bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obstetrical Nurses’ Perspectives of Pregnant Women Who Use Illicit Substances and Their Provision of Care: A Thematic Analysis
Authors: Menard-Kocik Jenna , Caine Vera 
Published: September 2019

Background The growing number of pregnant women using illicit substances presents a serious public health concern. Purpose The purpose of this study was to explore obstetrical nurses’ perspectives toward caring for pregnant women who use illicit substances in a large inner-city hospital in Western Canada. Methods Guided by an interpretivist and social constructivist epistemological approach, I engaged in a thematic content analysis of qualitative semistructured interviews. In total 18 registered nurses from multiple obstetrical units were recruited. Results Four major themes were identified: (i) services and care were recognized through elements of caring, creating a welcoming environment, and providing client-centered care; (ii) stigma and discrimination impacted nurses preconceptions of care; (iii) coping mechanisms were necessary when struggling professionally; and (iv) recommendations of continuing specialized education were identified. Conclusion Obstetrical nurses highlighted a number of conflicting views about caring for pregnant women who use illicit substances. Key actions, such as establishing professional support when nurses experience ethical distress or when they are unable to provide meaningful care to patients, were suggested. Strong recommendations for ongoing professional development, as well as increased educational opportunities during prelicensure programs were made in order to support nurses in their role.
A Cone-Beam Computed Tomographic Study of Alveolar Bone Morphology in Patients With Unilateral Cleft Lip and Palate
Authors: Movahhedian Najmeh , Vossoughi Mehrdad , Hajati-Sisakht Mahtab 
Published: September 2019

Objective: To evaluate the bony support around the teeth adjacent to the unilateral cleft lip and palate (ULCLP) using cone-beam computed tomography. Methods and Materials: Cone-beam computed tomographies of 48 cleft-adjacent teeth (28 anterior and 20 posterior to the cleft) and 48 noncleft control teeth were evaluated. The alveolar bone thickness at 3 and 6 mm apical to the cement–enamel junction (CEJ), the distance between the alveolar crest and CEJ (Alv-CEJ), and the presence of fenestration were assessed in buccal, palatal, and proximal surfaces. Results: The alveolar bone on the buccal and palatal sides of the teeth anterior to the cleft was significantly thinner than the noncleft teeth (all P < .05). The Alv-CEJ was significantly greater on the buccal and distal surfaces of the teeth anterior to the cleft ( P < .001 and P = .010, respectively) and on the palatal and mesial surfaces of the teeth posterior to the cleft ( P = .024 and P = .003, respectively) when compared to the noncleft teeth. The frequency of reduced alveolar bone height (>2 mm) was higher than noncleft side for buccal and distal sides of the teeth anterior to the cleft ( P = .016 and .006, respectively) and the buccal and mesial sides of the teeth posterior to the cleft ( P = .008 and <.001, respectively). The teeth anterior to the cleft had a higher prevalence of fenestration ( P = .004). Conclusion: Reduced alveolar bone height is more common in the cleft side compared to the control side. The teeth anterior to the ULCLP have thinner alveolar bone support and higher frequency of fenestration.
Pierre Robin Sequence: Incidence of Speech-Correcting Surgeries and Fistula Formation
Authors: Gustafsson Charlotta , Vuola Pia , Leikola Junnu , Heliövaara Arja 
Published: September 2019

Objective: Children with Pierre Robin sequence (PRS) and cleft palate have a high rate of velopharyngeal insufficiency (VPI) following primary palatoplasty. Our purpose was to determine the long-term incidence of speech-correcting surgeries (SCSs) and fistula rates in PRS after primary palatoplasty and the influence of possible causal factors. Design: A retrospective single-center, observational chart review study. Participants: After exclusion, the study cohort comprised 78 nonsyndromic PRS children (48 females) born between 1990 and 2009 and treated at the Cleft Palate and Craniofacial Center of Helsinki University Hospital, Finland. Causal factors included gender, surgeon, age at primary palatoplasty, surgical technique, airway obstruction in infancy, and cleft severity. We analyzed the outcome at age 8 years and at data retrieval, with a median follow-up of 14 years (range: 8-27 years). Results: Thirty-four (43.6%) children received SCS by age 8 years, and of the 19 (24.4%) postoperative fistulas, 6 (7.7%) underwent closure. At data retrieval, 37 (47.4%) children had undergone SCS and 8 (10.3%) had a fistula closure. Median age at SCS was 6 years. The results showed no significant association for gender, surgeon, age at primary palatoplasty, surgical technique, cleft severity, or airway obstruction in infancy regarding incidence of SCS, fistulas, or repaired fistulas. Conclusion: Pierre Robin sequence in children is associated with a high incidence of SCS and fistula formation, which necessitates accurate clinical follow-up and observation of speech development. The development of VPI in PRS is complex and most likely involving multiple factors.
Midterm outcomes of total hip arthroplasty with a modular Birmingham head
Authors: Cushnie Duncan W , Lanting Brent A , McCalden Richard , Naudie Douglas DR , Howard James L 
Published: September 2019

