bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends and causes of maternal death at the Lagos University teaching hospital, Lagos, Nigeria (2007–2019)
Authors: Olamijulo Joseph A. , Olorunfemi Gbenga , Okunola Halimat 
Published: April 2022

AbstractBackgroundNigeria has one of the worst global maternal mortality ratios (MMR). Institutional audit is invaluable in providing useful information for formulating preventive interventions.ObjectiveTo evaluate the trends, causes and socio-demographic characteristics of maternal mortality at a tertiary institution in South-western Nigeria over a period of 13 years (2007–2019).MethodologyCross sectional and temporal trend analysis of maternal deaths were conducted using chart reviews from 2007 to 2019. Socio-biological characteristics, booking status and ranking of clinical causes of maternal deaths were derived from patients’ chart review (2007–2019). Bivariate analysis and Annual percent change (APC) of the observed trends was respectively conducted using Stata version 17 and Joinpoint version 4.5.0.1 software respectively.ResultsIn the period 2007–2019, the mean age at maternal death was 30.8 ± 5.9 years and 88.8% of mortalities occurred among the “unbooked” women. The leading causes of direct maternal mortality were Hypertension (27.0%), Sepsis (20.6%) and haemorrhage (18.7%), while anaemia in pregnancy (3.2%), Human Immunodeficiency Virus (3.2%) and Sickle Cell Disease (2.4%) were the leading indirect causes of maternal mortality Joinpoint estimates showed a statistically significant increase in MMR of about 3.4% per annum from 2211 per 100,000 live births in 2007 to 3555.6 per 100,000 live births in 2019 (APC: +3.4%,P-value < 0.001).ConclusionContrary to some other reports, there was an increase in the institutional MMR between 2007 and 2019 even though the leading causes of death remained similar. Targeted interventions based on accurate data are urgently required in order to achieve the Sustainable Development Goal (SDG) 3.1.
Association of institutional transition of cancer care with mortality in elderly patients with lung cancer: a retrospective cohort study using national claim data
Authors: Han Kyu-Tae , Chang Jongwha , Choi Dong-Woo , Kim Seungju , Kim Dong Jun , Chang Yoon-Jung , Kim Sun Jung 
Published: April 2022

Abstract
Background
Although survival based outcomes of lung cancer patients have been well developed, institutional transition of cancer care, that is, when patients transfer from primary visiting hospitals to other hospitals, and mortality have not yet been explored using a large-scale representative population-based sample.

Methods
Data from the Korean National Elderly Sampled Cohort survey were used to identify patients with lung cancer who were diagnosed during 2005–2013 and followed up with for at least 1 year after diagnosis (3738 patients with lung cancer aged over 60 years). First, the authors examined the distribution of the study population by mortality, and Kaplan-Meier survival curves/log-rank test were used to compare mortality based on institutional transition of cancer care. Survival analysis using the Cox proportional hazard model was conducted after controlling for all other variables.

Results
Results showed that 1-year mortality was higher in patients who underwent institutional transition of cancer care during 30 days after diagnosis (44.2% vs. 39.7%, p = .027); however, this was not associated with 5-year mortality. The Cox proportional hazard model showed that patients who underwent institutional transition of cancer care during 30 days after diagnosis exhibited statistically significant associations with high mortality for 1 year and 5 years (1-year mortality, Hazard ratio [HR]: 1.279, p = .001; 5-year mortality, HR: 1.158, p = .002).

Conclusion
This study found that institutional transition of cancer care was associated with higher mortality among elderly patients with lung cancer. Future consideration should also be given to the limitation of patients’ choice when opting for institutional transition of care since there are currently no control mechanisms in this regard. Results of this study merit health policymakers’ attention.
The association between recommended and non-recommended food scores on cardiovascular risk factors in obese and overweight adult women: a cross-sectional study
Authors: Sabbari Maryam , Mirzababaei Atieh , Shiraseb Farideh , Clark Cain C. T. , Mirzaei Khadijeh 
Published: April 2022

Abstract
Objective
Obesity is a highly prevalent, non-communicable, disease associated with numerous comorbid complications, such as cardiovascular disease. Following a healthy diet is known to help reduce the risk of both obesity and cardiovascular disease. This study was conducted to evaluate the association of recommended food score (RFS) and none recommended food score (NRFS) with cardiovascular risk factors in overweight and obese women.

