bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of clinical risk factors on bacteriological profile in neonatal sepsis: A descriptive cross-sectional study at a tertiary care center, Nepal
Authors: Chaurasiya Prem Shankar , Singh Umesh Kumar , Yadav Bibek Kumar , Chaurasiya Ajay Kumar , Shah Poonam Rani 
Published: September 2023

Background: Neonatal sepsis is an important cause of neonatal mortality and morbidity worldwide. The common causative bacteria are Group B Streptococci, Escherichia coli, Listeria monocytogenes, Staphylococcus, Enterococci, Klebsiella, and Enterobacter. The risk factors are premature rupture of membrane, meconium-staining, foul-smelling amniotic fluid, low birth weight, prematurity, low Apgar score, mode of deliveries, and mechanical ventilation. The treatment for neonatal sepsis is a beta-lactam antibiotic combined with an aminoglycoside. The aim of the study was to find the incidence and factors associated with culture-positive neonatal sepsis, and common bacterial isolates. Methods: A hospital-based retrospective cross-sectional study was conducted among 385 neonates admitted with neonatal sepsis at Narayani Central Hospital, Birgunj from July 2021 to July 2022. Ethical approval was taken from the Institutional Review Committee, Nepalese Army Institute of Health Sciences, Nepal (Reference no. 669/ 2022). A convenient sampling was followed. Data regarding different clinical factors were collected in a structured questionnaire. The data was entered and analyzed through SPSS version 22.0 using a binary regression model. Results: The study revealed the mean age, weight, and gestational age of neonates were 2.79kg±0.55kg, 6.19±3.87 days, and 37.64±1.27 weeks respectively. Out of the total cases, 26.5% (102) were culture-positive neonatal sepsis. Staph aureus was the predominant pathogen (40, 39.2%) followed by Klebsiella (25, 24.5%) and Acinetobacter (16, 15.7%). The Premature rupture of membrane (OR=4.32, 95% CI: 2.20–8.47) and Mothers with foul-smelling amniotic fluid (OR=3.03, 95% CI: 1.32–6.92) are statistically associated with culture-positive neonatal sepsis. Conclusion: The factors responsible for the high burden of neonatal sepsis such as premature rupture of membrane, foul-smelling amniotic fluid, prematurity, low birth weight, unhygienic home delivery practices, can be avoided dramatically. The role of pediatricians, nurses, hospital administrations and general awareness among mothers about hygienic practices during parturition are essential to minimize neonatal mortality and morbidity.
Effect of epigallocatechin gallate nanoemulsion on submandibular salivary glands following application of botulinum neurotoxins in albino rats: potential therapeutic effects
Authors: Wahba Omneya , Elhelbawy Nahla Gamaeldin , El-Borady Ola M. , Labah Doaa Ahmed , Essa Ahmed Abdelaziz Mohamed 
Published: September 2023

Background: Injecting botulinum neurotoxin (BoNT) into the salivary glands is a common treatment for certain diseases. Green tea's active compound, epigallocatechin-3-gallate (EGCG), has been linked to a variety of health benefits, including the reduction of free radicals and inflammation. This study compared the effects of BoNT and BoNT/EGCG on the submandibular salivary glands (SMG) histology and ultrastructure. Methods: Both BoNT and BoNT/EGCG nanoemulsions were injected into the submandibular salivary glands (SMGs) in adult male albino rats, which were then euthanized, and the right SMGs were thoroughly dissected and prepared for histological, immunohistochemical, and transmission electron microscopic analysis. Results: When compared to the BoNT group, the BoNT/EGCG nanoemulsion group significantly improved SMG acinar and ductal cells using both H&E and immunohistochemical stainings. Ultrastructural findings of the BoNT/EGCG nanoemulsion group revealed marked improvement in the SMG structure, almost normal acini, and striated ducts. Conclusion: Salivary gland histological structures are significantly altered after BoNT administration, but the addition of EGCG causes only minor alterations and can be used to treat hyperfunction.
Towards successful aging classification using machine learning algorithms
Authors: Zaccheus Jesuloluwa , Atogwe Victoria , Oyejide Ayodele , Salau Ayodeji Olalekan 
Published: September 2023

