bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and efficacy of low-dose rt-PA with tirofiban to treat acute non-cardiogenic stroke: a single-center randomized controlled study
Authors: Liang Zhigang , Zhang Junliang , Huang Shuangfeng , Yang Shaowan , Xu Luyao , Xiang Wei , Zhang Manman 
Published: July 2022

Abstract
Background and purpose
The recanalization rate after intravenous thrombolysis (IVT) is not enough and there is still the possibility of re-occlusion. We aim to investigate the effectiveness and safety of infusing tirofiban after IVT.

Methods
We performed a prospective controlled study of 60 patients with acute non-cardiogenic ischemic stroke who were hospitalized in Yantai Yuhuangding Hospital from January 2018 to December 2019. The patients were divided into 2 groups: those who received tirofiban for 24 h after IVT (rt-PA + T group) and those who did not receive postprocedural intravenous tirofiban (rt-PA group). The rt-PA + T group received low-dose rt-PA (0.6 mg/kg). The rt-PA group received standard dose rt-PA (0.9 mg/kg). The main outcome measure were safety, included the symptomatic intracranial hemorrhage (sICH), any ICH, severe systemic bleeding, and mortality. The secondary outcome measure is curative efficacy which were evaluated by the 7d-NIHSS score and functional outcomes at 90 days. During hospitalization, the deterioration of neurological function was recorded.

Results
All patients completed the follow-up with complete data, there were 30 patients in each of groups. The general characteristics between the two group patients had no statistically significant differences. Compared with the rt-PA + T group and the rt-PA group, in terms of safety, the rates of the sICH, severe systemic bleeding, and mortality in both groups were 0, and there was no statistically significant difference in the rates of any ICH between the two groups (10.0% vs. 3.3%, P = 0.306). In terms of efficacy, the rate of the early neurological deterioration events (END) was no statistical significance (0 vs. 6.6%, P = 0.246). There was no significant difference in the NIHSS score between the two groups before the IVT, and also at 24 h, however, the 7d-NIHSS score was lower in the rt-PA + T group compared with the rt-PA group (2.33 ± 1.85 vs. 4.80 ± 4.02, P = 0.004). At 90 days, 83.3% of patients in the rt-PA + T group had favorable functional outcomes compared with 60.0% of patients in the rt-PA group (P = 0.045).

Conclusions
Low-dose rt-PA combined with tirofiban in acute non-cardiogenic ischemic stroke did not increase the risk of ICH, and mortality, and it was associated with neurological improvement.

Trial Registration
The trial has been registered at the ChiCTR and identified as ChiCTR1800014666 (28/01/2018).
Women’s use of non-conventional herbal uterotonic in pregnancy and labour: evidence from birth attendants
Authors: Sumankuuro Joshua , Baatiema Leonard , Crockett Judith , Young Jeanine 
Published: July 2022

Abstract
Background
Over the years, governments and stakeholders have implemented various policies/programmes to improve maternal health outcomes in low-middle-income countries. In Ghana, Community Health Officers were trained as midwives to increase access to skilled maternal healthcare. The government subsequently banned traditional birth attendants from providing direct maternal healthcare in 2000. Despite these, there is an unprecedented utilisation of TBAs’ services, including herbal uterotonics. This has attempted to defeat stakeholders’ campaigns to improve maternal health outcomes. Thus, we explored and highlighted herbal uterotonic consumption in pregnancy and birth and the implications on maternal and newborn health outcomes in North-Western Ghana.

Methods
This was an exploratory qualitative study that investigated traditional birth attendants (n = 17) and healthcare providers' (n = 26) perspectives on the intake of herbal uterotonics in pregnancy and childbirth in rural Ghana, using in-depth interviews. A combination of convenience, purposive and snowball sampling procedures were employed in selecting participants.

Results
Findings were captured in two domains: (1) perceived rationale for herbal uterotonic intake, and (2) potential adverse impacts of herbal uterotonic intake in pregnancy and labour, and nine topics: (i) confidence in unskilled attendance at birth, (ii) cost and a shortage of essential medicines, (iii) herbal uterotonics as a remedy for obstetric problems, (iv) herbal uterotonics facilitate birth, (v) attraction of home birth for cultural reasons, (vi) affordability of herbal uterotonics, (vii) unintended consequences and adverse outcomes, (viii) risks using herbal uterotonics to manage fertility and (ix) risks using herbal uterotonics to facilitate home birth.