Methods
This cross-sectional study was performed on 379 overweight and obese (BMI ≥25 kg/m2) women aged 18-48 years. Anthropometric measurements and body composition analysis were assessed in all participants. Dietary intake was assessed by a valid and reliable food frequency questionnaire (FFQ) containing 147 items, and RFS and NRFS was calculated. Biochemical assessments including TC, HDL, LDL, TG, FBS, insulin, HOMA-IR, and hs-CRP were quantified by ELISA.

Results
The mean age and BMI of participants were 36.73 ± 9.21 (y) and 31.17 ± 4.22 (kg/m2), respectively. Binary logistic regression showed that participants in the highest tertile of the RFS compared to the lowest tertile had 57% lower odds for hypertriglyceridemia [OR = 0.43, 95%CI = 0.20-0.92, P = 0.03]. Subjects with high adherence to the NRFS had lower HDL [OR = 2.11, 95%CI = 1.08-4.12, P = 0.02] and higher odds for hypertriglyceridemia [OR = 2.95, 95%CI = 1.47-5.94, P = 0.002] compared to low adherence.

Conclusions
There was an inverse significant association between adherence to RFS and odds of hypertriglyceridemia. There was a significant association between NRFS and hypertriglyceridemia, in addition to an inverse association between NRFS and HDL. We recommend that people increase their consumption of fruits, vegetables, whole grains, lean meats or meat alternates, and low-fat dairy and avoid red meat, processed meat, chips, high-fat dairy, solid oil, refined grains, and variety of sweetened foods to prevent cardiovascular disease.
Measuring school level attributable risk to support school-based HPV vaccination programs
Authors: Vujovich-Dunn C. , Wand H. , Brotherton J. M. L. , Gidding H. , Sisnowski J. , Lorch R. , Veitch M. , Sheppeard V. , Effler P. , Skinner S. R. , Venn A. , Davies C. , Hocking J. , Whop L. , Leask J. , Canfell K. , Sanci L. , Smith M. , Kang M. , Temple-Smith M. , Kidd M. , Burns S. , Selvey L. , Meijer D. , Ennis S. , Thomson C. , Lane N. , Kaldor J. , Guy R. 
Published: April 2022

AbstractBackgroundIn Australia in 2017, 89% of 15-year-old females and 86% of 15-year-old males had received at least one dose of the HPV vaccine. However, considerable variation in HPV vaccination initiation (dose one) across schools remains. It is important to understand the school-level characteristics most strongly associated with low initiation and their contribution to the overall between-school variation.MethodsA population-based ecological analysis was conducted using school-level data for 2016 on all adolescent students eligible for HPV vaccination in three Australian jurisdictions. We conducted logistic regression to determine school-level factors associated with lower HPV vaccination initiation (< 75% dose 1 uptake) and estimated the population attributable risk (PAR) and the proportion of schools with the factor (school-level prevalence).ResultsThe factors most strongly associated with lower initiation, and their prevalence were; small schools (OR = 9.3, 95%CI = 6.1–14.1; 33% of schools), special education schools (OR = 5.6,95%CI = 3.7–8.5; 8% of schools), higher Indigenous enrolments (OR = 2.7,95% CI:1.9–3.7; 31% of schools), lower attendance rates (OR = 2.6,95%CI = 1.7–3.7; 35% of schools), remote location (OR = 2.6,95%CI = 1.6–4.3; 6% of schools,) and lower socioeconomic area (OR = 1.8,95% CI = 1.3–2.5; 33% of schools). The highest PARs were small schools (PAR = 79%, 95%CI:76–82), higher Indigenous enrolments (PAR = 38%, 95%CI: 31–44) and lower attendance rate (PAR = 37%, 95%CI: 29–46).ConclusionThis analysis suggests that initiatives to support schools that are smaller, with a higher proportion of Indigenous adolescents and lower attendance rates may contribute most to reducing the variation of HPV vaccination uptake observed at a school-level in these jurisdictions. Estimating population-level coverage at the school-level is useful to guide policy and prioritise resourcing to support school-based vaccination programs.
Socioeconomic inequalities in the utilization of dental services among adults in Saudi Arabia
Authors: Sahab Deema A. , Bamashmous Mohamed S. , Ranauta Amitha , Muirhead Vanessa 
Published: April 2022

Abstract
Background
This study used the Anderson Behavioral Model to assess the socioeconomic inequalities in dental services utilization among adults in Saudi Arabia, along with other predictors of utilization, to inform future planning of dental care services.