Introduction: Birmingham Hip Resurfacing (BHR) implants may be combined with a conventional femoral stem to create a modular metal-on-metal total hip arthroplasty (BHR MoM THA). There is little outcome data regarding this construct. This study examines midterm outcomes of BHR MoM THA compared to oxidised zirconium total hip arthroplasty (THA). Methods: A retrospective institutional review identified all patients receiving BHR MoM THA between April 2005 and February 2011 and a matched control cohort of zirconium THA patients. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Harris Hip Score (HHS), and SF-12 Health status scores were obtained. Revisions and complications were collected from clinical records. Radiographs were assessed for evidence of component malposition, loosening, osteolysis, or heterotopic ossification. Results: 63 modular BHR MoM THA were identified in 61 patients (36 with BHR cups, 27 with R3 cups) and 63 zirconium THA in 58 matched controls. Mean follow-up was 58 months. 14 BHR MoM THA hips (22.2%) were revised (4 infections, 1 dislocation, 9 soft tissue reactions) compared to 3 (4.8%) zirconium THA (all infections). At latest follow-up, 18.4% of surviving BHR MoM THA hips were painful compared to 0.5% of zirconium THA controls ( p < 0.001). WOMAC, HHS, and SF-12 did not differ significantly between surviving members of the 2 groups. Discussion: BHR MoM THA demonstrated a high revision rate, largely for adverse local soft tissue reaction and pain. Among those not revised, many reported some residual pain despite similar quality of life measures to those who received zirconium THA.
Genetic and nongenetic factors explaining metabolically healthy and unhealthy phenotypes in participants with excessive adiposity: relevance for personalized nutrition
Authors: Ramos-Lopez Omar , Riezu-Boj Jose I. , Milagro Fermin I. , Cuervo Marta , Goni Leticia , Martinez J. Alfredo 
Published: September 2019

Background: Different genetic and environmental factors can explain the heterogeneity of obesity-induced metabolic alterations between individuals. In this study, we aimed to screen factors that predict metabolically healthy (MHP) and unhealthy (MUP) phenotypes using genetic and lifestyle data in overweight/obese participants. Methods: In this cross-sectional study we enrolled 298 overweight/obese Spanish adults. The Adult Treatment Panel III criteria for metabolic syndrome were used to categorize MHP (at most, one trait) and MUP (more than one feature). Blood lipid and inflammatory profiles were measured by standardized methods. Body composition was determined by dual-energy X-ray absorptiometry. A total of 95 obesity-predisposing single-nucleotide polymorphisms (SNPs) were genotyped by a predesigned next-generation sequencing system. SNPs associated with a MUP were used to compute a weighted genetic-risk score (wGRS). Information concerning lifestyle (dietary intake and physical activity level) was collected using validated questionnaires. Results: The prevalence of MHP and MUP was 44.3% and 55.7%, respectively, in this sample. Overall, 12 obesity-related genetic variants were associated with the MUP. Multiple logistic regression analyses revealed that wGRS (OR = 4.133, p < 0.001), total dietary fat [odds ratio (OR) = 1.105, p = 0.002], age (OR = 1.064, p = 0.001), and BMI (OR = 1.408, p < 0.001) positively explained the MUP, whereas female sex (OR = 0.330, p = 0.009) produced a protective effect. The area under the receiver operating characteristic curve using the multivariable model was high (0.8820). Interestingly, the wGRS was the greatest contributor to the MUP (squared partial correlation = 0.3816, p < 0.001). Conclusions: The genetic background is an important factor explaining MHP and MUP related to obesity, in addition to lifestyle variables. This information could be useful to metabolically categorize individuals, as well as for the design/implementation of personalized nutrition interventions aimed at promoting metabolic health and nutritional wellbeing.
Etiology and Outcomes of Spinal Cord Infarct: A Case Series From a Level 1 Trauma Center
Authors: Ge Laurence , Arul Karan , Stoner Michael , Mesfin Addisu 
Published: September 2019