Conclusion
The findings have suggested that the intake of non-conventional herbal uterotonic is widespread in the study area, although the constituents of the herb are unknown. However, complex and multiple factors of healthcare cost, desire for homebirth, unawareness of the negative effects of such substances, perceived way of addressing obstetric problems and cultural undertones, among others, accounted for herbal uterotonics consumption. We also encourage research into the constituents of ‘mansugo’ and the potential benefits and adverse effects. We recommend qualitative studies involving previous users of this herbal uterotonic to inform policy and healthcare provision.
Patient, primary care provider, and stakeholder perspectives on mammography screening frequency: lessons learned from a qualitative study
Authors: Ro Vicky , Jones Tarsha , Silverman Thomas , McGuinness Julia E. , Guzman Ashlee , Amenta Jacquelyn , Kukafka Rita , Crew Katherine D. 
Published: July 2022

Abstract
Background
U.S. professional organizations have provided conflicting recommendations on annual vs. biennial mammography screening. Potential harms of more frequent screening include increased anxiety and costs of false positive results, including unnecessary breast biopsies and overdiagnosis.

Objective
To characterize current practices and beliefs surrounding mammography screening frequency and perspectives on using risk-based screening to inform screening intervals.

Design
Semi-structured interviews informed by the Consolidated Framework for Implementation Research (CFIR).

Participants
Patients, primary care providers (PCPs), third-party stakeholders (breast radiologists, radiology administrators, patient advocates).

Main measures
Qualitative data, with a codebook developed based upon prespecified implementation science constructs.

Key results
We interviewed 25 patients, 11 PCPs, and eight key stakeholders, including three radiologists, two radiology administrators, and three patient advocates. Most patients reported having annual mammograms, however, half believed having mammograms every two years was acceptable. Some women were worried early breast cancer would be missed if undergoing biennial screening. PCPs were equally split between recommending annual and biennial mammograms. Although PCPs were interested in using breast cancer risk models to inform screening decisions, concerns raised include time burden and lack of familiarity with breast cancer risk assessment tools. All breast radiologists believed patients should receive annual mammograms, while patient advocates and radiology administrators were split between annual vs. biennial. Radiologists were worried about missing breast cancer diagnoses when mammograms are not performed yearly. Patient advocates and radiology administrators were more open to biennial mammograms and utilizing risk-based screening.

Conclusions
Uncertainty remains across stakeholder groups regarding appropriate mammogram screening intervals. Radiologists recommend annual mammography, whereas patients and PCPs were evenly split between annual vs. biennial screening, although both favored annual screening among higher-risk women. Breast cancer risk assessment tools may help facilitate decisions about screening intervals, but face barriers to widespread implementation in the primary care setting. These results will inform future implementation strategies to adopt risk-stratified breast cancer screening.
Clinical observation on healing of tarsal plate defect after reconstruction with xenogeneic acellular dermal matrix
Authors: Huang Qin , Fang Yangbin , Wang Yaohua , Liao Hongfei 
Published: July 2022

Abstract
Objective
To evaluate the safety, function, and cosmetic outcome of eyelid reconstruction using a xenogeneic acellular dermal matrix as a tarsal plate replacement in the repair of 50 to 100% eyelid defects following excision of large malignant tumours.

Methods
A retrospective, non-comparative, interventional study of 21 eyes was performed over 26 months. Fourteen patients were female and seven were male. In all cases, a xenogeneic acellular dermal matrix was used for total or subtotal replacement of the tarsal plate. The central vertical height of the palpebral fissure was measured immediately after eyelid margin incision and at 1 and 6 months postoperatively.

Results
In patients who underwent surgery, the mean palpebral fissure height (PFH) was not significantly different between immediately and 1 month after incision (8.10 ± 0.562 mm vs 8.17 ± 0.577 mm, respectively; P > 0.05). After 6 months, PFH was 8.26 ± 0.605 mm, which was significantly different from that immediately after incision (P < 0.05). After 6 months of follow-up, all patients had a good aesthetic appearance after eyelid reconstruction, with no obvious graft dissolution or rejection, normal eyelid activity, and normal opening, closing, and lifting function. None of the 21 patients experienced tumour recurrence during postoperative follow-up.

