPs also perceived that other diabetes care providers such as diabetes educators could play an important role in promoting oral health.

Conclusions

Despite current recommendations, GPs' current oral health care practices among people with diabetes are limited. Further strategies including capacity building GPs by developing appropriate oral health training programs and simple risk assessment tools along with accessible referral pathways are needed to address the current barriers.
Analysis of cumulative fluid balance impact on the stability of gastrointestinal tract anastomoses
Authors: Orhalmi Julius , Turek Z. , Čečka F. , Páral J. , Dolejš J. , Kallarackal A.P. , Kaška M. , Sotona O. , Malý Ondřej , Mynář M. , Černý V. 
Published: September 2019

Abstract
Background Anastomotic leakage is a serious post-operative complication after rectal resection. The main objective of this study was to gauge the impact of cumulative fluid balance on microcirculatory changes at anastomotic sites in the wall of the large bowel. Methods The study was performed using 14 female domestic pigs. Rectal resection was performed on all of them. During the operation and post-operative period they received IV crystalloids at constant rates 5,10 and 15ml/h. Large bowel micro-perfusion was observed at several points during the experiment using LDF. Each subject was observed for six hours after surgery.The measured LDF values for each group was statistically analyzed using Levene’s test and Welch’s ANOVA. Results The primary findings of this study found that the group mean values agreed at baseline; i.e., prior to intervention, as well as at the end of the study(p > 0.05). The same result was also confirmed for the second measurement, and the next to last measurement(p > 0.05). Conversely, differences in group mean values were demonstrated at the 2 intermediate time points (p <0.05). Conclusions The original hypothesis of a blood perfusion disorder developing in the large bowel region after administration of large fluid volumes was not confirmed. However, a 10 fold decrease in blood supply to the large bowel was observed after inferior mesenteric artery ligation. Secondarily, LDF was found to have high accuracy in measuring tissue microcirculation and has the potential to be used in clinical practice.
Long-term Tracing of Carbon Nanoparticles for Axillary Lymph Node Dissection in Patients with Fusion Lymph Nodes before Neoadjuvant Chemotherapy
Authors: Li Jian-Yi , Jia Shi , Wang Yi-Tong , Zhang Yang , Kong Lin-Na , Qi Ji , Cao Ya-Nan , Liu Yu-Shi , Zhang Yan , Chen Bo 
Published: September 2019

Abstract
Background: The regression model of positive nodes in breast cancer after neoadjuvant chemotherapy (NAC) remains controversial. This study aimed to investigate this regression model by injecting and tracing carbon nanoparticles (CNs) into the fusion node prior to NAC in patients with breast cancer. Methods: Guided by ultrasound, 0.3 mL of CNs suspension was injected in a fusion node prior to NAC in 110 patients with local advanced breast cancer. Patients underwent breast surgery and total axillary lymph node dissection following 2-6 cycles of NAC. The distribution by intercostobrachial nerves (ICBN) of positive nodes, black-stained nodes and lymphovascular invasion was investigated by response to NAC. Results: When patients were ranked by response to NAC (from sensitive to resistance), the number of positive nodes increased, as did the proportion of lymphovascular invasion, the number of black-stained nodes decreased. A significantly negative relationship was found between the number of positive nodes and the number of black-stained nodes (p < 0.001). The positive nodes in patients with sensitive consequence followed the rule from under the ICBN to above the ICBN. However, there was counter-example (skip metastasis) in the patients with resistance result. Conclusion: The regression model of positive nodes follows the rule from upper to under, inner to outer in the patients with sensitive consequence to NAC. Long-term staining and tracing by CNs might provide an acceptable and feasible technique to investigate the regression model of positive nodes, and would be a potential method for NAC-treated patients by using of ICBN. Trial registration: NCT 03355261. Retrospectively registered on November 28, 2017.
Prevalence and associated factors of Tardive dyskinesia among psychiatric patients on first-generation antipsychotics at Jimma University specialized hospital, psychiatric clinic, Ethiopia: Institution based a cross-sectional study
Authors: Abdeta Tilahun , Tolessa Daniel , Tsega Wondale 
Published: September 2019