Study Design: Retrospective study. Objectives: To evaluate the demographics, prevalence, etiology, severity, and outcomes of spinal cord injuries (SCIs) resulting from ischemic infarction. Methods: All patients with SCI and a diagnosis of cord infarct who were admitted to the inpatient rehabilitation unit at a level 1 trauma center from January 2003 to January 2014 were identified using an administrative billing database. Outcomes measures were evaluated. Results: Among 685 unique SCI patients who were identified, 30 (4.4%) had SCI due to spinal ischemic infarction. The mean age was 59 years (range 17-80 years). Fifty percent of patients had ASIA (American Spinal Injury Association) A and B severity. Most common causes were the following: 6 (20%) abdominal aortic aneurysm (AAA) repairs, 6 (20%) arteriovenous fistulas, and 6 (20%) with an unknown cause. Surgical complications led to 4 (13.3%) cord infarcts and was associated with a higher severity of injury ( P = .02) compared with other etiologies. Other causes included systemic hypotension, AAA rupture, trauma, diabetic ketoacidosis, and after radiation therapy. At follow-up, 6 (20%) of patients were able to ambulate normally without assistance, 7 (23.3%) were ambulating with assistance, and 17 (56.7%) were still wheelchair bound. Clinical improvement in ambulatory status was noted in 6 (20%) patients and was associated with less severe initial injury ( P = .02). Conclusions: While the existing literature associates spinal cord infarction with aortic pathologies and surgery, these caused less than 30% of cases, while nonaortic surgical complications were associated with the most severe injuries. Outcomes were worse than previously reported in the literature.
Does transforaminal lumbar interbody fusion produce leg pain?—Results from a RCT
Authors: Høy Kristian , Grycel Blazej , Andersen Thomas , Bünger Cody 
Published: September 2019

Background: Transforaminal lumbar interbody fusion (TLIF) is presently the most used method to achieve lumbar interbody fusion worldwide. The special preparation and cage insertion imply a risk of an undesirable side effect in the form of residual neurogenic pain. This issue has not been investigated prior in a randomized clinical trial (RCT) set up. Aim: To test whether TLIFs had a higher incidence of leg pain in comparison to a common instrumented posterolateral fusion (PLF) and to test whether a higher occurrence of leg pain on the ipsilateral side in the TLIF group was present. Methods: One hundred patients included in a RCT comparing TLIF and PLF fulfilled pain drawings and numeric rating scale (NRS) scale from 0 to 10 preoperatively, after 1 year, and after 2 years. Difference in pain appearance, type, localization, and intensity was compared between groups. Results: A slightly higher number of patients in the TLIF group reported leg pain at 2 years follow-up: no leg pain, 47% (PLF) and 37% (TLIF); unilateral leg pain, 31% (PLF) and 25% (TLIF); bilateral leg pain, 22% (PLF) and 37% (TLIF), p = 0.270. Numbness and pins and needles on the anterior aspect of the lower leg were marked by 10% and 12% of TLIF patients compared to 6% and 4% in PLF patients p = 0.498/0.197. The ipsilateral side of cage insertion in the TLIF group was not a place for new leg pain compared to the contralateral side. Conclusion: The special surgical preparation used in TLIFs does not result in the development of new ipsilateral leg pain. However, a higher percentage of the patients in the TLIF group had new leg pain in comparison to PLF after 2 years.
The modified anterior ellipsoidal cap titanium cable tension band for comminuted patellar fractures
Authors: Wang Fasheng , Luo Tianyi David , Chen Chunyong , Xie Yun , Lin Zhangxiong , Zeng Da , Lin Jianhua , Ye Junjian 
Published: September 2019

