bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of a midwife-coordinated, individualized, and specialized maternity care intervention (ChroPreg) in addition to standard care in pregnant women with chronic disease: protocol for a parallel randomized controlled trial
Authors: de Wolff Mie , Johansen Marianne , Ersboell Anne Schoedt , Rosthoej Susanne , Brunsgaard Anne , Midtgaard Julie , Tabor Ann , Hegaard Hanne Kristine 
Published: March 2019

Abstract
Background and objectives: The number of women of childbearing age with chronic diseases is rising. Evidence has shown that obstetric complications and poor psychological well-being are more prevalent among this group, in addition to these women reporting experiences of less than satisfactory care. More research is needed to investigate how to best meet the special needs of this group during pregnancy and postpartum. Previous research has shown that care coordination, continuity of care, woman-centered care and specialized maternity care interventions delivered to women with high-risk pregnancies can improve patient-reported outcomes, pregnancy outcomes, and be cost-effective. However, no previous trials have examined the efficacy and cost-effectiveness of such interventions among pregnant women with chronic diseases. This paper describes the protocol of a randomized controlled trial (RCT) of a midwife-coordinated, individualized and specialized maternity care intervention (ChroPreg) as an add-on to standard care for pregnant women with chronic diseases.
Methods/design: This two-arm parallel group RCT study will be conducted from October 2018 – June 2020 at the Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Denmark. Pregnant women with chronic diseases are invited to participate; women will be randomized and allocated 1:1 to the ChroPreg intervention plus standard care or standard care alone. The ChroPreg intervention consists of three main components: 1. Coordinated and individualized care, 2. Additional ante- and postpartum consultations, and 3. Specialized midwives.
The primary outcome is length of hospital stay (LOS) during pregnancy and postpartum period and secondary outcomes are: psychological well-being (the five-item World Health Organization Well-being Index, Edinburgh Postnatal Depression Scale, Cambridge Worry Scale), health-related quality of life (the 12-Item Short Form Survey), patient satisfaction (The Pregnancy and Childbirth Questionnaire), number of antenatal contacts, and pregnancy and delivery outcomes. Data is collected via patient-administered questionnaires and medical records.
Discussion: This trial is anticipated to contribute to the field of knowledge on which planning of improved antenatal, intra- and postpartum care for women with chronic disease is founded.
Clinical evaluation of narrow diameter implants versus standard diameter implants with bone augmentation in posterior jaws:study protocol for a randomized controlled clinical trial
Authors: Qian Shujiao , Qiao Shichong , Zhu Yu , Zhang Xiao , Mo Jiaji 
Published: March 2019

Abstract
Background: Nowadays, narrow diameter implants are being increasingly used in posterior regions with insufficient bone width to avoid invasive bone augmentation procedures. Recent studies have indicated that narrow implants with a diameter of 3.3 to 3.5mm showed comparable survival rate with standard diameter implants. However, there are no high-quality clinical trials comparing the clinical outcomes of narrow diameter implants to standard diameter implants with augmentation procedures in atrophic posterior region. The purpose of present study is to evaluate the clinical efficacy of narrow diameter implants in posterior jaws. Methods/Design: This study is designed as a prospective, single-center, 2-arm parallel, randomized controlled clinical trial. Patients in need of single implant crowns in posterior jaws will be included in the study according to clear defined inclusion-and-exclusion criteria. Randomized number table will be used to assign the patients into two groups: group 1: narrow diameter implant group (NDI); group 2: standard diameter implant with bone augmentation group (SDI). Implant survival rate, mechanical complications, marginal bone loss, peri-implant conditions and patients’ satisfaction will be recorded. Clinical and radiological re-evaluations will be performed at 6, 12, 36, 60 months after the final crowns delivery. Discussion: Our findings will help evaluate the clinical efficacy of narrow implant in posterior region. If the results were favorable, narrow implants might be recommended as a viable alternative for posterior region with insufficient bone width. Trial registration: Clinicaltrials.gov identifier: ChiCTR1800020426 (registered on 29 December 2018)
Precision and Agreement of Central Corneal Thickness Measured with E-pach, A-scan, Corvis ST and Pentacam
Authors: Liu Anqi , Xu Zequan , Wang Jingjing , Liu Feng , Jiang Yanming , Yang Min , Mei Lina , Ge Mei , Yang Qinghua , Huang Yifei , Wang Liqiang 
Published: March 2019

Abstract
Purpose

To assess the precision (repeatability and reproducibility) and agreement of central corneal thickness (CCT) measurements by E-pach, Pentacam, Corvis ST and A-scan devices in healthy eyes.

