bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effectiveness of different education methods conducted at different times for decreasing the time required for a parturient to position herself for epidural placement
Authors: Yang Chen , Cheng Yan , Hu Jianying , Lu Yaojun , Yu Xinhua , Huang Shaoqiang 
Published: July 2022

Abstract
Background
Decreasing the anaesthesia preparation time for primiparas experiencing painful uterine contractions is clinically relevant. This prospective intervention study investigated the effect of various educational methods conducted at different times on body positioning for primiparas undergoing labour analgesia.

Methods
Ninety primiparas who were about to receive labour analgesia were randomly divided into a verbal instruction group, a photo instructions group, and an educational video group for immediate education, and 60 primiparas who were willing to receive labour analgesia but were not in labour were randomly divided into a photo instruction group and an educational video group for advance education. The times required for body positioning were compared.

Results
In the immediate education cohort, the body positioning time in the verbal group (50.48 ± 28.97 s) was significantly longer than those in the photo group (30.47 ± 6.94 s) and the video group (23.14 ± 9.74 s) (P = 0.00). In the advance education cohort, the time in the photo group (17.47 ± 6.48 s) was longer than that in the video group (13.71 ± 7.01 s) (P = 0.042). Whether photos or videos are used, advance education can significantly decrease body positioning time.

Conclusions
Video or photo education for primiparas who are about to receive labour analgesia can decrease the body positioning time and is more effective when provided in advance.
Parental psychosocial factors, unmet dental needs and preventive dental care in children and adolescents with special health care needs: A stress process model
Authors: Gazzaz Arwa Z. , Carpiano Richard M. , Laronde Denise M. , Aleksejuniene Jolanta 
Published: July 2022

Abstract
Background
Children and adolescents with special health care needs (SHCN) have higher unmet dental needs, but the potential mechanisms by which parental factors can influence dental care use have not been determined. Parenting a child with SHCN can present special demands that affect parents’ well-being and, in turn, their caregiving. Hence, the study's overall aim was to apply the stress process model to examine the role of parental psychosocial factors in the association between child SHCN and dental care. Specifically, the study tested hypotheses regarding how (a) children’s SHCN status is associated with child dental care (unmet dental needs and lack of preventive dental visits), both directly and indirectly via parental psychosocial factors (parenting stress, instrumental, and emotional social support) and (b) parental social support buffers the association between parenting stress and child dental care.

Methods
A secondary data analysis of the 2011–2012 US National Survey of Children’s Health was performed for 6- to 11-year-old children (n = 27,874) and 12- to 17-year-old adolescents (n = 31,328). Our age-stratified models estimated associations between child SHCN status and parental psychosocial factors with two child dental care outcomes: parent-reported unmet child dental needs and lack of preventive dental care.

Results
Parents of children with (vs without) SHCN reported higher unmet child dental needs, higher parenting stress, and lower social support (instrumental and emotional). Instrumental, but not emotional, parental support was associated with lower odds of their child unmet dental needs in both age groups. The association between parenting stress and child dental care outcomes was modified by parental social support.

Conclusion
Differences existed in child unmet dental needs based on SHCN status, even after adjusting for parental psychosocial factors. SHCN status was indirectly associated with unmet dental needs via parental instrumental support among adolescents, and parental instrumental support buffered the negative association between parenting stress and both child dental care outcomes. Hence, parental social support was an important determinant of child dental care and partially explained the dental care disparities in adolescents with SHCN.
Qin Huang formula enhances the effect of Adriamycin in B-cell lymphoma via increasing tumor infiltrating lymphocytes by targeting toll-like receptor signaling pathway
Authors: Li Weili , Lv Lingling , Ruan Ming , Xu Jiayue , Zhu Wenhua , Li Qiong , Jiang Xufeng , Zheng Lan , Zhu Weirong 
Published: July 2022