Background: Aging is a significant risk factor for a majority of chronic diseases and impairments. Increased medical costs brought about by the increasing aging population in the world increases the strain on families and communities. A positive and qualitative perspective on aging is successful aging (SA). Successful aging refers to the state of being free from diseases or impairments that hinder normal functioning, as observed from a biological perspective. This differs from typical aging, which is associated with a gradual decrease in both physical and cognitive capacities as individuals grow older. Methods: In this study, the geriatric data acquired from the Afe Babalola University Multi-System Hospital, Ado-Ekiti was initially prepared, and three fundamental machine learning (ML) techniques such as artificial neural networks, support vector machines, and Naive Bayes—were then constructed using the data from a sample of 2000 individuals. The Rowe and Kahn Model determined that the dataset was SA based on factors such as the absence of fewer than or equivalent to two diseases, quality of life, nutrition, and capacity for everyday activities. Results: According to the experimental findings, the predictive network Artificial Neural Network (ANN) performed better than other models in predicting SA with 100% accuracy, 100% sensitivity, and 100% precision. Conclusions: The results show that ML techniques are useful in assisting social and health policymakers in their decisions on SA. The presented ANN-based method surpasses the other ML models when it comes to classifying people into SA and non-SA categories.
Bellavere's scoring in chronic kidney disease: A study protocol
Authors: Toshniwal Saket , Kumar Sunil , Acharya Sourya 
Published: September 2023

Background:Chronic kidney disease (CKD) refers to abnormalities in kidney structure and/or function for more than three months; cardiac autonomic neuropathy (CAN) is an indicator of cardiovascular death due to various abnormalities such as cardiac arrhythmias.Heart rate variability (HRV) is an important component of CAN and has been shown to be related to CAN. This study aims to evaluate cardiac autonomic neuropathy at different stages of CKD with the Bellavere score and to correlate CAN with lipids, plasma, electrolytes and blood pressure in patients with CKD at different stages.Methods:Consent of 95 patients who met the diagnosis of chronic kidney disease according to Modification of Diet in Renal Disease (MDRD) criteria were included in the study. All subjects will have blood tests for lipids, anaemia, and electrolytes. All participants' blood pressure will be monitored.All subjects will also be scored based on the Bellevere scoring system, the Valsava ratio, and the 30:15 ratio. Data will be analyzed using SPSS version 21 and appropriate statistical tests will be used depending on the study objectives and the data collected.Expected results:Based on the literature review and previous studies, the results of this study should demonstrate the relationship between CAN and CKD at this stage. The study also expects to find higher Bellavere scores in patients with different stages of CKD.
Assessing pooled prevalence of exclusive breastfeeding practice and addressing principal barriers to its practice in North African countries: A systematic review and meta-analysis
Authors: Nouira Mariem , Souayeh Nesrine , Arfa Sondess , Maatouk Mohamed , Hasnaoui Anis , Bouchahda Haifa , Ennigrou Samir 
Published: September 2023

Background: Exclusive breastfeeding (EBF) is a public health priority globally. According to the World Health Organisation (WHO), the global prevalence of EBF during the first six months of life remains low particularly in low- and middle-income countries. In this systematic review (SR) and meta-analysis (MA) we examine the existing evidence of the pooled prevalence and determinants of EBF during the first 6 months of infants’ lives in North African (NA) countries. Methods: This SR and MA followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. International databases were systematically searched. Inclusion criteria included studies conducted among mothers in NA countries (Tunisia, Algeria, Morocco, Libya, Egypt, Sudan) on breastfeeding prevalence. Meta-analyses were conducted using R (version 4.2.3). Results: 16 studies with a total of 7,849 participants were included in the analysis. The global pooled prevalence of EBF during the first six months in NA countries was 29.0% (CI95% [18.0; 42.0]) with heterogenous results (Tau2 = 1.41, I2 = 99%, p < 0.01). Tunisia had the lowest prevalence of EBF (11%) while Sudan (63%) and Morocco (48%) had the highest. The prevalence of EBF until the first six months of life (among infants aged at least 6 months) was 30.0% (CI95% [14.0; 52.0]). Barriers to EBF practice were examined, including mother's educational level, maternal employment, and mode of delivery. However no statistically significant factors were identified. Conclusion: EBF in NA countries falls below the recommendations of the WHO. Concerted efforts and adoption of a multi-dimensional approach is needed to promote and support EBF practices. EBF rates in NA vary widely, and efforts to promote and support this practice need to be context-specific and tailored to each country's unique challenges and opportunities. Implementation of Baby-Friendly Hospital Initiatives can contribute to the improvement of breastfeeding practices in this region.
Lessons Learned in Applying Decision Analysis to Natural Resource Management for High-Stakes Issues Surrounded by Uncertainty
Authors: Robinson Kelly F. , DuFour Mark R. , Fischer Jason L. , Herbst Seth J. , Jones Michael L. , Nathan Lucas R. , Newcomb Tammy J. 
Published: September 2023

