bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of intravenous administration of magnesium sulfate in propofol-based sedation for ERCP in elderly patients: a randomized, double-blind, placebo-controlled study
Authors: Chen Jie , Qian Ke , Liu Chun-hong , Li Xiao-li , Chen Yan , Wang Jin-quan 
Published: July 2023

Abstract
Background
Propofol-based sedations are widely used in elderly patients for endoscopic retrograde cholangiopancreatography (ERCP) procedure, but respiratory depression and cardiovascular adverse events commonly occur. Magnesium administered intravenously can alleviate pain and decrease propofol requirements during surgery. We hypothesized that intravenous magnesium was used as adjuvant to propofol might be beneficial in elderly patients undergoing ERCP procedures.

Methods
Eighty patients aged from 65 to 79 years who were scheduled for ERCP were enrolled. All patients were intravenously administered 0.1 µg/kg sufentanil as premedication. The patients were randomized to receive either intravenous magnesium sulfate 40 mg/kg (group M, n = 40) or the same volume of normal saline (group N, n = 40) over 15 min before the start of sedation. Intraoperative sedation was provided by propofol. Total propofol requirement during ERCP was the primary outcome.

Results
The total propofol consumption were reduced by 21.4% in the group M compared with the group N (151.2 ± 53.3 mg vs. 192.3 ± 72.1 mg, P = 0.001). The incidences of respiratory depression episodes and involuntary movement were less in the group M than those in the group N (0/40 vs. 6/40, P = 0.011; 4/40 vs. 11/40, P = 0.045; respectively). In the group M, the patients experienced less pain than those in the group N at 30 min after the procedure (1 [0–1] vs. 2 [1–2], P < 0.001). Correspondingly, the patients’ satisfaction was clearly higher in the group M (P = 0.005). There was a tendency towards lower intraoperative heart rate and mean arterial pressure in group M.

Conclusions
A single bolus of 40 mg/kg of intravenous magnesium can significantly reduce propofol consumption during ERCP, with higher sedation success and lower adverse events.

Trial Registration
ID UMIN000044737. Registered 02/07/2021.
Postpartum care needs assessment: women’s understanding of postpartum care, practices, barriers, and educational needs
Authors: Adams Yenupini Joyce , Miller Michelle Louise , Agbenyo John Stephen , Ehla Ethel Emefa , Clinton Grace Anne 
Published: July 2023

Abstract
Background
Complications in the postpartum period pose substantial risks to women and can result in significant maternal morbidity and mortality. However, there is much less attention on postpartum care compared to pregnancy and childbirth. The goal of this study was to gather information on women’s knowledge of postpartum care and complications, recovery practices after childbirth, perceived barriers to receiving care during the postpartum period, and educational needs in four health centers. The findings can inform the development of appropriate curriculum and interventions for postnatal care education in similar settings.

Methods
A descriptive qualitative study design was employed. Eight focus group discussions were conducted among 54 postpartum women who delivered in four health centers in Sagnarigu District in Tamale, Ghana. Audio recordings of focus group data were transcribed and translated, and thematic analysis was conducted.

Results
There were six main themes that emerged from the focus group discussions: 1) baby focused postpartum care; 2) postpartum practices; 3) inadequate knowledge ofpostpartum danger signs; 4) barriers to accessing postpartum care 5) experiences of poor mental health; and 6) need for postpartum education.

Conclusions
Postpartum care for women in this study was primarily perceived as care of the baby post-delivery and missing key information on physical and mental health care for the mother. This can result in poor adjustment postpartum and critically, a lack of knowledge on danger signs for common causes of morbidity and mortality in the postpartum period. Future research needs to understand how to communicate important information on postpartum mental and physical health to better protect mothers in the region.
Multidimensional assessment of infant, parent and staff outcomes during a family centered care enhancement project in a tertiary neonatal intensive care unit: study protocol of a longitudinal cohort study
Authors: Schuler Rahel , Woitschitzky Lea , Eiben Carola , Beck Judith , Jägers Alena , Windhorst Anita , Kampschulte Birgit , Petzinger Jutta , Waitz Markus , Kilsdonk Monique Oude Reimer-van , Neubauer Bernd A. , Zimmer Klaus-Peter , Ehrhardt Harald , Brosig Burkhard , Mihatsch Walter A. 
Published: July 2023