Methods

Instrument diagnostic test study. A total of 100 patients were enrolled to measure right-eye CCT by E-pach, Pentacam, Corvis ST, and A-scan devices. To assess repeatability and reproducibility, the test-retest repeatability (TRT) and intraclass correlation coefficient (ICC) were calculated. The agreement among the four devices was evaluated with Bland-Altman plots.

Results

The E-pach showed repeatability (ICC=0.9981), interobserver reproducibility (ICC=0.9971) and intersession reproducibility (ICC=0.9825); the Pentacam, Corvis ST and A-scan also showed similar repeatability (all ICC≥0.9679), interobserver reproducibility (all ICC≥0.9730) and intersession reproducibility (all ICC≥0.9647). However, the E-pach yielded CCT values that were obviously lower than those of the A-scan and Pentacam (P<0.001) but higher than those of the Corvis ST (P<0.001). The 95% limits of agreement (LoA) in the Bland-Altman plots were 44.5 µm (E-pach vs. A-scan), 34.9 µm (E-pach vs. Corvis CT) and 32.5 µm (E-pach vs. Pentacam).

Conclusions

The E-pach is a portable, reliable and inexpensive pachymeter. However, the CCT values obtained from the E-pach are not interchangeable with those from Pentacam, Corvis ST and A-scan devices.
THE ASSOCIATION BETWEEN LOCATION OF BRAIN LESION AND FINDINGS OF FLEXIBLE ENDOSCOPIC EVALUATION OF SWALLOWING (FEES) IN STROKE PATIENTS: WHICH EXERCISE IS BENEFICIAL?
Authors: Kusumaningsih Widjajalaksmi , Lestari Nur Indah , Purba Herdiman 
Published: March 2019

Abstract
Background: Dysphagia is a frequent occurrence following stroke. Various brain regions have been shown to control deglutition. However, it is still controversial as to which of the two hemispheres plays more important role in deglutition, and which injured hemisphere is more likely to cause the specific patterns of dysphagia seen in stroke patients. An accurate estimate of the incidence of dysphagia will be critical to assess benefits of dysphagia interventions.
Objective: To investigate whether patterns of dysphagia are associated with the location of brain lesion in stroke patients and to examine whether pharyngeal strengthening exercise and hyolaryngeal exercise are proper for patients, based on the findings of FEES and location of brain lesion.
Methods: The subjects were stroke outpatients who visited our clinic from January 2016 to April 2018. To localize brain lesion, Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) have been employed. The locations of brain lesions were classified into cortical, subcortical, and brain stem. FEES was conducted to assess the patterns of deglutition disorders. These data were collected via retrospective chart review.
Results: Of the 11 subjects, mean age (SD) was 62.73 (8.67) years and seven (63.64%) subjects were male. All subjects got ischemic stroke, eight (72.73%) had right hemispheric lesion and three (27.27%) had left hemispheric lesion. By brain lesion, there were nine subcortical, five cortical, and four brain stem lesions. All FEES findings, especially standing secretion, penetration, residue, and reduced hypopharynx sensitivity were higher in subcortical lesion, followed by brain stem and cortical lesion successively.
Conclusion: Right hemisphere was involved more than left hemisphere in dysphagia patients. Standing secretion, penetration, residue, and reduced hypopharynx sensitivity occurs more often in subcortical lesion. Further studies on big samples in a perspective structure are needed. Based on this result, there is a place for pharyngeal strengthening exercise and hyolaryngeal complex range of motion and strengthening exercise to be implemented to the patients with neurogenic dysphagia after stroke.
Correlation of anti-acetylcholine receptor antibody levels and long-term outcomes of juvenile myasthenia gravis in Taiwan: a case control study
Authors: chou cheng che , Su I Chen , Chou I Jun , LIN Jainn Jim , Lan Shih Yun , Wang Yi Shan , Kong Shu Sing , Chen Yun Ju , Hsieh Meng Ying , Hung Po Cheng , Wang Huei Shyong , Chou Min Liang , Lin Kuang Lin 
Published: March 2019

Abstract
Background

Myasthenia gravis is the most common disease affecting the neuromuscular junction. The most common etiology among patients with juvenile myasthenia gravis is the production of antibodies against the acetylcholine receptor. However, the clinical outcome in relation to serum levels of anti-acetylcholine receptor antibodies in juvenile myasthenia gravis has rarely been discussed. We aimed to analyze the correlation between the presence of anti-acetylcholine receptor antibodies and outcome in juvenile myasthenia gravis.