Conclusion
The xenogeneic acellular dermal matrix was a successful tarsal plate replacement. This material is readily available, and a second surgical site is avoided. The xenogeneic acellular dermal matrix is considered a promising alternative material for tarsal replacement in future generations.
Synchronous bilateral multifocal basal cell adenomas of the parotid gland—a case report
Authors: Piątkowski Jakub , Garsta Ewa , Śmigielski Grzegorz , Markiet Karolina , Wasąg Bartosz , Ciarka Aleksandra , Mikaszewski Bogusław 
Published: July 2022

Abstract
Background
Bilateral parotid gland tumors account for up to 3% of cases. In this group, the vast majority are Warthin’s tumors. However, bilateral presentations of other parotid gland tumor entities is also possible, an example of which is a basal cell adenoma (BCA). Bilateral BCA is extremely rare, which could cause misdiagnosing it as a Warthin tumor.

Case presentation
The current study reports the unique case of a 48-year-old woman who presented with a 6-month history of slowly growing masses located bilaterally in the parotid region, surgically treated with 5-year follow-up (no recurrence, normal facial nerve function). Magnetic resonance imaging (MRI) revealed three lesions: two in the superficial and deep lobes of the right parotid gland, and one in the superficial lobe of the left parotid gland. A total parotidectomy with facial nerve preservation was performed on the right side, and superficial parotidectomy on the left side 6 months later. Histopathological examination confirmed that all three tumors were BCAs. Molecular analysis didn’t show any strong, potential of unknown clinical significance in the studied sample.

Conclusions
Multifocal bilateral lesions of the parotid gland are usually Warthin tumors. Detailed preoperative diagnostics including MRI and histopathological examination is essential to avoid misdiagnosing BCA and Warthin tumors. To our best knowledge, no case of synchronous bilateral multifocal basal cell adenomas of the parotid gland has been reported in English literature so far.
A prospective interventional study of recombinant human interleukin-11 mouthwash in chemotherapy-induced oral mucositis
Authors: Wei Hangping , Wei Juan , Dong Xiaofang 
Published: July 2022

Abstract
Background
This prospective interventional study aimed to evaluate and analyse the efficacy of rhIL-11 mouthwash compared to Kangfuxin fluid in treatment and blank control in prevention of oral mucositis (OM) in patients receiving chemotherapy.

Materials and Methods
In total, 50 patients in the treatment group and 62 patients in the prevention group were included. Subsequently, each group was divided into an experimental group and a control group. In the treatment group, the experimental patients received recombinant human interleukin-11 (rhIL-11) mouthwash, whereas the control group received Kangfuxin fluid. In the prevention group, experimental patients still received rhIL-11 mouthwash based on routine oral care, whereas the control group only received routine oral care. Meanwhile, we observed and recorded the efficacy in the treatment group, and the occurrence and grades of OM in the prevention group.

Results
Through statistical analysis, the results showed that on the seventh day of treatment, the experimental group showed more improvement compared to the control group, and it was statistically significant (p = 0.032). The average healing time in the experimental group (3.59 ± 1.927 days) was shorter than that in the control group (4.96 ± 2.421 days; p = 0.031). In the prevention group, we observed the incidence of oral mucositis. No significant differences were found in the occurrence and grades of OM in the experimental and control groups (p = 0.175).

Conclusion
Our preliminary results indicate that rhIL-11 mouthwash may be a superior option to treat OM, especially in severe cases, compared to Kangfuxin fluid. However, there is no advantage in prevention.
A comprehensive search string informed by an operational definition of complementary, alternative, and integrative medicine for systematic bibliographic database search strategies
Authors: Ng Jeremy Y. , Dhawan Tushar , Dogadova Ekaterina , Taghi-Zada Zhala , Vacca Alexandra , Fajardo Renee-Gabrielle , Masood Hooriya A. , Patel Riva , Sunderji Samira , Wieland L. Susan , Moher David 
Published: July 2022

Abstract
Background
Determining which therapies fall under the umbrella of complementary, alternative, and/or integrative medicine (CAIM) is difficult for several reasons. An operational definition is dynamic, and changes depending on both historical time period and geographical location, with many countries integrating or considering their traditional system(s) of medicine as conventional care. We have previously reported the first operational definition of CAIM informed by a systematic search. In the present study, we have developed a comprehensive search string informed by an operational definition of CAIM for systematic bibliographic database search strategies.