Management agencies are tasked with difficult decisions for conservation and management of natural resources. These decisions are difficult because of ecological and social uncertainties, the potential for multiple decision makers from multiple jurisdictions, and the need to account for the diverse values of stakeholders. Decision analysis provides a framework for accounting for these difficulties when making conservation and management decisions. We discuss the benefits of the application of decision analysis for these types of issues and provide insights from three case studies from the Laurentian Great Lakes. These case studies describe applications of decision analysis for decisions within an agency (management of double-crested cormorant), among agencies (response to invasive grass carp), and among agencies and stakeholders (sustainable fisheries harvest management). These case studies provide insight into the ways that decision analysis can be useful for conservation and management of natural resources, but we also highlight future needs for decision making for these resources. In particular, applications of decision analysis for conservation and management would benefit from enhanced integration of both ecological and social science, inclusion of a broader base of stakeholders and rightsholders, and better educational opportunities surrounding decision analysis for undergraduates and graduate students of natural resources management programs. Specific lessons from our experiences include the importance of establishing trust and transparency early through the formation of a working group, collaboratively defining objectives and evaluating uncertainties, risks, and tradeoffs, and implementing participatory modeling processes with an independent facilitator with appropriate quantitative skills. History: This paper has been accepted for the Decision Analysis Special Issue on Decision Analysis to Advance Environmental Sustainability. Funding: This study was supported by Great Lakes Restoration Initiative funding provided to the Michigan Department of Natural Resources [Grant F16AP01094] from the U.S. Fish and Wildlife Service and sub-awarded to Michigan State University.
Evaluation of the analytical and clinical performance of a new high-sensitivity cardiac troponin I assay: hs-cTnI (CLIA) assay
Authors: Li Ling , Shu Xin , Zhang Litao , Xu Ao , Yang Juan , Jing Yisha , Wang Hui , Zhang Zhenlu 
Published: September 2023

Abstract

Objectives
Cardiac troponin (cTn) is the key biomarker for diagnosis of acute coronary syndrome (ACS). We performed a complete assessment of the high-sensitivity cardiac troponin I (hs-cTnI) (CLIA) assay on the analytical performance and clinical diagnostic performance, which was compared with Abbott ARCHITECT hs-cTnI assay.

Methods
Sex-specific 99th percentile upper reference limits (URLs) were determined from a healthy population of 424 males and 408 females. High-sensitivity performance was assessed by examining the imprecision at sex-specific URLs and the detectable results above LoD in a cohort of healthy population. The diagnostic performance of the hs-cTnI (CLIA) assay was validated in a population of 934 patients with suspected ACS.

Results
The 99th percentile URLs were 15.3 ng/L for female, 31.3 ng/L for male and 24.2 ng/L for overall population. The total imprecision near the sex-specific 99th percentile URLs were <5 %. 76.74 % of females, 97.12 % of males and 86.69 % of overall population had cTnI values exceeding the LoD, which met the criteria of high-sensitivity troponin assay. No cross-reactivity or interference was identified. The diagnostic sensitivity, specificity, PPV, NPV, and AUC of hs-cTnI (CLIA) assay were 97.97 , 90.70, 79.02, 99.21 % and 0.9885, respectively, which were comparable to ARCHITECT hs-cTnI assay.