Abstract
Background Tardive Dyskinesia is described as a movement disorder that can be caused by the prolonged use of antipsychotics. It is a permanent condition that affects quality of life. However, studies on TD among psychiatric patients in Ethiopia are limited. The objective of this study was to determine the prevalence and associated factors of Tardive dyskinesia among psychiatric patients on first-generation antipsychotics at Jimma University specialized hospital (JUSH) psychiatric clinic, Jimma, South west Ethiopia.Method Hospital based cross-sectional study was conducted using Abnormal Involuntary Movement Scale (AIMS) and Schooler and Kane research criteria to identify cases of first-generation antipsychotic-induced TD among 151 psychiatric outpatients on first-generation antipsychotics at Jimma University Specialized Hospital psychiatric clinic. Simple random sampling method was employed to select subjects from a total of 912 patients on follow-up and logistic regression analysis was employed to identify associated factorsResult In our study the prevalence of first-generation antipsychotic induced TD was 14.6% (95%CI: 10.76%, 18.4%). In the final model multivariate logistic regression analysis revealed that age (AOR 4.5, 95%CI: 9.7, 20.4), current smoking cigarettes (AOR 1.4, 95%CI: 2.6, 7.8) and chlorpromazine equivalent dose (AOR 6.5, 95%CI: 2.6, 26.8) had statistically significant association with first-generation antipsychotic induced TD.Conclusions Considerable number of psychiatric patients were suffered from first-generation antipsychotic induced TD. Age and current smoking cigarettes and chlorpromazine equivalent dose had significant association with first-generation antipsychotic induced TD. Therefore, stakeholders should consider and appropriately address these statistically identified associated factors in order to reduce antipsychotic induced TD.
Etiology analysis of lower gastrointestinal bleeding in children
Authors: liu yun , Chen XiuWen , Wan ShengHua 
Published: September 2019

Abstract
Background: In a clinical setting, the common causes of lower gastrointestinal bleeding are often easy to identify, but some cases require detailed examinations to make a diagnosis. At present, the cause of lower gastrointestinal bleeding is unclear. The aim of this study was to review cases of children hospitalized for lower gastrointestinal bleeding in the past 5 years at our hospital and analyze the etiologies according to age group.Methods: In this study, we statistically analyzed the etiologies of lower gastrointestinal bleeding in children of different ages and sexes from Jiangxi Province, China. From January 2013 to August 2018, 8,036 patients hospitalized for lower gastrointestinal bleeding in Jiangxi Provincial Children’s Hospital were divided into groups to analyze the etiologies.Results: Of these 8,036 patients, 7,827 were clearly diagnosed. Etiologies included intussusception (4,741 cases, 60.6%), infectious diarrhea (2,171 cases, 27.7%), colon polyps (405 cases, 5.2%), Meckel’s diverticulum (292 cases, 3.7%), allergic colitis (113 cases, 1.4%), anal fissures (34 cases, 0.4%), Henoch-Schönlein purpura (27 cases, 0.3%), eosinophilic gastrointestinal disease (27 cases, 0.3%), and inflammatory bowel disease (17 cases, 0.2%). Generally, the condition presents with blood in the stool, bloody diarrhea, or fecal occult blood. Abdominal color Doppler ultrasonography, colonoscopy, computed tomography, 99 m Tc pertechnetate imaging, and other blood tests can aid in the diagnosis.Conclusions: We found that the type of lower gastrointestinal bleeding in children is related to age. Intussusception was the most common cause of intestinal obstruction overall and in infants between 6 and 36 months of age. Treatment of children with lower gastrointestinal bleeding should be based on prevention. Medical staff should actively raise awareness of the condition, identify the severity of the disease in a timely manner, make early diagnoses, provide prompt treatment, and cooperate with providers in multiple disciplines to save patients’ lives. Keywords: lower gastrointestinal bleeding, children, etiology, intussusception
Antimicrobial susceptibility pattern of Salmonella enterica, blood-stream isolates, among febrile children: a prospective study from Nepal
Authors: Khadka Priyatam , Thapaliya Januka , Thapa Shovana 
Published: September 2019