Methods

Patients diagnosed with juvenile myasthenia gravis younger than of 20 years of age were retrospectively recruited from January 1995 to February 2017 in a tertiary referral medical center. According to the Myasthenia Gravis Foundation of America outcome scale, the primary outcome was complete symptom remission and cessation of medications for at least 1 year measured 2 years after diagnosis. Secondary outcome was complete symptom remission at the last outpatient clinic.

Results

A total of 54 patients were followed up for over 2 years. Nine patients (9/54, 16.7%) achieved complete remission without medication use at two years after diagnosis. Thirteen (24.1%) patients achieved complete remission during longer follow-up periods. Those with negative anti-acetylcholine receptor antibodies were more likely to achieve complete remission at 2 years (6/15 [40%] vs. 3/39 [7.7%], 95% Confidence interval [CI] 1.670 to 38.323) and at the last outpatient clinic follow-up (8/15 [53.3%] vs. 5/39 [12.8%], 95% CI 2.367 to 20.704). Thirteen patients with comorbid autoimmune thyroid diseases were older than those without disease (11.8 ± 5.8 years old vs. 8.0 ± 6.3 years old, 95% CI 0.018 to 7.33). Moreover, patients negative for anti-acetylcholine receptor antibodies were less likely comorbid with autoimmune thyroid disease (1/35 [2.9%] vs. 12/71 [16.9%], 95% CI 0.018 to 1.161).

Conclusions

Juvenile myasthenia gravis patients without anti-acetylcholine antibodies exhibited significantly increased complete remission rates and a reduced likelihood of comorbid autoimmune thyroid diseases compared with those with anti-acetylcholine receptor antibodies.
Impact of brief prewarming on anesthesia-related core-temperature drop, hemodynamics, microperfusion and postoperative ventilation in cytoreductive surgery of ovarian cancer a randomized trial
Authors: Kaufner Lutz , Niggemann Phil , Baum Tobias , Casu Sara , Sehouli Jalid , Bietenbeck Andreas , Boschmann Michael , Spies Claudia , Henkelmann Anne , von Heymann Christian 
Published: March 2019

Abstract
Background:

General (GA)- and epidural anesthesia (EDA) may cause a drop in body core-temperature (BCTdrop), and hypothermia, which may alter tissue oxygenation (StO2) and microperfusion after cytoreductive surgery for ovarian cancer. We hypothesized that forced-air prewarming (PW) during epidural catheter placement and induction of GA maintains normothermia and improves microperfusion.

Methods:

After ethics approval 47 women scheduled for cytoreductive surgery were prospectively enrolled. Women in the study group were treated with a prewarming (PW) of 43°C during epidural catheter placement. BCT (Spot on®, 3M) was measured before (T1), after induction of GA (T2) at 15 min (T3) after start of surgery, and until 2h after ICU admission (TICU2h). Primary endpoint was BCTdrop between T1 and T2. Microperfusion-, hemodynamic- and clinical outcomes were defined as secondary outcomes. Statistical analysis used the Mann-Whitney-U- and non-parametric-longitudinal tests.

Results:

BCTdrop was 0.35 °C with PW and 0.9 °C without PW (p< 0.005) and BCT remained higher over the observation period (ΔT4 = 0.9 °C up to ΔT7 = 0.95 °C, p<0.001). No significant differences in hemodynamic parameters, transfusion, arterial lactate and dCO2 were measured. In MD the ethanol ratio was temporarily, but not significantly, reduced after PW. Lactate, glucose and glycerol after PW tended to be more constant over the entire period. Postoperatively, six women without PW, but none after PW were mechanical ventilated (p< 0.001).

Conclusion: PW at 43°C reduces the BCTdrop and maintains normothermia without impeding the perioperative routine patient flow. Microdialysis indicate better preserved parameters of microperfusion.

Trial registration: ClinicalTrials.gov; ID: NCT02364219; Date of registration: 18-febr-2015
A Case of Hyperventilation leading to apnea and desaturation in PACU: A root cause analysis
Authors: Thapa Parineeta , Asish Subedi , Anjali Poudel , Pankaj Baral 
Published: March 2019

Abstract
Background

Respiratory adverse events are not uncommon in the post anesthesia care unit (PACU) following general anesthesia. In this regard, hyperventilation leading to apnea and desaturation is a rare entity. Here we have reported a case of a 15 year old girl who, following an uneventful general anesthesia, developed severe hyperventilation leading to apnea and desaturation in the PACU.