Conclusions
hs-cTnI (CLIA) assay is a high-sensitivity troponin I method with high precision, sensitivity and specificity. The clinical diagnostic performance of hs-cTnI (CLIA) is comparable to the established ARCHITECT hs-cTnI assay. Mindray’s hs-cTnI (CLIA) assay is an attractive alternative for diagnosis of myocardial infarction with a high level of accuracy and safety.
Amino acid sequence homology of monoclonal serum free light chain dimers and tissue deposited light chains in AL amyloidosis: a pilot study
Authors: Goldis Rivka , Kaplan Batia , Arad Michael , Dispenzieri Angela , Dasari Surendra , Kukuy Olga Lesya , Simon Amos J. , Dori Amir , Shavit-Stein Efrat , Ziv Tamar , Murray David , Kourelis Taxiarchis , Gertz Morie A. , Dominissini Dan , Magen Hila , Muchtar Eli 
Published: September 2023

Abstract

Objectives
Diagnosis of light chain amyloidosis (AL) requires demonstration of amyloid deposits in a tissue biopsy followed by appropriate typing. Previous studies demonstrated increased dimerization of monoclonal serum free light chains (FLCs) as a pathological feature of AL. To further examine the pathogenicity of FLC, we aimed at testing amino acid sequence homology between circulating and deposited light chains (LCs).

Methods
Matched tissue biopsy and serum of 10 AL patients were subjected to tissue proteomic amyloid typing and nephelometric FLC assay, respectively. Serum FLC monomers (M) and dimers (D) were analyzed by Western blotting (WB) and mass spectrometry (MS).

Results
WB of serum FLCs showed predominance of either κ or λ type, in agreement with the nephelometric assay data. Abnormal FLC M–D patterns typical of AL amyloidosis were demonstrated in 8 AL-λ patients and in one of two AL-κ patients: increased levels of monoclonal FLC dimers, high D/M ratio values of involved FLCs, and high ratios of involved to uninvolved dimeric FLCs. MS of serum FLC dimers showed predominant constant domain sequences, in concordance with the tissue proteomic amyloid typing. Most importantly, variable domain sequence homology between circulating and deposited LC species was demonstrated, mainly in AL-λ cases.

Conclusions
This is the first study to demonstrate homology between circulating FLCs and tissue-deposited LCs in AL-λ amyloidosis. The applied methodology can facilitate studying the pathogenicity of circulating FLC dimers in AL amyloidosis. The study also highlights the potential of FLC monomer and dimer analysis as a non-invasive screening tool for this disease.
Analysis of secondary metabolites in Xinjiang Morus nigra leaves using different extraction methods with UPLC-Q/TOF-MS/MS technology
Authors: Guo Xue-Li , Yang Lu , Yu Si-Lin , Zhang Ke , Wang Jin-Hui , Wang Hang-Yu 
Published: September 2023

Abstract

Objective
The differences in the chemical composition of Morus nigra (M. nigra) extracts from four different extraction methods, ultrasound-assisted extraction with pure water (WU), pure water decoction extraction (WD), ultrasonic-assisted extraction with formic acid water (FAU), and pure water heat reflux extraction (WHR), were identified using ultra-high performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry (UPLC-Q-TOF-MS/MS) technology.

Method
A Waters ACQUITY BEH C18 (1.7 μm, 2.1 mm × 100 mm) was used, with a column temperature of 45°C, mobile phase of methanol and 0.1% formic acid aqueous solution, and gradient elution with a flow rate of 0.4 mL/min. Detection was performed in positive and negative ion modes, and compounds were identified using Progenesis QI software and mass spectrometry data reported according to the literature and laboratory self-built databases of the Mulberry genus. Multivariate statistical techniques, such as principal component analysis and orthogonal partial least squares-discriminant analysis, were applied to differential cluster metabolic profiles and chemical components and to screen the differential chemical components of M. nigra leaves.

Results
There were significant differences in the chemical composition between WD and the other extraction methods of M. nigra leaves. A total of 13 differential metabolites (4 flavonoids, 3 organic acids, 3 phenylpropanoids, 2 alkaloids, and 1 trisaccharide) were identified.

