bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of an Educational Intervention on Nurses’ Competency in the Neonatal Unit of a Teaching Hospital in Nigeria: A Pilot Study
Authors: Ike Elizabeth Urenna , Oluwatosin Oyeninhun Abimbola 
Published: August 2022

Background: Clinical competency of nurses has been identified to be vital in making the difference between survival and death of neonates. Continuing education (CE) is essential to enhance the competency of nurses. This study aims to evaluate the effect of an educational intervention on nurses’ competency as regards their knowledge, attitude, and practices of neonatal care in a teaching hospital in Ogun State. Methods: A quasi experimental one (1) group pre- and postintervention design was used. Purposive sampling of all registered nurses working in the neonatal unit of Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu Ogun State was utilized. Two tools were used for data collection: a semi-structured questionnaire and nurses’ clinical performance observational checklist. Data were collected before and 2 weeks after educational intervention. Data collected was managed using Statistical Package for Social Sciences (SPSS), version 20 software. Descriptive statistics was used to analyze and present variables. Inferential statistics of student t test was employed for hypotheses testing at P ≤ .05. Result: Nurses’ knowledge and practice improved at postintervention. Knowledge mean score at pretest was 35.21 (±6.33) which increased to 43.74 (±3.30) in the posttest (t = −7.33, P = .000). Practice mean score at pretest was 32.7 (±6.04) which increased to 44.8 (±7.22) postintervention (t = 7.26, P = .000). However, no significant difference was observed between the attitude of nurses regarding care of neonates pretest 71.0 (±7.15) and posttest 71.1 (±13.5) (t = 0.04, P = .968). Overall, there is a significant difference in the nurses’ competency score at pretest 192.21 (±20.23) and posttest 203.79 (±4.78) (t = −2.21, P = .040). Majority (94.7%) of the nurses agreed that CE would facilitate their competent in the care of neonates in neonatal units while 31.6% established that financial constraint was a barrier to attending CE to improve themselves. Conclusion: Implementation of educational program for nurses working in the neonatal unit improved their competency toward neonatal care. It is recommended that CE and training programs should be organized for nurses on a regular basis to sustain their competency.
Is the Nasolabial Region Symmetric in Individuals With Cleft Lip and Palate?
Authors: Dindaroglu Furkan , Dogan Ege , Dogan Servet 
Published: August 2022

Objective To assess the nasolabial symmetry in smile and resting position in individuals with nonsyndromic unilateral cleft lip and palate (UCLP) and compare with Class I individuals without cleft lip and palate (CLP). Materials and Methods Frontal photographs of 40 individuals with UCLP (mean age 14.30 ± 0.25 years; 20 female, 20 male) and 40 skeletal Class I individuals without CLP (mean age 14.60 ± 0.34 years; 20 female and 20 male) were examined. Bland–Altman Levels of Agreements, Mann–Whitney U test, independent sample t-test were conducted, and intraclass correlation coefficients (ICCs) were calculated for statistical analysis. Results Differences in the transverse lip distance (d-d’) and vertical lip height at crista philtri (e-e’) were lesser in the UCLP group at smile ( P = .001; P = .005, respectively). When comparing the differences in these measurements at rest between control and UCLP groups, vertical lip height was longer at crista philtri (e-e’) ( P = .014), crista philtri was more laterally located (f-f’) ( P = .002), and the transverse lip distance was greater (d-d’) ( P = .004) in the UCLP group. Distance of the crista philtri to the midline of the face (f-f’) ( P = .007) were higher in the UCLP group during smiling compared to control group. Conclusions Nasolabial region asymmetry in smiling and rest position in individuals with UCLP was significantly different from the control group. However, the asymmetry in the nasolabial region, which is more evident in the resting position in individuals with UCLP, decreases during smiling.
LDL Reduction and Risk of Diabetes in Veteran Statin Users
Authors: Gross Michaela , Schwartz Skai W. , Sebastião Yuri V. , Alman Amy , Salemi Jason L. , Ghimire-Aryal Pragati , Foulis Philip 
Published: August 2022