Purpose: The purpose of this study was to assess the outcomes in a series of patients, who underwent cerclage and figure-of-eight tension band wiring using a single titanium cable for comminuted patellar fractures. Methods: We describe a modified tension band technique using a single titanium cable to create an ellipsoidal cap structure that combines the circumferential and figure-of-eight wrapping in the fixation of closed Association for the Study of Internal Fixation/Orthopaedic Trauma Association 34C2 and 34C3 patellar fractures. We retrospectively reviewed 25 patients (16 males and 9 females, mean age 54 years) who underwent the described fixation technique between 2015 and 2017. Postoperative function was evaluated using the Böstman score. Results: At the mean follow-up of 25 months (range 17–39 months), the mean Böstman score was 27.3 ± 2.6 points (range 23–30). Eighteen patients (72%) had excellent results (score ≥28); seven patients (28%) had good results (score 20–27); and no patients had an unsatisfactory result (score < 20). All surgical incisions healed without major wound complications. Two patients reported minor complications (soft tissue irritation, cellulitis). No patients demonstrated loss of reduction or implant failure during the follow-up period. Conclusion: The modified anterior ellipsoidal cap tension band using a single titanium cable created an effective tension band structure in the treatment of comminuted patella fractures. It is a simple operative technique that produced a stable fixation construct, which allowed early functional rehabilitation and weight-bearing with a high rate of excellent outcomes at 2 years after surgery.
Automatic discovery of 100-miRNA signature for cancer classification using ensemble feature selection
Authors: Lopez-Rincon Alejandro , Martinez-Archundia Marlet , Martinez-Ruiz Gustavo U. , Schoenhuth Alexander , Tonda Alberto 
Published: September 2019

AbstractBackgroundMicroRNAs (miRNAs) are noncoding RNA molecules heavily involved in human tumors, in which few of them circulating the human body. Finding a tumor-associated signature of miRNA, that is, the minimum miRNA entities to be measured for discriminating both different types of cancer and normal tissues, is of utmost importance. Feature selection techniques applied in machine learning can help however they often provide naive or biased results.ResultsAn ensemble feature selection strategy for miRNA signatures is proposed. miRNAs are chosen based on consensus on feature relevance from high-accuracy classifiers of different typologies. This methodology aims to identify signatures that are considerably more robust and reliable when used in clinically relevant prediction tasks. Using the proposed method, a 100-miRNA signature is identified in a dataset of 8023 samples, extracted from TCGA. When running eight-state-of-the-art classifiers along with the 100-miRNA signature against the original 1046 features, it could be detected that global accuracy differs only by 1.4%. Importantly, this 100-miRNA signature is sufficient to distinguish between tumor and normal tissues. The approach is then compared against other feature selection methods, such as UFS, RFE, EN, LASSO, Genetic Algorithms, and EFS-CLA. The proposed approach provides better accuracy when tested on a 10-fold cross-validation with different classifiers and it is applied to several GEO datasets across different platforms with some classifiers showing more than 90% classification accuracy, which proves its cross-platform applicability.ConclusionsThe 100-miRNA signature is sufficiently stable to provide almost the same classification accuracy as the complete TCGA dataset, and it is further validated on several GEO datasets, across different types of cancer and platforms. Furthermore, a bibliographic analysis confirms that 77 out of the 100 miRNAs in the signature appear in lists of circulating miRNAs used in cancer studies, in stem-loop or mature-sequence form. The remaining 23 miRNAs offer potentially promising avenues for future research.
Phylogenomics resolves major relationships and reveals significant diversification rate shifts in the evolution of silk moths and relatives
Authors: Hamilton C. A. , St Laurent R. A. , Dexter K. , Kitching I. J. , Breinholt J. W. , Zwick A. , Timmermans M. J. T. N. , Barber J. R. , Kawahara A. Y. 
Published: September 2019

AbstractBackgroundSilkmoths and their relatives constitute the ecologically and taxonomically diverse superfamily Bombycoidea, which includes some of the most charismatic species of Lepidoptera. Despite displaying spectacular forms and diverse ecological traits, relatively little attention has been given to understanding their evolution and drivers of their diversity. To begin to address this problem, we created a new Bombycoidea-specific Anchored Hybrid Enrichment (AHE) probe set and sampled up to 571 loci for 117 taxa across all major lineages of the Bombycoidea, with a newly developed DNA extraction protocol that allows Lepidoptera specimens to be readily sequenced from pinned natural history collections.ResultsThe well-supported tree was overall consistent with prior morphological and molecular studies, although some taxa were misplaced. The bombycid Arotros Schaus was formally transferred to Apatelodidae. We identified important evolutionary patterns (e.g., morphology, biogeography, and differences in speciation and extinction), and our analysis of diversification rates highlights the stark increases that exist within the Sphingidae (hawkmoths) and Saturniidae (wild silkmoths).ConclusionsOur study establishes a backbone for future evolutionary, comparative, and taxonomic studies of Bombycoidea. We postulate that the rate shifts identified are due to the well-documented bat-moth “arms race”. Our research highlights the flexibility of AHE to generate genomic data from a wide range of museum specimens, both age and preservation method, and will allow researchers to tap into the wealth of biological data residing in natural history collections around the globe.
Alternative methods improve the accuracy of genomic prediction using information from a causal point mutation in a dairy sheep model
Authors: Oget Claire , Teissier Marc , Astruc Jean-Michel , Tosser-Klopp Gwenola , Rupp Rachel 
Published: September 2019