Abstract
Background
The therapeutic advances and progress in the care for preterm infants have enabled the regular survival of very immature infants. However, the high burden of lifelong sequelae following premature delivery constitutes an ongoing challenge. Regardless of premature delivery, parental mental health and a healthy parent–child relationship were identified as essential prerogatives for normal infant development. Family centered care (FCC) supports preterm infants and their families by respecting the particular developmental, social and emotional needs in the Neonatal Intensive Care Unit. Due to the large variations in concepts and goals of different FCC initiatives, scientific data on the benefits of FCC for the infant and family outcome are sparse and its effects on the clinical team need to be elaborated.

Methods
This prospective single centre longitudinal cohort study enrols preterm infants ≤ 32 + 0 weeks of gestation and/or birthweight ≤ 1500 g and their parents at the neonatal department of the Giessen University Hospital, Giessen, Germany. Following a baseline period, the rollout of additional FCC elements is executed following a stepwise 6-months approach that covers the NICU environment, staff training, parental education and psychosocial support for parents. Recruitment is scheduled over a 5.5. year period from October 2020 to March 2026. The primary outcome is corrected gestational age at discharge. Secondary infant outcomes include neonatal morbidities, growth, and psychomotor development up to 24 months. Parental outcome measures are directed towards parental skills and satisfaction, parent-infant-interaction and mental health. Staff issues are elaborated with particular focus on the item workplace satisfaction. Quality improvement steps are monitored using the Plan- Do- Study- Act cycle method and outcome measures cover the infant, the parents and the medical team. The parallel data collection enables to study the interrelation between these three important areas of research. Sample size calculation was based on the primary outcome.

Discussion
It is scientifically impossible to allocate improvements in outcome measures to individual enhancement steps of FCC that constitutes a continuous change in NICU culture and attitudes covering diverse areas of change. Therefore, our trial is designed to allocate childhood, parental and staff outcome measures during the stepwise changes introduced by a FCC intervention program.

Trial registration
Clinicaltrials.gov, trial registration number NCT05286983, date of registration 03/18/2022, retrospectively registered, http://clinicaltrials.gov.
Effect of Orlistat on anthropometrics and metabolic indices in children and adolescents: a systematic review and meta-analysis
Authors: Nikniaz Zeinab , Nikniaz Leila , Farhangi Mahdieh Abbasalizad , Mehralizadeh Hossein , Salekzamani Shabnam 
Published: July 2023

Abstract
Background
Childhood obesity is one of the main concerns of public health. Considering its long-term adverse health effect, various studies investigated the effect of drug therapy on anthropometric parameters and provided mixed results. In this systematic review and meta-analysis, we aimed to determine the effect of Orlistat on anthropometrics and biochemical parameters in children and adolescents.

Materials and methods
The databases of PubMed, Scopus, and Web of Science were searched until September 2022. Experimental and semi-experimental studies were included if they evaluated the effect of Orlistat on obesity-related parameters in children and reported the before and after anthropometric values. A revised Cochrane risk-of-bias (Rob2) was used to evaluate the methodological quality. STATA software version 16.0 was used for the meta-analysis of the random-effect model.

Results
Of 810 articles retrieved in the initial search, four experimental and two semi-experimental studies were selected for systematic review. The result of the meta-analysis of experimental studies indicated the significant effect of Orlistat on waist circumference (SMD: -0.27, 95% CI: -0.47, -0.07) and serum insulin level (SMD: -0.89, 95% CI: -1.52, 0.26). However, there were no significant effects of orlistat on body weight, body mass index, lipid profile, and serum glucose level.