Abstract
Background Still, in developing the children are being treated empirically and irrationally with accessible antibiotic without susceptibility testing and minimal lethal dose calculations, defying the probable MDR (multi-drug resistance) isolates. This study was undertaken in the febrile children to determine the antimicrobial susceptibility pattern of Salmonella enterica against commonly prescribed antibiotics. Method All isolates were identified by biotyping and serotyping standard protocols then tested against antibiotics by modified Kirby disk-diffusion method. Minimum Inhibitory Concentration (MIC) of isolates were determined by agar dilution method and compared with disk diffusion results and on nalidixic-acid sensitive/resistant strains. Result Among 1815 enteric-fever-suspects, 90(4.9%) isolates of Salmonella enterica [serovar: 62(68.8%) Salmonella Typhi and 28 (31.1%) Salmonella Paratyphi A] were recovered. The incidence of infection was higher among male, age group 5 to 9, and patient from the out-patient department (OPD). On disk-diffusion test most isolates, were sensitive against first-line drugs, cephalosporins, and macrolides. However, against quinolone, a huge percentile i.e. 93.3%, of isolates were resistant [including 58 Typhi and 26 Paratyphi serovar], and nearly 14% against fluoroquinolones. When MIC breakpoint was adjusted 4µg/ml for azithromycin, ≥1 µg/ml for ciprofloxacin, 2µg/ml for ofloxacin, 8µg/ml for nalidixic acid, 1µg/ml for cefixime, higher sensitivity and specificity achieved while screening decreased susceptibility. Among tested antibiotics, low rate of resistant strain observed on MIC of azithromycin. Also, higher resistance against fluoroquinolones observed on NARS strain. Conclusion Higher susceptibility of Salmonella enterica to first-line drugs (the conventional antityphoidal drugs), third-generation cephalosporins, and azithromycin; advocates for its reconsideration in the implicated therapy. However, lower susceptibility against fluoroquinolones among nalidixic-acid resistant Salmonella (NARS) strain negates its empirical use in children. Keywords Enteric fever, Nepal, children, Salmonella enterica
Analysis of related factors of recurrence in pediatric hepatoblastoma-A single center retrospective study
Authors: Yang Wei , Chen Yiwei , Huang Yijin , Wang Huanmin 
Published: September 2019

Abstract
Introduction This study was performed in order to find out the relevant factors of the recurrence of hepatoblastoma .Materials and Methods 28 patients that presenting with recurrent hepatoblastoma in our hospital from 2012 to 2015 were included in the investigation. The pathological subtype,clinical stage, serum levels of alpha fetoprotein (AFP), the change trend of the tumor volume and AFP value of each case after they received neoadjuvant chemotherapy and after surgical resection were recorded. The χ2 test was used to analyze the relationship between tumor recurrence and the aforementioned factors.Results The results showed that in the recurrence group, the patients were in higher clinical stage than that in the non-recurrence group. In the patients with recurrent tumors, the rate of tumor volume reduction, the extent of AFP level decrease and the proportion of those in the group whose AFP level fell to normal range in one month after tumor resection were all apparently lower than those in the non-recurrence patients.Conclusion The main risk-altering factors involved in the recurrence of hepatoblastoma were: clinical stage, reduction in tumor size after neoadjuvant chemotherapy, and the rate of descent of AFP levels to within normal range after tumor resection. These indicators can be used as important biomarkers for personalized treatment, assessment of treatment efficacy and prognostic indicators.
How many words are Australian children hearing in the first year of life?
Authors: Brushe Mary E , Lynch John W. , Reilly Sheena , Melhuish Edward , Brinkman Sally A. 
Published: September 2019

Abstract
Background: There is evidence that parents from more socioeconomically disadvantaged backgrounds engage in fewer verbal interactions with their child than more advantaged parents. This leads to the so-called, ‘30 million-word gap’. We used improved technology to investigate the number of words children hear in their first year of life. Methods: Mothers were recruited into a five-year prospective cohort study and categorized into either high or low maternal education groups. Data was derived from the first two waves of the study, when the children were six and twelve months old. At both waves, children were involved in day-long audio recordings using the Language Environment Analysis software that provided automatic counts of adult words spoken to the child, child vocalizations and conversational turns. Descriptive results are presented by maternal education groups. Results: There was large variation within each maternal education group, with the number of adult words spoken to the child ranging from 2,958 to 39,583 at six months and 4,389 to 45,849 at twelve months. There were no meaningful differences between adult words, child vocalizations or conversational turns across maternal education groups at either wave of data collection. Conclusions: These results show that a word gap related to maternal education is not apparent up to twelve months of age. The large variability among both maternal education groups suggests that universal interventions that encourage all parents to talk more to their child may be more appropriate than interventions targeted towards disadvantaged families during the first year of life.