Background: While statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) reduce cardiovascular morbidity and mortality, there is controversy regarding a potentially causal link with incident diabetes mellitus (DM). This association may partially be due to confounding by indication; since prescription guidelines encourage statin use among those diagnosed with DM, this may encourage their prescription among those with elevated blood glucose in the absence of DM diagnosis. Objective: The study examined the association between low-density lipoprotein (LDL) reduction following initiation of statin use and new-onset DM among veterans. Methods: We conducted a retrospective cohort study using data from the James A. Haley Veteran’s Hospital in Tampa, Florida. Patients with a visit between January 2007 and December 2011 were selected from the Veterans Information Systems and Technology Architecture system. Individuals were classified into categories of statin usage based on LDL reduction percentages and frequency-matched with controls. The primary outcome of interest was incident DM. Results: There was a significant association between LDL reduction and DM which was higher in lower LDL reduction groups (low response hazard ratio [HR]: 2.12, 95% CI: 1.62, 2.79; moderate response HR: 1.85, 95% CI: 1.40, 2.45; high response HR: 1.24, 95% CI: 0.74, 2.07). Conclusion and Relevance: This association may partially be explained by potential lifestyle modifications individuals may make when prescribed a statin which may reduce their risk of DM independent of the statin usage. This research has demonstrated a protective association between greater LDL reduction and DM at the individual level while reenforcing the evidence of an association between statin usage and DM.
Motivational patterns of emergent and fully bilingual children learning English and Japanese at an international school
Authors: Tanaka Yumi , Kutsuki Aya 
Published: August 2022

Purpose: Based on self-determination theory, this study compared the motivation of emergent bilinguals and full bilinguals in English and Japanese learning at an international elementary school in Japan. Methodology: This study employed a questionnaire on motivational orientations in English and Japanese learning. Data and analysis: Participants were 104 children who had either English or Japanese as their first language or had an English and Japanese bilingual background. A mixed-measures analysis of variance and correlation analysis were performed on the survey data. Findings: Although the degree of internalization of motivation differed depending on whether students were emergent or full bilinguals, the pattern of their motivational intensity in learning English and Japanese was similar among the three groups. Specifically, the full bilinguals internalized motivation in English and Japanese learning equally, while members of both the emergent bilingual groups internalized motivation only in learning the main language of instruction, English. Regarding the respective motivational intensity in the learning of the two languages, autonomous motivation (intrinsic motivation and identified regulation) was significantly stronger in English learning than Japanese learning among the groups, except identified regulation in the emergent bilinguals with English as their first language, while controlled motivation (introjected and external regulation) was significantly stronger in Japanese learning than English learning. Correlation analysis between English learning and Japanese learning additionally showed that for the full bilinguals, intrinsic motivation in English learning did not correlate to that in Japanese learning, whereas such motivation was positively correlated among emergent bilinguals. Originality: This is the first cross-lingual study using self-determination theory to compare motivation between emergent children reciprocally learning their first and second languages. It also compares the motivation of emergent children to that of fully bilingual children learning two first languages. Implications: Different patterns of motivation among emergent and full bilinguals necessitate corresponding classroom strategies.
Endovascular thrombectomy in young patients with stroke
Authors: Weller Johannes M , Dorn Franziska , Meissner Julius N , Stösser Sebastian , Beckonert Niklas M , Nordsiek Julia , Kindler Christine , Deb-Chatterji Milani , Petzold Gabor C , Bode Felix J , Reich A. , Nikoubashman O. , Röther J. , Eckert B. , Braun M. , Hamann G.F. , Siebert E. , Nolte C.H. , Bohner G. , Eckert R.M. , Borggrefe J. , Schellinger P. , Berrouschot J. , Bormann A. , Kraemer C. , Leischner H. , Petersen M. , Stögbauer F. , Boeck-Behrens T. , Wunderlich S. , Ludolph A. , Henn K.H. , Gerloff C. , Fiehler J. , Thomalla G. , Alegiani A. , Schäfer J.H. , Keil F. , Tiedt S. , Kellert L. , Trumm C. , Ernemann U. , Poli S. , Liman J. , Ernst M. , Gröschel K. , Uphaus T. 
Published: August 2022