Case presentation

The 15 year old girl underwent cortical mastoidectomy under general anesthesia. After a smooth anesthesia and an uneventful early recovery, she developed hyperventilation after about 15 minutes in the PACU. The symptom was severe enough to lead to apnea, desaturation and severe respiratory alkalosis. She required bag and mask ventilation and the symptoms resolved only transiently with propofol sedation. Finally she responded to intravenous haloperidol and did not have any further episode after receiving haloperidol

Conclusion

Hyperventilation after a smooth recovery from anesthesia is not a common presentation. In this article we have tried to discuss the possible cause of such symptom in our patient and how we successfully managed this case. We have also proposed an algorithmic approach to diagnose and manage such a case in the PACU.
Predominance of Lactobacillus plantarum Strains in Peruvian Amazonian Fruits
Authors: SÁNCHEZ JOHANNA , VEGAS CARLOS , ZAVALETA AMPARO IRIS , ESTEVE-ZARZOSO BRAULIO 
Published: March 2019

Abstract
The objective of this research was the identification and characterization of lactic acid bacteria (LAB) isolated from Peruvian Amazonian fruits. Thirty-seven isolates were obtained from diverse Amazonian fruits. Molecular characterization of the isolates was performed by ARDRA, 16S-23S ITS RFLP and rep-PCR using GTG5 primers. Identification was carried out by sequencing the 16S rDNA gene. Phenotypic characterization included nutritional, physiological and antimicrobial resistance tests. Molecular characterization by Amplified Ribosomal DNA Restriction Analysis (ARDRA) and 16S-23S ITS RFLP resulted in four restriction profiles while GTG5 analysis showed 14 banding patterns. Based on the 16S rDNA gene sequence, the isolates were identified as Lactobacillus plantarum (75.7%), Weissella cibaria (13.5%), Lactobacillus brevis (8.1%), and Weissella confusa (2.7%). Phenotypic characterization showed that most of the isolates were homofermentative bacilli, able to ferment glucose, maltose, cellobiose, and fructose and grow in a broad range of temperatures and pH. The isolates were highly susceptible to ampicillin, amoxicillin, clindamycin, chloramphenicol, erythromicyn, penicillin, and tetracycline and showed great resistance to kanamycin, gentamycin, streptomycin, sulfamethoxazole/trimethoprim, and vancomycin. No proteolytic or amylolytic activity was detected. L. plantarum strains produce lactic acid in higher concentrations and Weissella strains produce exopolymers only from sucrose. Molecular methods allowed to accurately identify the LAB isolates from the Peruvian Amazonian fruits, while phenotypic methods provided information about their metabolism, physiology and other characteristics that may be useful in future biotechnological processes. Further research will focus especially on the study of L. plantarum strains.
Comparing Four Methods of Measuring Soil Organic Matter in North Carolina Soils
Authors: Roper Wayne R. , Robarge Wayne P. , Osmond Deanna L. , Heitman Joshua L. 
Published: March 2019

Core IdeasResults of agronomic management effects on SOM are inconsistent among methods.Correlations among methods of measuring SOM differ depending on soil.Soil organic matter content should be compared using similar procedures.Soil organic matter (SOM) provides many beneficial soil ecosystem services for sustainable soil management, but it is unclear how results from different methods of measuring SOM should be compared when making soil management decisions. To compare different methods, we used 84 soil samples from long‐term agronomic trials in the coastal plain, piedmont, and mountain regions of North Carolina. Coastal plain and mountain trials included combinations of tillage and management (conventional vs. organic), whereas piedmont trials were configured to evaluate tillage intensity. The methods used to measure SOM were Walkley‐Black (WB), mass loss on ignition (LOI), automated dry combustion (ADC), and humic matter (HM) colorimetry. Correlations among LOI, WB, and ADC were significant (p< 0.0001) for SOM measured from the total population of soils, but variability due to location implied that HM had no correlation to other methods. For measures of soil organic carbon compared to SOM, the WB results were biased high compared to ADC, and ADC was more strongly correlated to LOI than WB. When using the methods to evaluate the effects of agronomic management on SOM, results varied for different methods and locations. Conservation management did not consistently accumulate more SOM than other soil management practices, and no method consistently differentiated soils based on management. Variation in the composition of SOM measured using conventional methods may be causing discrepancies in reported changes in SOM content over time. To avoid confusion about how agronomic management affects SOM, assessments should limit comparisons to methodologies with similar measurement protocols.
Soil Microbial Community Structure Shifts Induced by Biochar and Biochar‐Based Fertilizer Amendment to Karst Calcareous Soil
Authors: Zhou Zhidong , Gao Ting , Van Zwieten Lukas , Zhu Qian , Yan Taotao , Xue Jianhui , Wu Yongbo 
Published: March 2019