Conclusion
The multivariate statistical analysis and UPLC-Q-TOF-MS/MS method established in this study identified the differential chemical constituents of Xinjiang M. nigra leaves using different extraction methods, which provides a basis for the quality control of M. nigra leaves, and provides basic data for revealing the influence of extraction methods on the synthesis and accumulation of M. nigra leaf metabolites, which has certain reference significance.
How do patients and care partners describe diagnostic uncertainty in an emergency department or urgent care setting?
Authors: DeGennaro Athena P. , Gonzalez Natalia , Peterson Susan , Gleason Kelly T. 
Published: September 2023

Abstract

Objectives
Little is known about how patients perceive diagnostic uncertainty. We sought to understand how patients and care partners perceive uncertainty in an emergency or urgent care setting, where making a final diagnosis is often not possible.

Methods
We administered a survey to a nationally representative panel on patient-reported diagnostic excellence in an emergency department or urgent care setting. The survey included items specific to perceived diagnostic excellence, visit characteristics, and demographics. We analyzed responses to two open-ended questions among those who reported uncertainty in the explanation they were given. Themes were identified using an inductive approach, and compared by whether respondents agreed or disagreed the explanation they were given was true.

Results
Of the 1,116 respondents, 106 (10 %) reported that the care team was not certain in the explanation of their health problem. Five themes were identified in the open-ended responses: poor communication (73 %), uncertainty made transparent (10 %), incorrect information provided (9 %), inadequate testing equipment (4 %), and unable to determine (4 %). Of the respondents who reported uncertainty, 21 % (n=22/106) reported the explanation of their problem given was not true.

Conclusions
The findings of this analysis suggest that the majority of patients and their care partners do not equate uncertainty with a wrong explanation of their health problem, and that poor communication was the most commonly cited reason for perceived uncertainty.
The Effects of Learning Design on Learning Activities Based on Higher Order Thinking Skills in Vocational High Schools
Authors: Rachmawati Dainita , Suharno Suharno , Roemintoyo Roemintoyo 
Published: September 2023

Abstract
The twenty-first century requires Vocational High School (VHS) graduates to have high-order thinking skills (HOTS). Although HOTS-based learning in VHS has been implemented in Indonesia, the graduates are less creative in complex work. Also, teachers have insufficient knowledge about this learning design. Therefore, the purpose of this study was to examine the relationship between learning implementation and planning, specifically focusing on the knowledge of teachers in planning lessons. To measure this knowledge, several aspects were established based on the concept of Anderson and Krathwohl’s Taxonomy 2001. The concept was used to measure knowledge, which was categorized into the factual, conceptual, procedural, and meta-cognitive dimensions. To analyze each dimension, critical thinking, creativity, collaboration, and communication were employed as key elements. A quantitative approach with a survey design and a random sample of productive subject teachers was used. Cross-sectional analysis and F-test were applied to the primary data using multiple linear regression. According to the F-test results, planning aspects simultaneously affect the implementation of HOTS-based learning in VHS. This is because the calculated F-value was greater than the table F-value. HOTS-based learning activities can be easily achieved in case the lesson plan has the same basis.
Testing for association between ordinal traits and genetic variants in pedigree-structured samples by collapsing and kernel methods
Authors: Chien Li-Chu 
Published: September 2023

Abstract
In genome-wide association studies (GWAS), logistic regression is one of the most popular analytics methods for binary traits. Multinomial regression is an extension of binary logistic regression that allows for multiple categories. However, many GWAS methods have been limited application to binary traits. These methods have improperly often been used to account for ordinal traits, which causes inappropriate type I error rates and poor statistical power. Owing to the lack of analysis methods, GWAS of ordinal traits has been known to be problematic and gaining attention. In this paper, we develop a general framework for identifying ordinal traits associated with genetic variants in pedigree-structured samples by collapsing and kernel methods. We use the local odds ratios GEE technology to account for complicated correlation structures between family members and ordered categorical traits. We use the retrospective idea to treat the genetic markers as random variables for calculating genetic correlations among markers. The proposed genetic association method can accommodate ordinal traits and allow for the covariate adjustment. We conduct simulation studies to compare the proposed tests with the existing models for analyzing the ordered categorical data under various configurations. We illustrate application of the proposed tests by simultaneously analyzing a family study and a cross-sectional study from the Genetic Analysis Workshop 19 (GAW19) data.