Conclusion
The present meta-analysis showed the significant effect of Orlistat on the reduction of waist circumference and insulin level in overweight and obese adolescents. However, due to the paucity of studies included in the meta-analysis, more prospective studies with longer duration and more sample sizes will be needed in this age group.
Morphological evaluation of gonial and antegonial regions in bruxers on panoramic radiographic images
Authors: Unal Erzurumlu Zerrin , Sadik Elif , Gokkurt Busra Nur , Ozbey Furkan , Erzurumlu Kerem , Kasko Arici Yeliz 
Published: July 2023

Abstract
Background
This is the first study to report both cortical and trabecular bone evaluation of mandibles in bruxers, within the knowledge of the authors. The purpose of this study was to evaluate the effects of bruxism on both the cortical and the trabecular bone in antegonial and gonial regions of the mandible, which is the attachment of the masticatory muscles, by using panoramic radiographic images.

Methods
In this study, the data of 65 bruxer (31 female, 34 male) and 71 non-bruxer (37 female, 34 male) young adult patients (20–30 years) were evaluated. Antegonial Notch Depth (AND), Antegonial-Index (AI), Gonial-Index, Fractal Dimension (FD) and Bone Peaks (BP) were evaluated on panoramic radiographic images. The effects of the bruxism, gender and side factors were investigated according to these findings. The statistical significance level was set atP ≤ 0.05.

Results
The mean AND of bruxers (2.03 ± 0.91) was significantly higher than non-bruxers (1.57 ± 0.71; P < 0.001). The mean AND of males was significantly higher than females on both sides (P < 0.05). The mean AI of bruxers (2.95 ± 0.50) was significantly higher than non-bruxers (2.77 ± 0.43; P = 0.019). The mean FD on each side was significantly lower in bruxers than in non-bruxers (P < 0.05). The mean FD of males (1.39 ± 0.06) was significantly higher than females (1.37 ± 0.06; P = 0.049). BP were observed in 72.5% of bruxers and 27.5% of non-bruxers. The probability of existing BP, in bruxers was approximately 3.4 times higher than in non-bruxers (P = 0.003), in males was approximately 5.5 times higher than in females (P < 0.001).

Conclusion
According to the findings of this study, the morphological differences seen in cortical and trabecular bone in the antegonial and gonial regions of the mandible in bruxers can be emphasized as deeper AND, higher AI, increased of existing BPs, and lower FD, respectively. The appearance of these morphological changes on radiographs may be useful for indication and follow-up of bruxism. Gender is an effective factor on AND, existing BP and FD.
Effectiveness of a virtual program for OSCE preparation during COVID-19: a descriptive and repeated cross-sectional study among nursing students
Authors: Avraham Rinat , Cohen Tanya , Artzi-Medvedik Rada , Hurvitz Nancy , Cohen Odeya 
Published: July 2023

Abstract
Background
Despite the prevalence of distance learning during COVID-19, conducting clinical training for nursing students remains challenging. In compliance with social-distancing restrictions, a Zoom-based virtual OSCE preparation program for nursing students was designed, and it included clinical skills. The aims of this study were to assess nursing students’ satisfaction with a virtual program for Objective Structured Clinical Examination (OSCE) preparation, and to evaluate its learning outcomes measured by OSCE scores as compared to those of in-person preparation programs.

Methods
A descriptive and repeated cross-sectional study was designed. Students’ satisfaction with the virtual program was based on a post-course survey and personal reflections. OSCE scores of graduates of the virtual program (n = 82) tested in 2021 were compared to those of 337 graduates of in-person programs tested in 2017–2020.

Results
A post-program survey revealed that 88% of the students in 2021 were satisfied with the virtual program and felt it prepared them properly for the OSCE (26% agree and 62% strongly agree). No significant differences were found between OSCE scores following the virtual program conducted in 2021 and scores following in-person programs conducted in 2017–2020.

Conclusions
This study suggests that nursing education can benefit from integrating virtual programs which incorporate clinical practices into the curricula, without harming student competency. The study results may address the problem of maintaining clinical practices in a time of limited accessibility, and in settings of low resources. It is important to expand the investigation to long-term impact of virtual training programs on nursing students’ competencies.
Enhancing the interferon-γ release assay through omission of nil and mitogen values
Authors: Jung Yun Jung , Park Ji Eun , Park Ji Won , Lee Keu Sung , Chung Wou Young , Park Joo Hun , Sheen Seung Soo , You Seulgi , Sun Joo Sung , Park Kyung Joo , Kim Youn Jung , Park Kwang Joo 
Published: July 2023

Abstract
Purpose
To address the limited utility of the interferon (IFN)-γ release assay (IGRA) caused by its variability and inconsistency.