Methods
We developed a single search string for the most common bibliographic databases, including those searchable on the OVID platform (e.g., MEDLINE, EMBASE, PsycINFO, AMED), the EBSCO platform (e.g., ERIC, CINAHL), Scopus, and Web of Science, using the finalised operational definition of CAIM’s 604 therapies. We searched the Therapeutic Research Center’s “Natural Medicines” database for all 604 therapies, and each item’s scientific name and/or synonym was included as a keyword or phrase in the search string.

Results
This developed search string provides a standardised list of CAIM terms (i.e., keywords and phrases) that may be searched on bibliographic databases including those found on the OVID platform (e.g., MEDLINE, EMBASE, PsycINFO, AMED), the EBSCO platform (e.g., ERIC, CINAHL), Scopus, and Web of Science.

Conclusion
Researchers can select relevant terms for their CAIM study and insert the keywords/phrases into these databases to receive all accessible data. This search technique can simply be copied and pasted into the search bar of each database to identify research by keywords, which is the most inclusive, or by words in the article title, which is more selective. Given its versatility across multiple commonly used academic platforms/databases, it is expected that this search string will be of great value to those conducting research on CAIM topics involving systematic search strategies.
“Taking care of your pregnancy”: a mixed-methods study of group antenatal care in Kakamega County, Kenya
Authors: Somji Aleefia , Ramsey Kate , Dryer Sean , Makokha Fredrick , Ambasa Constance , Aryeh Brittany , Booth Kathleen , Xueref Serge , Moore Seneca , Mwenesi Ralpher , Rashid Shafia 
Published: July 2022

Abstract
Background
Traditional antenatal care (ANC) models often do not meet women’s needs for information, counseling, and support, resulting in gaps in quality and coverage. Group ANC (GANC) provides an alternative, person-centered approach where pregnant women of similar gestational age meet with the same health provider for facilitated discussion. Few studies show associations between GANC and various outcomes.

Methods
We employed a pre-post quasi-experimental design using mixed methods to assess a GANC model (Lea Mimba Pregnancy Clubs) at six health facilities in Kakamega County, Kenya. Between April 2018 and January 2019, we tracked 1652 women assigned to 162 GANC cohorts. Using an intention-to-treat approach, we conducted baseline (N = 112) and endline surveys (N = 360) with women attending immunization visits to assess outcomes including experience of care, empowerment and self-efficacy, knowledge of healthy practices and danger signs, and practice of healthy behaviors, including ANC retention. At endline, we conducted 29 in-depth interviews (IDIs) and three focus group discussions with women who were currently and previously participating in GANC, and 15 IDIs with stakeholders.

Results
The proportion of survey respondents with knowledge of three or more danger signs during pregnancy more than tripled, from 7.1% at baseline to 26.4% at endline (OR: 4.58; 95% CI: 2.26–10.61). We also found improvements in women’s reports about their experience of care between baseline and endline, particularly in their assessment of knowledge and competence of health workers (OR: 2.52 95% CI: 1.57–4.02), respect shown by ANC providers (OR: 1.82, 95% CI: 1.16–2.85), and women’s satisfaction with overall quality of care (OR: 1.62, 95% CI: 1.03–2.53). We saw an increase from 58.9% at baseline to 71.7% at endline of women who strongly agreed that they shared their feelings and experiences with other women (OR: 1.73, 95% CI: 1.1–2.7). The mean number of ANC visits increased by 0.89 visits (95% CI: 0.47–1.42) between baseline (4.21) and endline (5.08). No changes were seen in knowledge of positive behaviors, empowerment, self-efficacy, and several aspects related to women’s experience of care and adoption of healthy behavior constructs. Qualitatively, women and stakeholders noted improved interactions between health providers and women, improved counseling, increased feelings of empowerment to ask questions and speak freely and strengthened social networks and enhanced social cohesion among women.