Methods
This cross-sectional study was a secondary analysis using national data from the 2019 Kingdom of Saudi Arabia World Health Survey (KSAWHS). The survey consisted of two interviewer-administered questionnaires: one household and one individual interview. The questions covered predisposing factors (age, gender, marital status, nationality, education, employment), enabling factors (income, household wealth, area-based socioeconomic class, health insurance, eligibility for free governmental health care, transportation and region of residence) and self-reported need for dental treatment. The main outcome was dental utilization in the past year; predisposing, enabling and need factors were independent variables. Hierarchical logistic regression analyses identified significant predictors of dental utilization, applying survey weights to adjust for the complex survey design. Adjusted odds ratios with 95% confidence intervals and p values were reported in the final model.

Results
The final dataset included 8535 adults (response rate = 95.4%). Twenty percent of adults had visited the dentist at least once in the past year (95% CI 18–21%). There were socioeconomic inequalities in dental utilization. High household income (OR 1.43, p = 0.043), second and middle household wealth status (OR 1.51, p = 0.003 and OR 1.57, p = 0.006) and access to free governmental health care (OR 2.05, p = 0.004) were significant predictors in the final regression model along with perceived need for dental treatment (OR 52.09, p < 0.001).

Conclusion
Socioeconomic inequalities in the utilization of dental services exist in Saudi Arabia. The need for treatment was the strongest predictor suggesting predominantly symptomatic attendance. Increasing awareness about the importance of preventive dental visits rather than symptomatic attendance could be an important policy implication to improve oral health and optimize dental care expenditure. Further research should explore the drivers for adults to seek preventive care in the absence of any recognized dental problems.
Developing long-term conservation priority planning for medicinal plants in China by combining conservation status with diversity hotspot analyses and climate change prediction
Authors: Xia Changying , Huang Yunfeng , Qi Yaodong , Yang Xudong , Xue Tiantian , Hu Renchuan , Deng Hongping , Bussmann Rainer W. , Yu Shengxiang 
Published: April 2022

Abstract
Background
Medicinal plants have always played an important role in the history of human health. However, the populations and sustainable use of medicinal plants have been severely affected by human activities and climate change. Little is known about the current conservation status and distribution pattern of medicinal plants. In this study, based on accurate geographical distribution information of 9756 medicinal plants, we identified diversity hotspots and conservation gaps, evaluated conservation effectiveness of nature reserves, and predicted suitable habitat areas for medicinal plants in China to provide scientific guidance for their long-term conservation and sustainable use.

Results
A total of 150 diversity hotspot grid cells, mainly concentrated in central and southern China, were identified. These only accounted for 5% of the total distribution area but contained 96% of the medicinal plants of the country. The hotspot grid cells included all traditional hotspot areas, but we also detected three new hotspots, namely Mufu-Lushan Mountains, Tianshan-Altai Mountains, and Changbai Mountains. The current national and provincial nature reserves protect 125 hotspot grid cells, which harbor 94% of all medicinal plants. However, 25 hotspot grid cells, distributed in the Tianshan-Altai Mountains and Hengduan Mountains, are located outside the national and provincial nature reserves. An analysis of the predicted effects of climate change indicated that the suitable habitat areas will shift from southern to northern China, and that southern China will face a considerable loss of suitable habitat areas, while the east and west parts of China will encompass remarkably more suitable habitat areas in the future.