Methods
This retrospective cohort study was based on data obtained between 2011 and 2019. QuantiFERON-TB Gold-In-Tube was used to measure IFN-γ levels in nil, tuberculosis (TB) antigen, and mitogen tubes.

Results
Of 9,378 cases, 431 had active TB. The non-TB group comprised 1,513 IGRA-positive, 7,202 IGRA-negative, and 232 IGRA-indeterminate cases. Nil-tube IFN-γ levels were significantly higher in the active TB group (median = 0.18 IU/mL; interquartile range: 0.09–0.45 IU/mL) than in the IGRA-positive non-TB (0.11 IU/mL; 0.06–0.23 IU/mL) and IGRA-negative non-TB (0.09 IU/mL; 0.05–0.15 IU/mL) groups (P < 0.0001). From receiver operating characteristic analysis, TB antigen tube IFN-γ levels had higher diagnostic utility for active TB than TB antigen minus nil values. In a logistic regression analysis, active TB was the main driver of higher nil values. In the active TB group, after reclassifying the results based on a TB antigen tube IFN-γ level of 0.48 IU/mL, 14/36 cases with negative results and 15/19 cases with indeterminate results became positive, while 1/376 cases with positive results became negative. Overall, the sensitivity for detecting active TB improved from 87.2 to 93.7%.

Conclusion
The results of our comprehensive assessment can aid in IGRA interpretation. Since nil values are governed by TB infection rather than reflecting background noise, TB antigen tube IFN-γ levels should be used without subtracting nil values. Despite indeterminate results, TB antigen tube IFN-γ levels can be informative.
CXCL5 suppression recovers neovascularization and accelerates wound healing in diabetes mellitus
Authors: Chen Ching , Lin Liang-Yu , Chen Jaw-Wen , Chang Ting-Ting 
Published: July 2023

Abstract
Background
Higher chemokine C-X-C motif ligand 5 (CXCL5) level was observed in type 2 diabetes mellitus (DM) patients; however, its role in diabetic vasculopathy was not clarified. This study aimed to explore the impacts and mechanistic insights of CXCL5 in neovasculogenesis and wound healing in DM.

Methods
Endothelial progenitor cells (EPCs) and human aortic endothelial cells (HAECs) were used in vitro. Streptozotocin-induced diabetic mice and Leprdb/JNarl mice were used as type 1 and type 2 DM models. Moreover, CXCL5 knockout mice were used to generate diabetic mice. Hindlimb ischemia surgery, aortic ring assays, matrigel plug assay, and wound healing assay were conducted.

Results
CXCL5 concentrations were increased in plasma and EPCs culture medium from type 2 DM patients. CXCL5 neutralizing antibody upregulated vascular endothelial growth factor (VEGF)/stromal cell-derived factor-1 (SDF-1) and promoted cell function in EPCs from type 2 DM patients and high glucose-treated EPCs from non-DM subjects as well as HAECs. CXCL5 directly up-regulated interleukin (IL)-1β/IL-6/tumor necrosis factor-α and down-regulated VEGF/SDF-1 via ERK/p65 activation through chemokine C-X-C motif receptor 2 (CXCR2). CXCL5 neutralizing antibody recovered the blood flow after hindlimb ischemia, increased circulating EPC number, and enhanced VEGF and SDF-1 expression in ischemic muscle. CXCL5 suppression promoted neovascularization and wound healing in different diabetic animal models. The above observation could also be seen in streptozotocin-induced CXCL5 knockout diabetic mice.

Conclusions
CXCL5 suppression could improve neovascularization and wound healing through CXCR2 in DM. CXCL5 may be regarded as a potential therapeutic target for vascular complications of DM.
An optimized GATK4 pipeline for Plasmodium falciparum whole genome sequencing variant calling and analysis
Authors: Niaré Karamoko , Greenhouse Bryan , Bailey Jeffrey A. 
Published: July 2023

Abstract
Background
Accurate variant calls from whole genome sequencing (WGS) of Plasmodium falciparum infections are crucial in malaria population genomics. Here a falciparum variant calling pipeline based on GATK version 4 (GATK4) was optimized and applied to 6626 public Illumina WGS samples.