Core Ideas
Biochar‐based fertilizer treatments induced significant microbial community structure shifts compared with no‐biochar and biochar alone.
Biochar‐based fertilizer especially at higher biochar addition rate increased soil microbial biomass and fertility.
Soil microbial species were strongly correlated with soil nutrients under biochar and biochar‐based fertilizer into karst soil.
Karst ecosystems are vulnerable to degradation and constitute a significant proportion of southwestern China. Here, we explore the amendment of these soils with wood biochar in combination with N‐P‐K fertilizer and swine manure compost with the goal of improving microbial community structure and soil nutrient status of these soils. A pot experiment with six treatments, including control (CK, no amendment), swine manure compost plus N‐P‐K fertilizer (MF), wood biochar at 2% in soil (W2), wood biochar at 4% in soil (W4), wood biochar‐based fertilizer at 2% in soil (W2MF), and biochar‐based fertilizer at 4% in soil (W4MF), was set up for 20 months. The results showed that soil organic matter and soil available nutrients N, P, and K in W4MF increased by 63.95, 66.23, 284.96, and 94.56%, respectively, compared with CK. Soil microbial biomass C, N, and P increased in sequence by 60.05, 87.64, and 307.85%, respectively. Soil bacterial and fungal diversity indices (Simpson and Shannon) and richness index (Chao1) were generally higher in biochar‐based fertilizer treatments (W2MF and W4MF) than biochar alone (W2 and W4). The bacterial and fungal community structures of biochar based fertilizer treatments differed from those of biochar amendment alone or control (P < 0.05). Linear discriminant (Effect Size) analysis showed that the bacterial biomarkers of the W2MF + W4MF group were mainly the phylum Acidobacteria and class Alphaproteobacteria, and the fungal biomarkers were the phylum Rozellomycota and Glomeromycota. Redundancy analysis revealed strong relationships between microbial community structure and soil organic matter and soil available nutrients N, P, and K (P < 0.05). In conclusion, either sole biochar or biochar‐based fertilizer amendment improved karst soil nutrient conditions and induced microbial community structural shifts. The performance was better in biochar‐based fertilizer treatment than that in biochar addition alone.
Effects of Biomass Removal Levels on Soil Carbon and Nutrient Reserves in Conifer‐Dominated, Coarse‐Textured Sites in Northern Ontario: 20‐Year Results
Authors: Morris Dave M. , Hazlett Paul W. , Fleming Rob L. , Kwiaton Martin M. , Hawdon Laura A. , Leblanc J.‐D. , Primavera M.J. , Weldon Tom P. 
Published: March 2019

Core Ideas
Biomass removal trials targeted soils sensitive to nutrient removal (shallow to bedrock and infertile sands).
14 long‐term sites (42 plots per treatment) were used to evaluate C and nutrient reserves 20 years post‐harvest.
After 20 years, soil C, N, and K reserves did not differ between pre‐harvest levels and SO and FT.
Soil reserves of FTB treatments remained significantly lower than the pre‐harvest levels.
Jack pine and black spruce declined in height on FTB on sandy sites; there were no differences between SO and FT.
Here we report on 20‐yr soil (forest floor plus the upper 20 cm of mineral soil) carbon and nutrient reserves from 14 biomass removal trials established on coarse‐textured, nutrient poor sites. Harvest treatments included stem only (SO, delimbed at the stump), full‐tree (FT, entire trees with boles and branches removed), and full‐tree plus forest floor blading (FTB, full‐tree harvest followed by removal of the forest floor and approximately the upper 5 cm of mineral soil). After 20 yr, there were no significant differences in soil C, N, and K reserves between pre‐harvest levels and the SO and FT treatments. Only the soil reserves of the FTB treatment remained significantly lower than the pre‐harvest levels. Extractable soil Ca and Mg reserves increased in Year 5 in all treatments, followed by slow declines, but all treatments remained comparable to or exceeded pre‐harvest levels at Year 20. For P, harvesting (SO and FT) resulted in significant declines that remain after 20 yr. Both jack pine and black spruce showed reduced top height growth on FTB, but only on some of the sandy sites. There were no differences in top height for either species between SO and FT across all 14 study sites. Current results suggest there is no need for restrictions on full‐tree harvesting for traditional wood products on these nutrient poor sites. However, from a cautionary perspective, it seems prudent at this time to restrict more intensive bioenergy harvests to deep, finer‐textured sites that have larger soil C and nutrient reserves.