Conclusions
The current conservation networks have achieved high conservation effectiveness with regard to medicinal plants; however, the conservation gaps we identified should not be neglected, and conservation planning needs to take into account the predicted shifts of some hotspots of medicinal plants due to climate change.
Diagnostic value of endoscopic retrograde cholangiopancreatography and therapeutic value of endoscopic sphincterotomy in dogs with suspected hepatobiliary disorders
Authors: Rahmani Vahideh , Spillmann Thomas , Halttunen Jorma , Syrjä Pernilla , Ruohoniemi Mirja 
Published: April 2022

Abstract
Background
Conventional diagnostic methods have some limitations in diagnosing specific causes of canine hepatobiliary disorders. In the evaluation of the hepatobiliary system in dogs, ultrasonography (US) is the first imaging method of choice. Nonetheless, endoscopic retrograde cholangiopancreatography (ERCP) has also been proven to be a practicable technique for evaluating canine hepatobiliary (endoscopic retrograde cholangiography, ERC) and pancreatic duct (endoscopic retrograde pancreatography, ERP) disorders, providing additional therapeutic options by sphincterotomy (EST). To date, the efficacy and safety of diagnostic and therapeutic ERCP has not been evaluated in veterinary medicine literature. The present study sought to report complications and outcomes of dogs undergoing ERCP and EST, and to assess the usefulness of diagnostic ERCP by comparing the findings of US, ERCP and histopathological findings in liver and pancreas.

Results
This retrospective case series comprises data collected from 15 dogs that underwent successful ERC/ERCP. Nine dogs underwent EST following ERC. US and ERC were best in agreement when assessing the common bile duct. In case of disagreement between the modalities, the ERC findings of the ductal structures were in line with the available pathology findings more often than the US findings, whereas the opposite was noted for the gallbladder. The technical success rates were 88.2% for ERC, 66.7% for ERP, and 81.8% for EST, with no major complications during or immediately after the procedure. Immediate bile flow after EST was recorded in 7/9 dogs but only four showed coinciding clinical and laboratory improvement and four dogs were euthanized within 1-6 days after EST.

Conclusions
US remains a valuable initial diagnostic imaging method for hepatobiliary disorders and allows good assessment of the gallbladder. ERC can serve as a complementary procedure for diagnostic assessment of the hepatobiliary duct disorders. However, in order to improve the outcomes of EST, careful selection of patients for the procedure would require more advanced diagnostic imaging of the hepatobiliary area.
Prevalence and associated factors of gastrointestinal helminthiasis of lactating cow and effect of strategic deworming on milk quantity, fat, and protein in Kucha, Ethiopia
Authors: Haymanot Fikre , Kaba Tamirat 
Published: April 2022

AbstractBackgroundGastrointestinal helminthiasis poses economic impacts on the dairy sector by reducing milk production. This study aimed at estimating the prevalence of gastrointestinal helminthiasis, the burden of helminths, and appraising potential factors associated with the prevalence in lactating cows. The study was also designed to elucidate the effects of anthelmintic treatment on milk yield, milk fat, and protein content in the Kucha district.MethodsA cross-sectional and field clinical trial study designs were used. Standard parasitological techniques (floatation and sedimentation) were employed to detect cows’ infection status. McMaster and Stoll’s egg counting methods were used to estimate helminths' burden. All putative factors that might have been linked with infection were recorded by field observations and farmers' interviews. Sixty cows tested positive for the parasitic infection in the cross-sectional study design were randomly assigned into one of the two groups (dewormed Vs control). Milk yield, milk fat and protein contents were recorded in both groups on day zero and then on weekly basis. Descriptive statistics, binary logistic regression, and repeated measure ANOVA were used to analyze the data.ResultsOverall, of 422 examined cows, 150 (35.5%, 95% CI; 30.9-40.3%) were infected with at least one of the gastrointestinal helminth parasites. Strongyle nematode was the predominant type accounting for 52% of the total record. Analysis of fecal egg count (FEC) in infected cows depicts the highest record ofParampistomumegg, accounting 457.14 ± 275.45 Egg per gram (EPG) of feces. The prevalence of gastrointestinal helminthiasis in cow that had an average body condition score of 1.7 was over two fold higher (OR = 2.19, 95% CI = 1.17–4.17,P = 0.016) than in cows with 6.3 body condition score. A significant improvement in milk yield, milk fat, and milk protein was observed in dewormed cows over 28 days period.ConclusionGastrointestinal helminthiasis is threatening the welfare of lactating cows in Kucha, Ethiopia given its negative association with the body condition score. Gastrointestinal helminths are responsible for the reduction of milk yield and loss of milk fat and protein. However, an improvement in milk yield, milk fat, and milk protein after deworming using Tetrox® (Tetramisole and Oxyclozanide combination), a new drug to the area/ a drug used by relatively few farmers in the study area, proves the effectiveness of strategic deworming.
Effects of nicotinamide on follicular development and the quality of oocytes
Authors: Guo Ziyu , Yang Jihong , Yang Guangping , Feng Ting , Zhang Xinyue , Chen Yao , Feng Ruizhi , Qian Yun 
Published: April 2022