Background: Endovascular treatment (ET) is standard of care in patients with acute ischemic stroke due to large vessel occlusion, but data on ET in young patients remain limited. Aim: We aim to compare outcomes for young stroke patients undergoing ET in a matched cohort. Methods: We analyzed patients from an observational multicenter cohort with acute ischemic stroke and ET, the German Stroke Registry—Endovascular Treatment trial. Baseline characteristics, procedural parameters, and functional outcome at 90 days were compared between young (<50 years) and older (⩾50 years) patients with and without nearest-neighbor 1:1 propensity score matching. Results: Out of 6628 acute ischemic stroke patients treated with ET, 363 (5.5%) were young. Young patients differed with regard to prognostic outcome characteristics. Specifically, National Institutes of Health Stroke Scale (NIHSS) at admission was lower (median 13, interquartile range (IQR) 8–17 vs. 15, IQR 9–19, p < 0.001), and prestroke dependence was less frequent (2.9% vs. 12.2%, p < 0.001) than in older patients. Compared to a matched cohort of older patients, ET was faster (time from groin puncture to flow restoration, 35 vs. 45 min, p < 0.001) and intracranial hemorrhage was less frequent in young patients (10.0% vs. 25.9%, p < 0.001). Good functional outcome (modified Rankin Scale (mRS) 0–2) at 3 months was achieved more frequently in young patients (71.6% vs. 44.1%, p < 0.001), and overall mortality was lower (6.7% vs. 25.4%, p < 0.001). Among previously employed young patients (n = 177), 37.9% returned to work at 3-month follow-up, while 74.1% of the remaining patients were still undergoing rehabilitation. Conclusion: Young stroke patients undergoing ET have better outcomes compared to older patients, even when matched for prestroke condition, comorbidities, and stroke severity. Hence, more liberal guidelines to perform ET for younger patients may have to be established by future studies.
Pain acceptance predicts healthcare utilization in women with chronic pelvic pain
Authors: Kreher Donna A , Li Rui , Gubbels Ashley L 
Published: August 2022

Background: Chronic pelvic pain (CPP) in women is common and costly, and little is known about patient characteristics predicting healthcare utilization within this population. The present study examined the role of pain acceptance and pain catastrophizing, assessed prior to treatment initiation, in predicting future uptake of medical and surgical interventions specifically for pain management. Methods: Our sample comprised women referred to a tertiary gynecological center. Baseline pain catastrophizing and pain acceptance scores were compared across each major medication class and surgery type, as well as across the total number of medication classes and the total number of surgery types using analysis of variance (ANOVA). We then performed multivariable analyses for the association between pain catastrophizing and pain acceptance and treatment utilization by controlling for potential confounders. Results: Three hundred eighteen patients met inclusion criteria. Pain catastrophizing was associated with increased likelihood of neuromodulator prescription, while pain acceptance was associated with reduced likelihood of neuromodulator prescription and fewer medication classes prescribed. Overall, no associations between pain catastrophizing and surgeries were observed, while pain acceptance was significantly associated with lower risk of hysterectomy/oophorectomy. Conclusion: Pain acceptance was a robust predictor of number of medication classes prescribed and use of radical surgeries even when controlling stringently for confounders. It is worth considering routine assessment of pain acceptance early in treatment of CPP to identify those more at-risk of higher treatment utilization, and potentially mitigate this through engagement with appropriate behavioral therapies.
Caries Preventive Interventions and Oral Health Inequalities: A Scoping Review
Authors: van Meijeren-van Lunteren A.W. , You Y. , Raat H. , Wolvius E.B. , Kragt L. 
Published: August 2022