AbstractBackgroundAs an original traditional Chinese medicinal formula, Qin Huang formula (QHF) is used as adjuvant therapy for treating lymphoma in our hospital and has proven efficacy when combined with chemotherapy. However, the underlying mechanisms of QHF have not been elucidated.MethodsA network pharmacological-based analysis method was used to screen the active components and predict the potential mechanisms of QHF in treating B cell lymphoma. Then, a murine model was built to verify the antitumor effect of QHF combined with Adriamycin (ADM) in vivo. Finally, IHC, ELISA,18F-FDG PET-CT scan, and western blot were processed to reveal the intriguing mechanism of QHF in treating B cell lymphoma.ResultsThe systemic pharmacological study revealed that QHF took effect following a multiple-target and multiple-pathway pattern in the human body. In vivo study showed that combination therapy with QHF and ADM potently inhibited the growth of B cell lymphoma in a syngeneic murine model, and significantly increased the proportion of tumor infiltrating CD4+ and CD8+ T cells in the tumor microenvironment (TME). Furthermore, the level of CXCL10 and IL-6 was significantly increased in the combination group. Finally, the western blot exhibited that the level of TLR2 and p38 MAPK increased in the combination therapy group.ConclusionQHF in combination of ADM enhances the antitumor effect of ADM via modulating tumor immune microenvironment and can be a combination therapeutic strategy for B cell lymphoma patients.
Quantitative comparison between carotid plaque hardness and histopathological findings: an observational study
Authors: Fukushima Daisuke , Kondo Kosuke , Harada Naoyuki , Terazono Sayaka , Uchino Kei , Shibuya Kazutoshi , Sugo Nobuo 
Published: July 2022

Abstract
Background
Plaque hardness in carotid artery stenosis correlates with cerebral infarction. This study aimed to quantitatively compare plaque hardness with histopathological findings and identify the pathological factors involved in plaque hardness.

Methods
This study included 84 patients (89 lesions) undergoing carotid endarterectomy (CEA) at our institution. Plaque hardness was quantitatively measured immediately after excision using a hardness meter. Collagen and calcification were evaluated as the pathological factors. Collagen was stained with Elastica van Gieson stain, converted to a gray-scale image, and displayed in a 256-step histogram. The median gray-scale median (GSM) was used as the collagen content. The degree of calcification was defined by the hematoxylin–eosin stain as follows: "0:" no calcification, "1:" scattered microcalcification, or "2:" calcification greater than 1 mm or more than 2% of the total calcification. Carotid echocardiographic findings, specifically echoluminance or the brightness of the narrowest lesion of the plaque, classified as hypo-, iso-, or hyper-echoic by comparison with the intima-media complex surrounding the plaque, and clinical data were reviewed.

Results
Plaque hardness was significantly negatively correlated with GSM [Spearman's correlation coefficient: -0.7137 (p < 0.0001)]: the harder the plaque, the higher the collagen content. There were significant differences between plaque hardness and degree of calcification between "0" and "2" (p = 0.0206). For plaque hardness and echoluminance (hypo-iso-hyper), significant differences were found between hypo-iso (p = 0.0220), hypo-hyper (p = 0.0006), and iso-hyper (p = 0.0015): the harder the plaque, the higher the luminance. In single regression analysis, GSM, sex, and diabetes mellitus were significant variables, and in multiple regression analysis, only GSM was extracted as a significant variable.

Conclusions
Plaque hardness was associated with a higher amount of collagen, which is the main component of the fibrous cap. Greater plaque hardness was associated with increased plaque stability. The degree of calcification may also be associated with plaque hardness.
Integrated PERSEVERE and endothelial biomarker risk model predicts death and persistent MODS in pediatric septic shock: a secondary analysis of a prospective observational study
Authors: Atreya Mihir R. , Cvijanovich Natalie Z. , Fitzgerald Julie C. , Weiss Scott L. , Bigham Michael T. , Jain Parag N. , Schwarz Adam J. , Lutfi Riad , Nowak Jeffrey , Allen Geoffrey L. , Thomas Neal J. , Grunwell Jocelyn R. , Baines Torrey , Quasney Michael , Haileselassie Bereketeab , Lindsell Christopher J. , Alder Matthew N. , Wong Hector R. 
Published: July 2022

Abstract
Background
Multiple organ dysfunction syndrome (MODS) is a critical driver of sepsis morbidity and mortality in children. Early identification of those at risk of death and persistent organ dysfunctions is necessary to enrich patients for future trials of sepsis therapeutics. Here, we sought to integrate endothelial and PERSEVERE biomarkers to estimate the composite risk of death or organ dysfunctions on day 7 of septic shock.

Methods
We measured endothelial dysfunction markers from day 1 serum among those with existing PERSEVERE data. TreeNet® classification model was derived incorporating 22 clinical and biological variables to estimate risk. Based on relative variable importance, a simplified 6-biomarker model was developed thereafter.