Conclusions
GANC offers promise for enhancing women’s experience of care by providing improved counseling and social support. Additional research is needed to develop and test measures for empowerment, self-efficacy, and experience of care, and to understand the pathways whereby GANC effects changes in specific outcomes.
Navigating the healthcare system in Nairobi City County: perspectives and experiences in the utilization of oral healthcare by caregivers of children with HIV/AIDS
Authors: Masiga Mary Atieno , Wandibba Simiyu 
Published: July 2022

Abstract
Background
The healthcare system in any republic can cause inequalities in health outcomes if they do not take into account the needs of deprived populations. Children with HIV/AIDS are known to have a high vulnerability to oral diseases; yet, they continue to face limitations in the utilization of oral healthcare. While other determinants of healthcare utilization may co-exist, possible gaps in the oral healthcare system can collectively affect a vulnerable group disproportionately in the utilization of oral healthcare.

Objective
To explore qualitatively, the perspectives, experiences and attributions of a cohort of caregivers of children with HIV/AIDS and their Health Care Providers (HCPs), on the utilization of oral healthcare within the structure of the oral healthcare system in Nairobi City County (NCC).

Design
A cross-sectional explorative mixed methods study design of two hundred and twenty one (221) female caregivers of children with HIV/AIDS and their HCPs using a survey, Focus Group Discussions (FGDs) and In-depth Interviews (IDIs). The study setting was the HIV-Care Facilities (HIV-CCFs) at three large hospitals in NCC.

Results
Caregivers mainly utilized independent ‘nearby’ private dental clinics for oral healthcare services, attributing their selection to cheaper user-fees, proximal service location, and recommendations from social networks. Wait time, opening and closing hours, health workers’ attitudes and inferred opportunity costs were perceived as important quality issues in the utilization of oral healthcare.

Conclusion
The oral healthcare system in NCC does not support the utilization of oral healthcare within the context of providing comprehensive healthcare for children with HIV/AIDS. Absence of ‘in-house’ oral health services at the HIV- CCFs is viewed as a defining structural barrier.
Oceanospirillales containing the DMSP lyase DddD are key utilisers of carbon from DMSP in coastal seawater
Authors: Liu Jingli , Xue Chun-Xu , Wang Jinyan , Crombie Andrew T. , Carrión Ornella , Johnston Andrew W. B. , Murrell J. Colin , Liu Ji , Zheng Yanfen , Zhang Xiao-Hua , Todd Jonathan D. 
Published: July 2022

AbstractBackgroundUbiquitous and diverse marine microorganisms utilise the abundant organosulfur molecule dimethylsulfoniopropionate (DMSP), the main precursor of the climate-active gas dimethylsulfide (DMS), as a source of carbon, sulfur and/or signalling molecules. However, it is currently difficult to discern which microbes actively catabolise DMSP in the environment, why they do so and the pathways used.ResultsHere, a novel DNA-stable isotope probing (SIP) approach, where only the propionate and not the DMS moiety of DMSP was13C-labelled, was strategically applied to identify key microorganisms actively using DMSP and also likely DMS as a carbon source, and their catabolic enzymes, in North Sea water. Metagenomic analysis of natural seawater suggested thatRhodobacterales(Roseobactergroup) and SAR11 bacteria were the major microorganisms degrading DMSP via demethylation and, to a lesser extent, DddP-driven DMSP lysis pathways. However, neitherRhodobacteralesand SAR11 bacteria nor their DMSP catabolic genes were prominently labelled in DNA-SIP experiments, suggesting they use DMSP as a sulfur source and/or in signalling pathways, and not primarily for carbon requirements. Instead, DNA-SIP identified gammaproteobacterialOceanospirillales, e.g.Amphritea, and their DMSP lyase DddD as the dominant microorganisms/enzymes using DMSP as a carbon source. Supporting this, most gammaproteobacterial (with DddD) but few alphaproteobacterial seawater isolates grew on DMSP as sole carbon source and produced DMS. Furthermore, our DNA-SIP strategy also identifiedMethylophagaand otherPiscirickettsiaceaeas key bacteria likely using the DMS, generated from DMSP lysis, as a carbon source.ConclusionsThis is the first study to use DNA-SIP with13C-labelled DMSP and, in a novel way, it identifies the dominant microbes utilising DMSP and DMS as carbon sources. It highlights that whilst metagenomic analyses of marine environments can predict microorganisms/genes that degrade DMSP and DMS based on their abundance, it cannot disentangle those using these important organosulfur compounds for their carbon requirements. Note, the most abundant DMSP degraders, e.g.Rhodobacteraleswith DmdA, are not always the key microorganisms using DMSP for carbon and releasing DMS, which in this coastal system wereOceanospirillalescontaining DddD.