Introduction: Dental caries remains one of the most prevalent but preventable diseases among children worldwide and especially affects children with a lower socioeconomic status or ethnic minority background. It is important that all groups of children are reached by preventive interventions to reduce oral health inequalities. So far, it is unknown whether children from different social and ethnic groups benefit equally from potentially effective oral health interventions. Objectives: This scoping review aimed to identify European public health interventions that report their effect on dental caries across different social groups. Methods: Four databases were searched for studies evaluating the effect of oral health interventions on dental caries among children from 0 to 12 y, and studies were included when results were presented by children of different social groups separately. Results: A total of 14 studies were included, representing 4 different countries: 3 randomized and 11 nonrandomized studies. Most studies were performed at schools. Six studies showed results indicative of a reduction in oral health inequalities, 4 studies showed results that potentially widen oral health inequalities, and 5 studies showed results that were indicative of no impact on oral health inequalities. Interventions that contain early approaches, with a high frequency, approaching multiple levels of influence, and including at least the broader organizational or public policy level, may have the potential to reduce oral health inequalities among children from birth to young adolescence. Conclusion: We recommend researchers to perform high-quality intervention studies and to evaluate the effectiveness of oral health intervention always in different socioeconomic or ethnic groups separately, to better understand their contribution toward oral health (in)equalities. Knowledge Transfer Statement: This review offers insight in the differential effects that oral health interventions might have across different social groups. Its results can be used to develop interventions that might reduce oral health inequalities among children. Also, we recommend future researchers to always evaluate the effects of any preventive oral health measure in different social groups separately.
D-dimer and reduced-dose apixaban for extended treatment after unprovoked venous thromboembolism: the Apidulcis study
Authors: Palareti Gualtiero , Poli Daniela , Ageno Walter , Legnani Cristina , Antonucci Emilia , Bucherini Eugenio , Testa Sophie , Paoletti Oriana , Chistolini Antonio , Serrao Alessandra , Martinelli Ida , Bucciarelli Paolo , Falanga Anna , Tosetto Alberto , Sarti Luca , Mastroiacovo Daniela , Cosmi Benilde , Visonà Adriana , Santoro Rita Carlotta , Zanatta Nello , Grandone Elvira , Bertù Lorenza , Pengo Vittorio , Caiano Lucia , Prandoni Paolo 
Published: August 2022

Abstract
D-dimer assay is used to stratify patients with unprovoked venous thromboembolism (VTE) for the risk of recurrence. However, this approach was never evaluated since direct oral anticoagulants are available. With this multicenter, prospective cohort study, we aimed to assess the value of an algorithm incorporating serial D-dimer testing and administration of reduced-dose apixaban (2.5 mg twice daily) only to patients with a positive test. A total of 732 outpatients aged 18 to 74 years, anticoagulated for ≥12 months after a first unprovoked VTE, were included. Patients underwent D-dimer testing with commercial assays and preestablished cutoffs. If the baseline D-dimer during anticoagulation was negative, anticoagulation was stopped and testing repeated after 15, 30, and 60 days. Patients with serially negative results (286 [39.1%]) were left without anticoagulation. At the first positive result, the remaining 446 patients (60.9%) were given apixaban for 18 months. All patients underwent follow-up planned for 18 months. The study was interrupted after a planned interim analysis for the high rate of primary outcomes (7.3%; 95% confidence interval [CI], 4.5-11.2), including symptomatic proximal deep vein thrombosis (DVT) or pulmonary embolism (PE) recurrence, death for VTE, and major bleeding occurring in patients off anticoagulation vs that in those receiving apixaban (1.1%; 95% CI, 0.4-2.6; adjusted hazard ratio [HR], 8.2; 95% CI, 3.2-25.3). In conclusion, in patients anticoagulated for ≥1 year after a first unprovoked VTE, the decision to further extend anticoagulation should not be based on D-dimer testing. The results confirmed the high efficacy and safety of reduced-dose apixaban against recurrences. This trial was registered at www.clinicaltrials.gov as #NCT03678506.
Species-specific identification of Pseudomonas based on 16S–23S rRNA gene internal transcribed spacer (ITS) and its combined application with next-generation sequencing
Authors: Hu Shuqian , Li Xiang , Yin Xin , Li Runmeng , Zhang Ruiyang , Zang Junhao , Liu Yin 
Published: August 2022

Abstract
Background
Pseudomonas species are widely distributed in the human body, animals, plants, soil, fresh water, seawater, etc. Pseudomonas aeruginosa is one of the main pathogens involved in nosocomial infections. It can cause endocarditis, empyema, meningitis, septicaemia and even death. However, the Pseudomonas classification system is currently inadequate and not well established.

Results
In this study, the whole genomes of 103 Pseudomonas strains belonging to 62 species available in GenBank were collected and the specificity of the 16S–23S ribosomal RNA internal transcribed spacer (ITS) sequence was analysed. Secondary structures of ITS transcripts determining where the diversity bases were located were predicted. The alignment results using BLAST indicated that the ITS sequence is specific for most species in the genus. The remaining species were identified by additional frequency analyses based on BLAST results. A double-blind experiment where 200 ITS sequences were randomly selected indicated that this method could identify Pseudomonas species with 100% sensitivity and specificity. In addition, we applied a universal primer to amplify the Pseudomonas ITS of DNA extracts from fish samples with next-generation sequencing. The ITS analysis results were utilized to species-specifically identify the proportion of Pseudomonas species in the samples.