Results
Among 502 patients, 49 patients died before day 7 and 124 patients had persistence of MODS on day 7 of septic shock. Area under the receiver operator characteristic curve (AUROC) for the newly derived PERSEVEREnce model to predict death or day 7 MODS was 0.93 (0.91–0.95) with a summary AUROC of 0.80 (0.76–0.84) upon tenfold cross-validation. The simplified model, based on IL-8, HSP70, ICAM-1, Angpt2/Tie2, Angpt2/Angpt1, and Thrombomodulin, performed similarly. Interaction between variables—ICAM-1 with IL-8 and Thrombomodulin with Angpt2/Angpt1—contributed to the models’ predictive capabilities. Model performance varied when estimating risk of individual organ dysfunctions with AUROCS ranging from 0.91 to 0.97 and 0.68 to 0.89 in training and test sets, respectively.

Conclusions
The newly derived PERSEVEREnce biomarker model reliably estimates risk of death or persistent organ dysfunctions on day 7 of septic shock. If validated, this tool can be used for prognostic enrichment in future pediatric trials of sepsis therapeutics.

Graphical abstract
Metagenomic prediction of antimicrobial resistance in critically ill patients with lower respiratory tract infections
Authors: Serpa Paula Hayakawa , Deng Xianding , Abdelghany Mazin , Crawford Emily , Malcolm Katherine , Caldera Saharai , Fung Monica , McGeever Aaron , Kalantar Katrina L. , Lyden Amy , Ghale Rajani , Deiss Thomas , Neff Norma , Miller Steven A. , Doernberg Sarah B. , Chiu Charles Y. , DeRisi Joseph L. , Calfee Carolyn S. , Langelier Charles R. 
Published: July 2022

Abstract
Background
Antimicrobial resistance (AMR) is rising at an alarming rate and complicating the management of infectious diseases including lower respiratory tract infections (LRTI). Metagenomic next-generation sequencing (mNGS) is a recently established method for culture-independent LRTI diagnosis, but its utility for predicting AMR has remained unclear. We aimed to assess the performance of mNGS for AMR prediction in bacterial LRTI and demonstrate proof of concept for epidemiological AMR surveillance and rapid AMR gene detection using Cas9 enrichment and nanopore sequencing.

Methods
We studied 88 patients with acute respiratory failure between 07/2013 and 9/2018, enrolled through a previous observational study of LRTI. Inclusion criteria were age ≥ 18, need for mechanical ventilation, and respiratory specimen collection within 72 h of intubation. Exclusion criteria were decline of study participation, unclear LRTI status, or no matched RNA and DNA mNGS data from a respiratory specimen. Patients with LRTI were identified by clinical adjudication. mNGS was performed on lower respiratory tract specimens. The primary outcome was mNGS performance for predicting phenotypic antimicrobial susceptibility and was assessed in patients with LRTI from culture-confirmed bacterial pathogens with clinical antimicrobial susceptibility testing (n = 27 patients, n = 32 pathogens). Secondary outcomes included the association between hospital exposure and AMR gene burden in the respiratory microbiome (n = 88 patients), and AMR gene detection using Cas9 targeted enrichment and nanopore sequencing (n = 10 patients).

Results
Compared to clinical antimicrobial susceptibility testing, the performance of respiratory mNGS for predicting AMR varied by pathogen, antimicrobial, and nucleic acid type sequenced. For gram-positive bacteria, a combination of RNA + DNA mNGS achieved a sensitivity of 70% (95% confidence interval (CI) 47–87%) and specificity of 95% (CI 85–99%). For gram-negative bacteria, sensitivity was 100% (CI 87–100%) and specificity 64% (CI 48–78%). Patients with hospital-onset LRTI had a greater AMR gene burden in their respiratory microbiome versus those with community-onset LRTI (p = 0.00030), or those without LRTI (p = 0.0024). We found that Cas9 targeted sequencing could enrich for low abundance AMR genes by > 2500-fold and enabled their rapid detection using a nanopore platform.