AbstractBackgroundGenomic evaluation is usually based on a set of markers assumed to be linked with causal mutations. Selection and precise management of major genes and the remaining polygenic component might be improved by including causal polymorphisms in the evaluation models. In this study, various methods involving a known mutation were used to estimate prediction accuracy. TheSOCS2gene, which influences body growth, milk production and somatic cell scores, a proxy for mastitis, was studied as an example in dairy sheep.MethodsThe data comprised 1,503,148 phenotypes and 9844 54K SNPs genotypes. TheSOCS2SNP was genotyped for 4297 animals and imputed in the above 9844 animals. Breeding values and their accuracies were estimated for each of nine traits by using single-step approaches. Pedigree-based BLUP, single-step genomic BLUP (ssGBLUP) involving the 54K ovine SNPs chip, and four weighted ssGBLUP (WssGBLUP) methods were compared. In WssGBLUP methods, weights are assigned to SNPs depending on their effect on the trait. The ssGBLUP and WssGBLUP methods were again tested after including theSOCS2causal mutation as a SNP. Finally, the Gene Content approach was tested, which uses a multiple-trait model that considers theSOCS2genotype as a trait.ResultsEBV accuracies were increased by 14.03% between the pedigree-based BLUP and ssGBLUP methods and by 3.99% between ssGBLUP and WssGBLUP. Adding theSOCS2SNP to ssGBLUP methods led to an average gain of 0.26%. Construction of the kinship matrix and estimation of breeding values was generally improved by placing emphasis on SNPs in regions with a strong effect on traits. In the absence of chip data, the Gene Content method, compared to pedigree-based BLUP, efficiently accounted for partial genotyping information onSOCS2as accuracy was increased by 6.25%. This method also allowed dissociation of the genetic component due to the major gene from the remaining polygenic component.ConclusionsCausal mutations with a moderate to strong effect can be captured with conventional SNP chips by applying appropriate genomic evaluation methods. The Gene Content method provides an efficient way to account for causal mutations in populations lacking genome-wide genotyping.
Uncovering sperm metabolome to discover biomarkers for bull fertility
Authors: Menezes E. B. , Velho A. L. C. , Santos F. , Dinh T. , Kaya A. , Topper E. , Moura A. A. , Memili E. 
Published: September 2019

AbstractBackgroundSubfertility decreases the efficiency of the cattle industry because artificial insemination employs spermatozoa from a single bull to inseminate thousands of cows. Variation in bull fertility has been demonstrated even among those animals exhibiting normal sperm numbers, motility, and morphology. Despite advances in research, molecular and cellular mechanisms underlying the causes of low fertility in some bulls have not been fully elucidated. In this study, we investigated the metabolic profile of bull spermatozoa using non-targeted metabolomics. Statistical analysis and bioinformatic tools were employed to evaluate the metabolic profiles high and low fertility groups. Metabolic pathways associated with the sperm metabolome were also reported.ResultsA total of 22 distinct metabolites were detected in spermatozoa from bulls with high fertility (HF) or low fertility (LF) phenotype. The major metabolite classes of bovine sperm were organic acids/derivatives and fatty acids/conjugates. We demonstrated that the abundance ratios of five sperm metabolites were statistically different between HF and LF groups including gamma-aminobutyric acid (GABA), carbamate, benzoic acid, lactic acid, and palmitic acid. Metabolites with different abundances in HF and LF bulls had also VIP scores of greater than 1.5 and AUC- ROC curves of more than 80%. In addition, four metabolic pathways associated with differential metabolites namely alanine, aspartate and glutamate metabolism, β-alanine metabolism, glycolysis or gluconeogenesis, and pyruvate metabolism were also explored.ConclusionsThis is the first study aimed at ascertaining the metabolome of spermatozoa from bulls with different fertility phenotype using gas chromatography-mass spectrometry. We identified five metabolites in the two groups of sires and such molecules can be used, in the future, as key indicators of bull fertility.