AbstractBackgroundNicotinamide (NAM) is an important antioxidant, which is closely related to female fertility, but its role has not been clearly elucidated. The purpose of the present study was to investigate the effects of NAM on follicular development at different stages and the quality of oocytes.MethodsThe concentration of NAM in follicular fluid (FF) of 236 women undergoing in vitro fertilization (IVF) was ascertained by enzyme-linked immunosorbent assay (ELISA), and the correlation between NAM and clinical indexes was analyzed. During the in vitro maturation (IVM) of mice cumulus-oocyte complexes (COCs), different concentrations of NAM were added to check the maturation rate and fertilization rate. The reactive oxygen species (ROS) levels in the oocytes treated with different hydrogen peroxide (H2O2) and NAM were assessed. Immunofluorescence staining was performed to measure the proportion of abnormal spindles.ResultsThe level of NAM in large follicles was significantly higher than that in small follicles. In mature FF, the NAM concentration was positively correlated with the rates of oocyte maturation and fertilization. Five mM NAM treatment during IVM increased maturation rate and fertilization rate in the oxidative stress model, and significantly reduced the increase of ROS levels induced by H2O2in mice oocytes.ConclusionsHigher levels of NAM in FF are associated with larger follicle development. The supplement of 5 mM NAM during IVM may improve mice oocyte quality, reducing damage caused by oxidative stress.
Fast anther dehiscence status recognition system established by deep learning to screen heat tolerant cotton
Authors: Tan Zhihao , Shi Jiawei , Lv Rongjie , Li Qingyuan , Yang Jing , Ma Yizan , Li Yanlong , Wu Yuanlong , Zhang Rui , Ma Huanhuan , Li Yawei , Zhu Li , Zhu Longfu , Zhang Xianlong , Kong Jie , Yang Wanneng , Min Ling 
Published: April 2022

Abstract
Background
From an economic perspective, cotton is one of the most important crops in the world. The fertility of male reproductive organs is a key determinant of cotton yield. Anther dehiscence or indehiscence directly determines the probability of fertilization in cotton. Thus, rapid and accurate identification of cotton anther dehiscence status is important for judging anther growth status and promoting genetic breeding research. The development of computer vision technology and the advent of big data have prompted the application of deep learning techniques to agricultural phenotype research. Therefore, two deep learning models (Faster R-CNN and YOLOv5) were proposed to detect the number and dehiscence status of anthers.

Result
The single-stage model based on YOLOv5 has higher recognition speed and the ability to deploy to the mobile end. Breeding researchers can apply this model to terminals to achieve a more intuitive understanding of cotton anther dehiscence status. Moreover, three improvement strategies are proposed for the Faster R-CNN model, where the improved model has higher detection accuracy than the YOLOv5 model. We have made three improvements to the Faster R-CNN model and after the ensemble of the three models and original Faster R-CNN model, R2 of “open” reaches to 0.8765, R2 of “close” reaches to 0.8539, R2 of “all” reaches to 0.8481, higher than the prediction results of either model alone, which are completely able to replace the manual counting results. We can use this model to quickly extract the dehiscence rate of cotton anthers under high temperature (HT) conditions. In addition, the percentage of dehiscent anthers of 30 randomly selected cotton varieties were observed from the cotton population under normal conditions and HT conditions through the ensemble of the Faster R-CNN model and manual counting. The results show that HT decreased the percentage of dehiscent anthers in different cotton lines, consistent with the manual method.

Conclusions
Deep learning technology have been applied to cotton anther dehiscence status recognition instead of manual methods for the first time to quickly screen HT–tolerant cotton varieties. Deep learning can help to explore the key genetic improvement genes in the future, promoting cotton breeding and improvement.