Conclusions
mNGS has utility for the detection and surveillance of resistant bacterial LRTI pathogens.
An assessment of current concussion identification and diagnosis methods in sports settings: a systematic review
Authors: Daly Ed , Pearce Alan J. , Finnegan Emma , Cooney Ciara , McDonagh Maria , Scully Grainne , McCann Michael , Doherty Rónán , White Adam , Phelan Simon , Howarth Nathan , Ryan Lisa 
Published: July 2022

AbstractBackgroundConcussion in sport is an ongoing global concern. The head injury assessment (HIA) by the field of play is acknowledged as the first step in recognising and identifying concussion. While previous systematic literature reviews have evaluated the sensitivity of side-line screening tools and assessment protocols, no systematic review has evaluated the research designs and assessments used in a field setting. This systematic review investigated existing screening and diagnostic tools used in research as part of the HIA protocol to identify concussion that are currently used in professional, semi-professional and amateur (club) sports settings.MethodsA systematic searching of relevant databases was undertaken for peer-reviewed literature between 2015 and 2020.ResultsTwenty-six studies met the inclusion criteria. Studies were of moderate to good quality, reporting a variety of designs. The majority of studies were undertaken in professional/elite environments with medical doctors and allied health practitioners (e.g., physical therapists) involved in 88% of concussion assessments. While gender was reported in 24 of the 26 studies, the majority of participants were male (77%). There was also a variety of concussion assessments (n = 20) with the sports concussion assessment tool (SCAT) used in less than half of the included studies.ConclusionThe majority of studies investigating concussion HIAs are focused on professional/elite sport. With concussion an issue at all levels of sport, future research should be directed at non-elite sport. Further, for research purposes, the SCAT assessment should also be used more widely to allow for consistency across studies.
Higher order Kantorovich-type Szász–Mirakjan operators
Authors: Sabancigil Pembe , Kara Mustafa , Mahmudov Nazim I. 
Published: July 2022

AbstractIn this paper, we define new higher order Kantorovich-type Szász–Mirakjan operators, we give some approximation properties of these operators in terms of various moduli of continuity. We prove a local approximation theorem, a Korovkin-type theorem, and a Voronovskaja-type theorem. We also prove weighted approximation theorems for these new operators.
Investigating the Hybrid Effect of Micro-steel Fibres and Polypropylene Fibre-Reinforced Magnesium Phosphate Cement Mortar
Authors: Feng Hu , Shao Qi , Yao Xupei , Li Lulu , Yuan Chengfang 
Published: July 2022

AbstractTo overcome the drawbacks caused by the intrinsic brittleness of cementitious materials, various types of fibres were incorporated as reinforcements. Extensive research on Ordinary Portland cement indicated that compared with the use of a single type of fibres, the mixed-use of multiple fibres can significantly improve both strength and toughness of the cementitious composites, which is referred to as the hybrid effect. However, such hybrid effect in multiple fibre-reinforced magnesium phosphate cement-based composite (HFRMC) still lack quantitative understanding. Therefore, this study conducted a series of experiments, including slump flow tests, compression tests, four-point bending tests and microstructure analysis, to investigate the hybrid effect of micro-steel fibres (MSF) and polypropylene (PP) fibres in HFRMC. Two types of mixed designs of HFRMC were conducted: 1. total fibres fraction (including both PP fibres and MSF) was fixed to be 1.6%; 2. PP fibres fraction was fixed to be 1.6% with different addition of MSF. Our results indicated that the slump flow of magnesium phosphate cement mortar varied around 7.6–8.8% with the hybrid use of MSF and PP fibres, while the flexural strength and toughness increased around 13.7–23.1% and 1.6–45.9%, respectively.
Effect of protease supplementation on apparent ileal crude protein and amino acid digestibility of over-processed soybean meals in broilers
Authors: Salazar-Villanea Sergio , Astúa-Ureña Maikol , Masís-Montoya Allison , Herrera-Muñoz Juan I. , Salas-Durán Catalina 
Published: July 2022

Abstract
Background
Nutritional value of proteins in feed ingredients can be negatively affected by hydrothermal processing, which causes large variation in the bioavailability of amino acids (AA) and negatively affects animal productive performance. Supplementation of exogenous proteases could increase the rate of digestion of damaged proteins, thereby increasing overall AA digestibility and bioavailability. The aim was to determine the effect of exogenous protease supplementation on the apparent ileal digestibility (AID) of crude protein (CP) and AA of soybean meals (SBM) with different degrees of hydrothermal processing in broilers.