Methods
Control WGS and accurate PacBio assemblies of 10 laboratory strains were leveraged to optimize parameters that control the heterozygosity, local assembly region size, ploidy, mapping and base quality in both GATK HaplotypeCaller and GenotypeGVCFs. From these controls, a high-quality training dataset was generated to recalibrate the raw variant data.

Results
On current high-quality samples (read length = 250 bp, insert size = 405–524 bp), the optimized pipeline shows improved sensitivity (86.6 ± 1.7% for SNPs and 82.2 ± 5.9% for indels) compared to the default GATK4 pipeline (77.7 ± 1.3% for SNPs; and 73.1 ± 5.1% for indels, adjusted P < 0.001) and previous variant calling with GATK version 3 (GATK3, 70.3 ± 3.0% for SNPs and 59.7 ± 5.8% for indels, adjusted P < 0.001). Its sensitivity on simulated mixed infection samples (80.8 ± 6.1% for SNPs and 78.3 ± 5.1% for indels) was again improved relative to default GATK4 (68.8 ± 6.0% for SNPs and 38.9 ± 0.7% for indels, adjusted, adjusted P < 0.001). Precision was high and comparable across all pipelines on each type of data tested. The resulting combination of high-quality SNPs and indels increases the resolution of local population population structure detection in sub-Saharan Africa. Finally, increasing ploidy improves the detection of drug resistance mutations and estimation of complexity of infection.

Conclusions
Overall, this study provides an optimized falciparum GATK4 pipeline resource for variant calling which should help improve genomic studies of malaria.
Regularized linear discriminant analysis via a new difference-of-convex algorithm with extrapolation
Authors: Wang Chunyan , Wang Wenjie , Li Mengzhen 
Published: July 2023

AbstractIn this paper, we transform the classical linear discriminant analysis (LDA) into a smooth difference-of-convex optimization problem. Then, a new difference-of-convex algorithm with extrapolation is introduced and the convergence of the algorithm is established. Finally, for a face recognition problem, the proposed algorithm achieves better classification performance compared with several current algorithms in the literature.
Role of early childhood educators’ demographic characteristics and perceived work environment in implementation of a preschool health promotion intervention
Authors: Gustafsson Jasmine , Ray Carola , Lehto Elviira , Roos Eva , Lehto Reetta 
Published: July 2023

Abstract
Background
Research has indicated that the effectiveness of intervention programs is affected by how well these programs are implemented, but key gaps remain in our understanding of the factors that promote or inhibit implementation. This study examined how demographic characteristics and perceived work environment among early childhood educators were associated with implementation outcomes of the Increased Health and Wellbeing in Preschools (DAGIS) intervention, which was conducted as a cluster randomized trial.

Methods
Participants included 101 educators from 32 intervention preschool classrooms. Data were analyzed at the classroom level, as the DAGIS intervention was delivered in preschool classrooms consisting of several educators instead of individual implementers. Linear regression was used to estimate the associations of educators’ demographic characteristics and perceived work environment with different aspects of implementation (i.e., dose delivered; dose received – exposure; dose received – satisfaction; and perceived quality, as well as a total sum score based on these four dimensions). Municipality was controlled in the adjusted models.

Results
Findings indicated that having a higher proportion of educators with a Bachelor’s or Master’s degree in education within the classroom was associated with higher dose received – exposure and higher total degree of implementation, and the significance of the models was unaffected by adjustment for municipality. Moreover, having a higher proportion of educators younger than 35 years within the classroom was associated with higher dose received – exposure. However, the association was non-significant when adjusted for municipality. No other educator factor (i.e., work experience in years and perceived support from coworkers, group work, and innovative climate) predicted implementation outcomes.

Conclusions
Higher educational attainment and younger age among educators at the classroom level were associated with higher scores for some of the implementation outcomes. Educators’ work experience in years at the current preschool and in early childhood education, support from coworkers, group work, and innovative climate were not significantly associated with any implementation outcomes. Future research should explore ways to improve educators’ implementation of interventions aimed at promoting children’s health behaviors.