Conclusions
The present study developed a species-specific method identification and classification of Pseudomonas based on ITS sequences combined NGS. The method showed its potential application in other genera.
Construction of drought stress regulation networks in potato based on SMRT and RNA sequencing data
Authors: Jian Hongju , Sun Haonan , Liu Rongrong , Zhang Wenzhe , Shang Lina , Wang Jichun , Khassanov Vadim , Lyu Dianqiu 
Published: August 2022

Abstract
Background
Potato (Solanum tuberosum) is the fourth most important food crop in the world and plays an important role in food security. Drought stress has a significantly negative impact on potato growth and production. There are several publications involved drought stress in potato, this research contributes to enrich the knowledge.

Results
In this study, next-generation sequencing (NGS) and single-molecule real-time (SMRT) sequencing technology were used to study the transcription profiles in potato in response to 20%PEG6000 simulates drought stress. The leaves of the variety “Désirée” from in vitro plantlets after drought stress at six time points from 0 to 48 hours were used to perform NGS and SMRT sequencing. According to the sequencing data, a total of 12,798 differentially expressed genes (DEGs) were identified in six time points. The real-time (RT)-PCR results are significantly correlated with the sequencing data, confirming the accuracy of the sequencing data. Gene ontology and KEGG analysis show that these DEGs participate in response to drought stress through galactose metabolism, fatty acid metabolism, plant-pathogen interaction, glutathione metabolism and other pathways. Through the analysis of alternative splicing of 66,888 transcripts, the functional pathways of these transcripts were enriched, and 51,098 transcripts were newly discovered from alternative splicing events and 47,994 transcripts were functionally annotated. Moreover, 3445 lncRNAs were predicted and enrichment analysis of corresponding target genes was also performed. Additionally, Alternative polyadenylation was analyzed by TADIS, and 26,153 poly (A) sites from 13,010 genes were detected in the Iso-Seq data.

Conclusion
Our research greatly enhanced potato drought-induced gene annotations and provides transcriptome-wide insights into the molecular basis of potato drought resistance.
Validation of the Dutch translation of the quality of recovery-15 scale
Authors: de Vlieger Johannes C. N. , Luiting Willem H. , Lockyer Jessica , Meyer Peter , Fleer Joke , Sanderman Robbert , Wietasch J. K. Götz 
Published: August 2022

Abstract
Background
The 15-item Quality of Recovery-15 (QoR-15) scale is strongly recommended as a standard patient-reported outcome measure assessing the quality of recovery after surgery and anesthesia in the postoperative period. This study aimed to validate the Dutch translation of the questionnaire (QoR-15NL).

Materials and methods
An observational, prospective, single-centre cohort study was conducted. Patients who underwent surgery under general anesthesia completed the QoR-15NL (preoperatively (t1) and twice postoperatively (t2 and t3)) and a visual analogue scale (VAS) for general recovery at t2. A psychometric evaluation was performed to assess the QoR-15NL’s validity, reliability, responsiveness, reproducibility and feasibility.

Results
Two hundred and eleven patients agreed to participate (recruitment rate 94%), and 165 patients were included (completion rate 78%). The QoR-15NL score correlated with the VAS for general recovery (rs = 0.59). Construct validity was further demonstrated by confirmation of expected negative associations between the QoR-15NL and duration of surgery (rs = -0.25), duration of Post Anesthesia Care Unit stay (rs = -0.31), and duration of hospital stay (rs = -0.27). The QoR-15NL score decreased significantly according to the extent of surgery. Cronbach’s alpha was 0.87, split-half reliability was 0.8, and the test–retest intra-class coefficient was 0.93. No significant floor- or ceiling effect was observed.

Conclusion
The QoR-15NL scale is a valid, easy-to-use, and reliable outcome assessment tool with high responsiveness for patient-reported quality of recovery after surgery and general anesthesia in the Dutch-speaking population. The QoR-15NL’s measurement properties are comparable to the original questionnaire and other translated versions.

Trial registration
not applicable.