Methods
The experiment involved a 3 × 2 factorial arrangement, with SBM processing time (commercial SBM or autoclaved for 30 or 60 min at 120 °C) and protease supplementation (not supplemented and supplemented) as factors. Protease was included at three times the recommended dose (0.06%) and the experimental diets were fed from 15 to 21 d.

Results
The interaction between the effects of SBM processing and protease supplementation was significant for the AID of CP (P = 0.01), Trp (P = 0.01), Gly (P = 0.03) and Pro (P = 0.03), and also for the average daily gain (P = 0.01) and feed conversion ratio (P = 0.04). Increasing the processing time of SBM decreased (P < 0.0001) the AID of all amino acids, whilst the effect of protease supplementation was only significant for the AID of Phe (P = 0.02) and Tyr (P = 0.01).

Conclusions
Exogenous protease supplementation at three times the commercial dose does not seem to offset the negative effects of hydrothermal processing of SBM on the apparent ileal digestibility of CP and amino acids or performance of broilers. Whilst positive numerical improvements of digestibility and performance (ADG and FCR) were noticed with protease supplementation at relatively mild processing levels, negative results were obtained with the harsh-processed meals.
Long-term work disability due to type I and II bipolar disorder: findings of a six-year prospective study
Authors: Arvilommi Petri , Pallaskorpi Sanna , Linnaranta Outi , Suominen Kirsi , Leppämäki Sami , Valtonen Hanna , Isometsä Erkki 
Published: July 2022

Abstract
Background
Bipolar disorder (BD) is one of the leading causes of disability worldwide. However, the prevalence and predictors of long-term work disability among patients with type I and II BD have scarcely been studied. We investigated the clinical predictors of long-term work disability among patients with BD.

Methods
The Jorvi Bipolar Study (JoBS) is a naturalistic prospective cohort study (n = 191) of adult psychiatric in- and out-patients with DSM-IV type I and II BD in three Finnish cities. Within JoBS we examined the prevalence and predictors of disability pension being granted during a six-year follow-up of the 152 patients in the labor force at baseline and collected information on granted pensions from national registers. We determined the predictors of disability pension using logistic regression models.

Results
Over the 6 years, 44% of the patients belonging to the labor force at baseline were granted a disability pension. Older age; type I BD; comorbidity with generalized anxiety disorder, post-traumatic stress disorder or avoidant personality disorder; and duration of time with depressive or mixed symptoms predicted disability pensions. Including disability pensions granted before baseline increased their total prevalence to 55.5%. The observed predictors were similar.

Conclusion
This regionally representative long-term prospective study found that about half of patients with type I or II bipolar disorder suffer from persistent work disability that leads to disability pension. In addition to the severity of the clinical course and type I bipolar disorder, the longitudinal accumulation of time depressed, psychiatric comorbidity, and older age predicted pensioning.
Gender and sociocultural factors in animal source foods (ASFs) access and consumption in lower-income households in urban informal settings of Nairobi, Kenya
Authors: Bukachi Salome A. , Ngutu Mariah , Muthiru Ann W. , Lépine Aurélia , Kadiyala Suneetha , Domínguez-Salas Paula 
Published: July 2022

Abstract
Background
Gender shapes household decision-making and access for nutritious diets, including animal source foods (ASFs) that impact on child health and nutrition status. However, research shows that the poorest households in the urban informal settlements of Nairobi have low ASFs consumption. This study was conducted to explore further from a qualitative perspective the gender, sociocultural factors affecting household ASF consumption this study.

Methods
To explore further on the topic of study, an exploratory qualitative study was carried out to establish the factors that influence access, allocation and consumption of animal source foods (ASFs) by households in urban informal settings of Nairobi. Nineteen focus group discussions with men and women were conducted to enable in-depth exploration of ASFs consumption.

Results
Gender influences decision-making of household ASFs dietary intake. Gendered power dynamics prevail with men as breadwinners and household heads often determining the food access and consumption of ASFs. Women are increasingly accessing short-term waged-based incomes in urban informal settings and now play a role in food and nutrition security for their households. This enforces the idea that women’s decision-making autonomy is an important aspect of women empowerment, as it relates to women’s dietary diversity and subsequently, better household nutritional status. As evidenced in this study, if a woman has bargaining power based on accessing incomes to support their household food needs, she will not jeopardize food security. The mobile digital money platform was key in enabling access to resources to access food. Use of trust to access food on credit and purchasing smaller packaged quantities of food were also enablers to access of food/ASFs.